ApoE E4 is a Susceptibility Factor in Amnestic But Not Aphasic Dementias

The goal of this study was to determine if the apolipoprotein epsilon gene, which is a well-established susceptibility factor for Alzheimer disease (AD) pathology in typical amnestic dementias, may also represent a risk factor in the language-based dementia, primary progressive aphasia (PPA). Apolipoprotein E genotyping was obtained from 149 patients with a clinical diagnosis of PPA, 330 cognitively healthy individuals (NC), and 179 patients with a clinical diagnosis of probable Alzheimer's disease (PrAD). Allele frequencies were compared among the groups. Analyses were also completed by sex and in 2 subsets of PPA patients: 1 in which the patients were classified by subtype (logopenic, agrammatic, and semantic) and another in which pathologic data were available. The allele frequencies for the PPA group (epsilon 2:5%, epsilon 3:79.5%, and epsilon 4:15.4%) showed a distribution similar to the NC group, but significantly different from the PrAD group. The presence of an e4 allele did not influence the age of symptom onset or aid in the prediction of AD pathology in PPA. These data show that e4 polymorphism, which is a well-known risk factor for AD pathology in typical amnestic dementias, has no similar relationship to the clinical syndrome of PPA or its association with AD pathology.