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Norberg, J.; Graff, Caroline; Almkvist, O.; Ewers, M.; Frisoni, G. B.; Frölich, Lutz; Hampel, H.; Jones, R. W.; Kehoe, P. G.; Lenoir, H.; Minthon, L.; Nobili, F.; Rikkert, M. Olde; Rigaud, A. -S.; Scheltens, P.; Soininen, H.; Spiru, L.; Tsolaki, M.; Wahlund, Lars-Olof; Vellas, B.; Wilcock, G.; Elias-Sonnenschein, L. S.; Verhey, F. R. J.; Visser, P. J. (2011): Regional Differences in Effects of APOE epsilon 4 on Cognitive Impairment in Non-Demented Subjects. In: Dementia and Geriatric Cognitive Disorders, No. 2: pp. 135-142


Background: The APOE epsilon 4 allele is a risk factor for Alzheimer's disease (AD). APOE epsilon 4 is common in non-demented subjects with cognitive impairment. In both healthy people and people with AD, its prevalence has a north-south gradient across Europe. In the present study, we investigated whether the relation between the APOE epsilon 4 allele and cognitive impairment varied across Northern, Middle and Southern Europe. We also investigated whether a north-south gradient existed in subjects with subjective cognitive impairment (SCI), amnestic mild cognitive impairment (MCI) and non-amnestic MCI. Methods: Data from 16 centers across Europe were analyzed. Results: A north-south gradient in APOE epsilon 4 prevalence existed in the total sample (62.7% for APOE epsilon 4 carriers in the northern region, 42.1% in the middle region, and 31.5% in the southern region) and in subjects with SCI and amnestic MCI separately. Only in Middle Europe was the APOE epsilon 4 allele significantly associated with poor performance on tests of delayed recall and learning, as well as with the amnestic subtype of MCI. Conclusion: The APOE epsilon 4 allele frequencies in subjects with SCI and amnestic MCI have a north-south gradient. The relation between the APOE epsilon 4 allele and cognition is region dependent. Copyright (C) 2011 S. Karger AG, Basel