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Submitted on October 21, 2004
From Rush AD Center and Rush Institute for Healthy Aging (D.A.B., R.S.W., D.A.E., J.A.S., J.L.B.), Department of Psychology (R.S.W.), Department of Neurological Sciences (D.A.B., R.S.W., D.A.E., J.A.S.), Department of Pathology (J.A.S.), Department of Internal Medicine (D.A.E., J.L.B.), Rush University Medical Center, Chicago, Ill. * To whom correspondence should be addressed. E-mail: Julie_A_Schneider{at}rush.edu.
Background and Purpose--Studies investigating the relation of the apolipoprotein E (apoE) Methods--We studied the apoE Results--Subjects included 96 males and 118 females with a mean age at death of 86 years (SD, 7). Sixty-five subjects (30.4%) had at least 1 apoE Conclusions--apoE
Revised on January 10, 2005
Accepted on January 19, 2005
The Apolipoprotein E
J. A. Schneider MD*;
4 Allele Increases the Odds of Chronic Cerebral Infection Detected at Autopsy in Older Persons
4 allele to clinical stroke and to vascular changes on magnetic resonance imaging have been conflicting. Little data are available regarding the relation of apoE
4 to cerebral infarctions documented on postmortem examination.
4 allele in 214 deceased members of the Religious Orders Study, a longitudinal clinical-pathologic study of aging and Alzheimer disease. The apoE genotype was determined using DNA from lymphocytes. Brains were removed a median of 5 hours (interquartile range, 5.5) after death. At postmortem examination, age, location, and size of macroscopic chronic cerebral infarctions were recorded from 1-cm coronal slabs after paraformaldehyde fixation. We also examined 20-µm paraffin-embedded sections of midfrontal and calcarine cortex for amyloid angiopathy on a scale of 1 to 4.
4 allele and 76 (35.5%) exhibited cerebral infarctions. More than 74% of the subjects exhibited amyloid angiopathy with a mean score of 1.4±1.2. After controlling for age and sex, apoE
4 increased the odds of cerebral infarction by 2.3-fold (95% CI, 1.2 to 4.2). apoE
4 increased the odds of cortical 3.2-fold (95% CI, 1.3 to 7.7) and subcortical infarctions 2.3-fold (95% CI, 1.2 to 4.5). The effect was unchanged after accounting for amyloid angiopathy.
4 increases the odds of chronic cerebral infarction detected at autopsy in older persons.
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