APOE and cerebral amyloid angiopathy in the elderly

Over 30% of normal elderly people have cerebral amyloid angiopathy (CAA). Possession of APOE epsilon4 is associated with increased prevalence and severity of CAA in Alzheimer's disease (AD) and in cerebral haemorrhage. We examined CAA in relation to APOE genotype in brains from 152 people aged 60-102 years, without AD or cerebral haemorrhage. Prevalence of CAA increased with age (p = 0.003). CAA was not associated with APOE genotype. The frequency of epsilon4 showed a significant negative association with age (p = 0.016). Age at death was significantly lower in those with than without epsilon4 (p = 0.028). Possession of epsilon4 does not by itself confer an increased risk of CAA but may be associated with reduced longevity even in the absence of AD or cerebral haemorrhage.