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Updated: Jul 23, 2026

A High Throughput, Multiplexed and Targeted Proteomic CSF Assay to Quantify Neurodegenerative Biomarkers and Apolipoprotein E Isoforms Status
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Apolipoprotein E phenotypes, dementia and mortality in a prospective population sample

R S Tilvis1, T E Strandberg, K Juva

  • 1University of Helsinki, Finland.

Journal of the American Geriatrics Society
|June 13, 1998
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Summary

The presence of the apolipoprotein E e4 allele is linked to worse cognitive function, dementia, and increased mortality in older adults. This genetic factor is associated with higher risks of Alzheimer's disease and all-cause death over five years.

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Area of Science:

  • Neuroscience
  • Genetics
  • Epidemiology

Background:

  • Apolipoprotein E (ApoE) phenotypes are crucial in lipid metabolism and have been implicated in neurodegenerative diseases.
  • The e4 allele of ApoE is a known genetic risk factor for Alzheimer's disease (AD).
  • Understanding the impact of ApoE phenotypes on cognitive decline and mortality in aging populations is essential for public health.

Purpose of the Study:

  • To investigate the association between apolipoprotein E (ApoE) phenotypes, cognitive function, dementia incidence, and mortality.
  • To determine the specific risks conferred by the ApoE e4 allele in an elderly Finnish population.

Main Methods:

  • A prospective population-based cohort study (Helsinki Ageing Study) involving 550 participants aged 75-85.
  • ApoE genotyping was performed on baseline blood samples.
  • Cognitive function was assessed using the Mini-Mental State Examination (MMSE) and Clinical Dementia Rating (CDR) at baseline and 5-year follow-up.
  • Dementia diagnosis and causes of death were determined by neurologists and medical records.
  • Survival analyses were conducted using Cox proportional hazards models.

Main Results:

  • The ApoE e4 allele was present in 27% of participants and was more frequent in individuals with Alzheimer's disease (51%) and vascular dementia (34%).
  • Subjects with the e4 allele exhibited significantly worse CDR scores at baseline and after 5 years.
  • The presence of the e4 allele was associated with a 61% increased risk of all-cause mortality (HR=1.61), a 2.2-fold increased risk of death from dementia, and a 3.2-fold increased risk of developing AD.

Conclusions:

  • In individuals aged 75-85, the ApoE e4 allele is significantly associated with impaired cognitive function and a higher incidence of dementia, including Alzheimer's disease.
  • Carrying the ApoE e4 allele increases the risk of mortality from both dementia and all causes over a 5-year period.
  • These findings highlight the substantial impact of the ApoE e4 genotype on cognitive health and survival in the elderly population.