Document Detail

The association between delirium and the apolipoprotein E epsilon4 allele in the elderly.
MedLine Citation:
PMID:  17728664     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: As not all patients with similar risk factors and eliciting conditions develop delirium; it may be hypothesized that genetic variation may play a role in the risk of delirium. On the basis of the relationship between dementia, respectively reduced cholinergic activity, and the APOE epsilon4-allele, and the similarities between dementia and delirium in reduced cholinergic activity, the APOE epsilon4-allele is a rational candidate-gene for delirium. This study examined the association between APOE epsilon4-allele and delirium in elderly patients. METHODS: Acutely admitted patients to the Department of Medicine of 65 years and over were included during a 27-month time period. Delirium was scored by the confusion assessment method. Cognitive impairment was diagnosed by Mini Mental State Examination and informant questionnaire on cognitive decline. Genotyping was done with matrix-assisted laser-desorption/ionization time-of flight mass spectrometry. RESULTS: Of 415 included patients, a random sample of 264 patients was genotyped for APOE. The patients who met the criteria for delirium (35%) were significantly older and more frequently had preexisting functional and cognitive impairment. APOE genotype was borderline significantly associated with cognitive impairment in patients below 75 years (P=0.057). The odds ratio for carriers of an APOE epsilon4-allele compared with patients without an APOE epsilon4-allele for developing delirium was 1.17 (95% confidence interval (CI): 0.49-2.78) in the cognitively intact patients and 0.42 (95% CI: 0.14-1.30) in the cognitively impaired patients. No relation existed between the total number of APOE epsilon4-alleles and the different delirium subtypes (P=0.12). CONCLUSIONS: We found no convincing evidence that carriers of the APOE epsilon4-allele have a higher risk of delirium.
Barbara C van Munster; Johanna C Korevaar; Sophia E de Rooij; Marcel Levi; Aeilko H Zwinderman
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Psychiatric genetics     Volume:  17     ISSN:  0955-8829     ISO Abbreviation:  Psychiatr. Genet.     Publication Date:  2007 Oct 
Date Detail:
Created Date:  2007-08-30     Completed Date:  2007-11-20     Revised Date:  2008-11-21    
Medline Journal Info:
Nlm Unique ID:  9106748     Medline TA:  Psychiatr Genet     Country:  England    
Other Details:
Languages:  eng     Pagination:  261-6     Citation Subset:  IM    
Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Academic Medical Center, University of Amsterdam, 1100 DD Amsterdam, The Netherlands.
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MeSH Terms
Aged, 80 and over
Apolipoprotein E4 / genetics*
Apolipoproteins E / genetics
Cognition Disorders / genetics
Delirium / genetics*,  psychology
Genetic Variation
Reg. No./Substance:
0/Apolipoprotein E4; 0/Apolipoproteins E

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