APOE genotype: No influence on galantamine treatment efficacy nor on rate of decline in Alzheimer's Disease.

Apolipoprotein E (APOE) has been extensively demonstrated to be a genetic risk factor for Alzheimer's disease (AD). Associations of APOE genotype have been reported with age at AD onset, rate of decline, and responsiveness to therapy. This study aimed to test these hypotheses in a large study population of AD patients. APOE genotype was determined from 1,528 Caucasian Ss. In addition to patient demographics and baseline scores for Mini Mental State Examination, scores on the Disability Assessment for Dementia (DAD) and the cognitive subscale of the Alzheimer's Disease Assessment Scale (ADAS-cog) were recorded. APOE ε4 homozygotes had a significantly lower age at disease onset compared to patients with other APOE genotypes. Based on longitudinal data of 504 placebo-treated AD patients, the linear annual rate of change in score was 5 points on the ADAS-cog scale and 11 on the DAD scale. Galantamine produced cognitive and functional improvement that were not affected by ε4 allele count. In conclusion, the data confirm a strong association between 4 homozygotes and age at onset of AD but do not support an effect of ε4 allele copy number on rate of cognitive and functional decline nor on the efficacy of galantamine in patients with AD. (PsycInfo Database Record (c) 2023 APA, all rights reserved)