The Relation between C -reactive Protein, Alpha 1-antichymotrypsin and APOE4 Gene, and Cognitive Functions in Elderly

Abstract

Dementia is a syndrome defined by progressive decline in multiple areas of cognitive functioning sufficient to interfere with social and occupational functioning. Alzheimer's disease (AD) is the most common cause of the dementia syndrome in later life and has reached epidemic proportion with the explosive growth of the number of the elderly. Patients with MCI are at higher risk for developing Alzheimer disease (AD) with an estimated conversion rate of 10 to 15% per year. Inflammatory mechanisms are associated with AD and they could have a role in contributing to the pathogenesis of this disease. The evidence is based on histopathological brain studies, laboratory studies of peripheral inflammation and the fact that certain anti-inflammatory drugs could modify the course of AD. APOE4 allele is the most common susceptibility gene for AD. It influences the course of disease by increasing the risk for developing AD and lowering the age at disease onset. The objective of this study was to assess the relation between inflammatory markers [C-reactive protein (CRP),alpha 1-antichymotrypsin], APOE4 gene and cognitive functions among elderly patients with AD and MCI compared to elderly with normal cognitive function. In this case control study 88 elderly subjects were recruited from the inpatients wards and outpatients clinics of Ain Shams University Hospitals. They were subdivided into 3 groups: - Group A: thirty two elderly patients with AD. - Group B: thirty two elderly patients with MCI. - Group C (controls): twenty four cognitively normal elderly participants. Diagnosis of probable AD was done according to NINCDS-ADRDA criteria (National Institute of Neurological and Communicable Disease and Stroke/AD and Related Disorders Association criteria). While diagnosis of mild cognitive impairment (MCI), adapted from published criteria (Petersen et al. 2004). • All the participants were subjected to: a) Comprehensive geriatric assessment including Assessments. b) Cognitive assessment using mini mental state examination (MMSE)and Montreal Cognitive Assessment (MOCA) c) Laboratory investigations to measure CRP and alpha 1-antichymotrypsin levels and APOE4 gene. d) CT brain for patients with cognitive impairment (AD or MCI) to exclude vascular causes.