Clinical features of dementia associated with apolipoprotein epsilon4: discrimination with a neural network genetic...

It is unclear whether the APOE epsilon4 allele is associated with distinct clinical features in dementia.

100 cases meeting ICD criteria for dementia were interviewed using standardized instruments and genotyped for APOE. The presence of the epsilon4 allele was used by a genetic algorithm neural network (GANN) to discriminate symptoms and signs.

The GANN selected six features: gender, systolic blood pressure, absence of ankle tendon reflexes, history of weight loss, history of falls, and interviewer observed lability of mood. Using these features, a neural network discriminated cases according to epsilon4 highly accurately (area under receiver operating characteristic=0.83, sensitivity=0.78, specificity=0.78).

A GANN is able to discriminate a clinically distinct group of features among dementia patients who express the epsilon4 allele.