Is Apolipoprotein E4 an Important Risk Factor for Dementia in Persons with Down

Down syndrome is one of the most common genetic causes of intellectual disability and is characterized by a number of behavioral as well as cognitive symptoms. Triplication of all or part of human chromosome 21 has been considered as the main cause of Down syndrome. Due to the location of the amyloid precursor protein on chromosome 21, many of the neuropathological features of early-onset Alzheimer’s disease including senile plaques and neurofibrillary tangles are also present in Down syndrome patients who are either demented or nondemented. Significant advances in medical treatment have increased longevity in people with Down syndrome resulting in an increased population that may be subjected to many of the same risk factors as those with Alzheimer’s disease. It is well established that harboring one or both apolipoprotein E4 alleles greatly increases the risk for Alzheimer’s disease. However, whether apolipoprotein E4 contributes to an earlier onset of dementia or increased mortality in Down syndrome patients is still a matter of debate. The purpose of this mini review is to provide an updated assessment on apolipoprotein E4 status and risk potential of developing dementia and mortality associated with Down syndrome. attention deficit hyperactivity, aggressive behavior, depression and aggression [9]. Dementia and Alzheimer’s disease in DS The increased risk of Alzheimer’s disease (AD) in patients with DS is well known. In DS, AD dementia is assumed to be caused by the over-expression of the amyloid precursor protein (APP) gene following triplication of chromosome 21, leading to the accumulation of beta-amyloid [10]. AD is a progressive neurodegenerative disorder characterized by an array of symptoms affecting memory and cognition. Some common symptoms of AD include memory loss that disrupts daily life, challenges in planning or solving problems, confusion with time or place, and changes in mood and personality [11]. Collectively