Apolipoprotein E e4 allele influences aggressive behaviour in Alzheimer's disease
Apolipoprotein E e4 allele influences aggressive behaviour in Alzheimer's disease
复制标题
DOI：
10.1136/jnnp.2003.032276
复制
发表时间：
2004-09-01
影响因子：
11
通讯作者：
Passmore, AP
中科院分区：
文献类型：
--
作者：
Craig, D;Hart, DJ;Passmore, AP
患有认知障碍的人数不断增加，使医疗保健预算面临巨大压力。痴呆症相关的行为改变是进入昂贵的机构护理的一个主要独立风险因素，护理人员尤其难以容忍攻击性症状，并且经常导致家庭应对策略的崩溃。激进的变化可能是由已知的阿尔茨海默病 (AD) 遗传风险因素引起的，因此伴随着载脂蛋白 E (ApoE) 等传统标记物。我们在 400 名中度至重度受影响的 AD 患者中测试了这一假设，这些患者在访谈前一个月使用照顾者痛苦神经精神调查表进行了攻击性或激越行为的表型分析。访谈前一个月出现攻击性/躁动的受试者比例为 51.8%。在访谈前一个月记录攻击/激动的个体中，e4 等位基因的频率显着较高（chi(2) = 6.69，df = 2，p = 0.03）。当将 e4 基因型与非 e4 基因型进行比较时，还注意到 e4 带来的攻击性/激动的额外风险（chi(2) = 5.45，df = 1，p = 0.02，OR = 1.60，置信区间 (CI) 1.06 至 2.43）。这些结果表明，由于载脂蛋白 E 的遗传缺陷，晚期阿尔茨海默病患者出现侵袭性症状的风险更大。
The rising number of people with cognitive impairment is placing health care budgets under significant strain. Dementia related behavioural change is a major independent risk factor for admission to expensive institutional care, and aggressive symptoms in particular are poorly tolerated by carers and frequently precipitate the collapse of home coping strategies. Aggressive change may result from known genetic risk factors for Alzheimer's disease ( AD) and therefore accompany conventional markers such as apolipoprotein E ( ApoE). We tested this hypothesis in 400 moderately to severely affected AD patients who were phenotyped for the presence of aggressive or agitated behaviour during the month prior to interview using the Neuropsychiatric Inventory with Caregiver Distress. The proportion of subjects with aggression/agitation in the month prior to interview was 51.8%. A significantly higher frequency of the e4 allele was found in individuals recording aggression/agitation in the month prior to interview (chi(2) = 6.69, df = 2, p = 0.03). The additional risk for aggression/agitation conferred by e4 was also noted when e4 genotypes were compared against non-e4 genotypes (chi(2) = 5.45, df = 1, p = 0.02, OR= 1.60, confidence interval ( CI) 1.06 to 2.43). These results indicate that advanced Alzheimer's disease patients are at greater risk of aggressive symptoms because of a genetic weakness in apolipoprotein E.