Apolipoprotein E Alleles and Motor Signs in Older Adults with Alzheimer’s Dementia

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We investigated associations between apolipoprotein E (APOE) alleles and motor mani-festations in Alzheimer’s dementia (AD) capitalizing on NACC data. The baseline evaluations of older adults (≥60years) with a diagnosis of AD were analysed. Those with a concomitant diagnosis Parkinson’s disease or other parkinsonian syndrome, and those treated with anti-parkinsonian agents were excluded. Three APOE groups were formed: APOE2 (APOE2 carriers), APOE3 (APOE3/APOE3) and APOE4 (AP-OE4/APOE4, APOE4/APOE3). UPDRS III was used to assess the presence or absence of motor signs in 9 domains. Adjusted binary logistic models featuring three APOE groups as exposures and motor domains as outcomes were estimated. Of 4979 included individuals, 389 were in the APOE2, 1799 in the APOE3 and 2791 in the APOE4 groups. Compared to the APOE2 group, individuals in the APOE4 group had 36% (18-50%) lower odds of having at least one motor sign; 47% (19-66%) lower odds of rigidity, 44% (23-60%) lower odds of bradykinesia, 44% (22-63%) lower odds of impaired chair rise and 44% (19-64%) lower odds of impaired posture-gait. Exploratory analyses using APOE genotypes suggested dose-response relationships for both APOE2 and APOE4. In conclusion, APOE2 confers a risk towards motor (mainly parkinsonian) signs in AD. APOE4 may have a protective effect.

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