TY - JOUR
T1 - Apolipoprotein ε4 status is associated with behavioral symptoms in nursing home residents with dementia
AU - Woods, Diana Lynn
AU - Bushnell, Brittany
AU - Kim, Haesook
AU - Geschwind, Daniel
AU - Cummings, Jeffrey
PY - 2009/8
Y1 - 2009/8
N2 - Background: While the relationship of apolipoprotein E (APOE) to behavioral symptoms of dementia (BSD) has been studied in community-dwelling persons with AD, it has received limited attention within the nursing home (NH) population. The aim of this study was to examine the association between APOE genotype and BSD in NH residents using direct observation. Methods: Thirty-six participants, aged 71-102 years, were compared using a non-randomized two-group design with continuous measures. APOE genotype was obtained by buccal swab. BSD, including restlessness, escape restraint, tapping and banging, searching and wandering, pacing and walking, and vocalization, were measured using the Modified Agitated Behavior Rating Scale. Participants were observed every 20 minutes for 12 hours per day for five days. Each participant's mean behavior scores were compared according to the presence or absence of the APOE ε4 allele. Results: Resident characteristics included a mean MMSE of 10.44 indicating moderate to severe dementia and a mean of 3.44 medical co-morbidities. Fifty-six percent of the participants had one ε4 allele. A significant difference was found between APOE ε4+/4- and mean behavioral scores (F1,31 = 4.40, p = 0.04). Restlessness was significantly inversely correlated with MMSE (r = -0.367, p = 0.03), but not APOE genotype. There was no significant correlation between proxy reporting and direct observation (r = 0.257, p = 0.13). Conclusion: Findings indicate that the presence of the APOE ε4+ genotype increases the risk for BSD in NH residents with dementia. Direct observation proved a more accurate estimate of BSD than proxy report.
AB - Background: While the relationship of apolipoprotein E (APOE) to behavioral symptoms of dementia (BSD) has been studied in community-dwelling persons with AD, it has received limited attention within the nursing home (NH) population. The aim of this study was to examine the association between APOE genotype and BSD in NH residents using direct observation. Methods: Thirty-six participants, aged 71-102 years, were compared using a non-randomized two-group design with continuous measures. APOE genotype was obtained by buccal swab. BSD, including restlessness, escape restraint, tapping and banging, searching and wandering, pacing and walking, and vocalization, were measured using the Modified Agitated Behavior Rating Scale. Participants were observed every 20 minutes for 12 hours per day for five days. Each participant's mean behavior scores were compared according to the presence or absence of the APOE ε4 allele. Results: Resident characteristics included a mean MMSE of 10.44 indicating moderate to severe dementia and a mean of 3.44 medical co-morbidities. Fifty-six percent of the participants had one ε4 allele. A significant difference was found between APOE ε4+/4- and mean behavioral scores (F1,31 = 4.40, p = 0.04). Restlessness was significantly inversely correlated with MMSE (r = -0.367, p = 0.03), but not APOE genotype. There was no significant correlation between proxy reporting and direct observation (r = 0.257, p = 0.13). Conclusion: Findings indicate that the presence of the APOE ε4+ genotype increases the risk for BSD in NH residents with dementia. Direct observation proved a more accurate estimate of BSD than proxy report.
KW - APOE ε4 allele
KW - Agitation
KW - Behavioral symptoms in dementia
KW - Long-term care
UR - http://www.scopus.com/inward/record.url?scp=69549088169&partnerID=8YFLogxK
U2 - 10.1017/S1041610209009235
DO - 10.1017/S1041610209009235
M3 - Article
C2 - 19470200
AN - SCOPUS:69549088169
SN - 1041-6102
VL - 21
SP - 722
EP - 728
JO - International Psychogeriatrics
JF - International Psychogeriatrics
IS - 4
ER -