Regional Differences in Effects of APOE epsilon 4 on Cognitive Impairment in Non-Demented Subjects

Research output: Contribution to journalArticle


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


  • J. Norberg
  • C. Graff
  • O. Almkvist
  • M. Ewers
  • G. B. Frisoni
  • L. Froelich
  • H. Hampel
  • R. W. Jones
  • P. G. Kehoe
  • H. Lenoir
  • F. Nobili
  • M. Olde Rikkert
  • A. -S. Rigaud
  • P. Scheltens
  • H. Soininen
  • L. Spiru
  • M. Tsolaki
  • L. -O. Wahlund
  • B. Vellas
  • G. Wilcock
  • L. S. Elias-Sonnenschein
  • F. R. J. Verhey
  • P. J. Visser
Research areas and keywords

Subject classification (UKÄ) – MANDATORY

  • Neurology


  • Alzheimer's disease, APOE epsilon 4 allele, Europe, Gradient
Original languageEnglish
Pages (from-to)135-142
JournalDementia and Geriatric Cognitive Disorders
Issue number2
Publication statusPublished - 2011
Publication categoryResearch