Smoking and risk of Alzheimer's disease

Will testing for apolipoprotein E assist in tailoring dementia risk reduction? A review

This paper aims to systematically review the influence of apolipoprotein E (ApoE) on the effects of potentially modifiable mid and late life risk factors for dementia. Scopus, Medline, PubMed, PsycINFO, and HuGE databases were searched up to November 2008. Two independent reviewers selected 94 articles from 13,122 results. Results suggest the deleterious effect of current smoking is limited only to persons without ApoE epsilon 4 (4 out of 4 studies), ApoE epsilon 4 increases the risk of dementia associated with greater fat consumption, particularly saturated fats (3 out of 4 studies), and increases the protective effect against dementia associated with HRT use (3 out of 5 with one of the non-significant studies suggesting a trend). There was evidence that ApoE does not modify the risk of dementia associated with measures of, and treatments for CVD, other dietary factors, and estradiol levels. There was inconsistent or contradictory evidence for other environmental factors reviewed. There is insufficient evidence for the recommendation of ApoE testing to assist with tailoring risk reduction recommendations for dementia.

Alzheimer's disease

This article reviews the clinical and neuropathological features of Alzheimer's disease, its known genetic and non-genetic risk factors, procedures used to make the diagnosis and rule out other reversible and non-reversible forms of dementia, and the treatment strategies used to help patients and their families cope with the problem. In addition, it considers how neuroimaging techniques promise to characterize the brain changes which precede the onset of cognitive impairment in persons at risk for Alzheimer's disease and identify treatments to prevent the onset of dementia.