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The association between delirium and the apolipoprotein E epsilon4 allele in the elderly.
Psychiatr Genet 2007; 17(5):261-6PG

Abstract

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.

Authors+Show Affiliations

Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Academic Medical Center, University of Amsterdam, 1100 DD Amsterdam, The Netherlands. b.c.vanmunster@amc.uva.nlNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

17728664

Citation

van Munster, Barbara C., et al. "The Association Between Delirium and the Apolipoprotein E Epsilon4 Allele in the Elderly." Psychiatric Genetics, vol. 17, no. 5, 2007, pp. 261-6.
van Munster BC, Korevaar JC, de Rooij SE, et al. The association between delirium and the apolipoprotein E epsilon4 allele in the elderly. Psychiatr Genet. 2007;17(5):261-6.
van Munster, B. C., Korevaar, J. C., de Rooij, S. E., Levi, M., & Zwinderman, A. H. (2007). The association between delirium and the apolipoprotein E epsilon4 allele in the elderly. Psychiatric Genetics, 17(5), pp. 261-6.
van Munster BC, et al. The Association Between Delirium and the Apolipoprotein E Epsilon4 Allele in the Elderly. Psychiatr Genet. 2007;17(5):261-6. PubMed PMID: 17728664.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The association between delirium and the apolipoprotein E epsilon4 allele in the elderly. AU - van Munster,Barbara C, AU - Korevaar,Johanna C, AU - de Rooij,Sophia E, AU - Levi,Marcel, AU - Zwinderman,Aeilko H, PY - 2007/8/31/pubmed PY - 2007/12/6/medline PY - 2007/8/31/entrez SP - 261 EP - 6 JF - Psychiatric genetics JO - Psychiatr. Genet. VL - 17 IS - 5 N2 - 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. SN - 0955-8829 UR - https://www.unboundmedicine.com/medline/citation/17728664/The_association_between_delirium_and_the_apolipoprotein_E_epsilon4_allele_in_the_elderly_ L2 - http://Insights.ovid.com/pubmed?pmid=17728664 DB - PRIME DP - Unbound Medicine ER -