Sains Malaysiana 42(3)(2013): 409–416

Apolipoprotein E Genotypes and Behavioural and Psychological Symptoms of Dementia (BPSD) in Malaysian Patients with Dementia

(Genotip Apolipoprotein E dan Gejala Tingkah Laku dan Psikologi Demensia (BPSD)

dalam Kalangan Pesakit Demensia di Malaysia)

Rosdinom Razali¹, Zanariah Mat Saher², Elinda Tunan^3,*, Wan Zurinah Wan Ngah⁴, Then Sue Mian⁴, Suriati Mohamed Saini¹, Abdul Hamid Abdul Rahman¹ & Shamsul Azhar Shah⁵

¹Department of Psychiatry, Universiti Kebangsaan Malaysia Medical Centre

Jalan Yaakob Latiff, Bandar Tun Razak, 56000 Cheras, Kuala Lumpur, Malaysia

²Department of Psychiatry and Mental Health, Hospital Kuala Lumpur, Aras 1, Bangunan Utama, Jalan Pahang, 50586 Kuala Lumpur, Malaysia

³Department of Psychiatry, Hospital Serdang, Jalan Puchong, 43000 Kajang, Selangor Darul Ehsan

Malaysia

⁴UKM Medical Molecular Biology Institute (UMBI), Aras 7, Blok Klinikal, Hospital UKM

56000 Cheras, Kuala Lumpur, Malaysia

⁵Department of Social Preventive Medicine, Universiti Kebangsaan Malaysia Medical Centre

Jalan Yaakob Latiff, Bandar Tun Razak, 56000 Cheras, Kuala Lumpur, Malaysia

Diserahkan: 18 Mei 2012/Diterima: 3 Ogos 2012

ABSTRACT

The aim of this study was to determine the relationships between ApoE genotypes and ‘behavioural and psychological symptoms of dementia’ (BPSD). A cross-sectional study was conducted on 46 outpatients with dementia (aged 60 and above) and their caregivers attending the psychogeriatric clinics at Universiti Kebangsaan Malaysia Medical Centre (UKMMC) and Hospital Kuala Lumpur. Neuropsychiatric Inventory (NPI) was used for the assessment of BPSD. The patients’ blood samples were taken for Apolipoprotein genotyping after consented by the caregivers. There were more female (69.6%) and Chinese (50%) patients with a mean age of 73.7 years. ApoE ε3/ε3 was the most common ApoE allele (60.7%) and mostly found in Chinese patients. ApoE genotype was significantly associated with ethnicity (p=0.03) and marital status (p=0.01). Alzheimer disease was the most common subtype of dementia (41.3%) and the highest carrier of ApoE ε3/ε3 (30.4%). The ApoE ε4/ ε4 scored highest in BPSD median score 44 (17.5 to 90) but the relationships between ApoE genotypes and subtypes of dementia or BPSD scores were not significant (p=0.20; p=0.64). Agitation was the most common symptom, with delusions showing the highest scores on the NPI with no significant association to ApoE 4 allele. In conclusion, there was no significant relationship between ApoE genotypes and severity or types of BPSD in dementia patients.

Keywords: Apolipoprotein E; dementia

ABSTRAK

Tujuan kajian ini adalah untuk menentukan kaitan antara jenis gen Apolipoprotein (Apo) E dan gejala tingkah laku dan psikologi demensia (BPSD). Satu kajian menggunakan kaedah hirisan lintang telah dikendalikan dalam kalangan sekumpulan 46 pesakit luar yang berumur 60 tahun ke atas bersama dengan penjaga masing-masing di klinik psikogeriatrik di Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM) dan Hospital Kuala Lumpur. ‘BPSD’ pesakit telah dinilai dengan menggunakan  inventori neuropsikiatri (NPI). Sampel darah pesakit diambil untuk menentukan genotip Apolipoprotin E setelah kebenaran diberi oleh penjaga pesakit. Terdapat lebih ramai pesakit perempuan (69.6%) dan berketurunan Cina (50%) dengan min umur 73.7 tahun. ApoE ε3/ε3 merupakan alel ApoE yang terbanyak (60.7%) dan banyak terdapat dalam kalangan pesakit berketurunan Cina. Genotip ApoE berkait rapat secara signifikan dengan bangsa (p=0.03) dan status perkahwinan (p=0.01). Penyakit Alzheimer merupakan jenis demensia yang terbanyak (41.3%) dan pembawa ApoE ε3/ε3 (30.4%) yang tertinggi. ApoE ε4/ ε4 menunjukkan skor median BPSD yang tertinggi iaitu 44 (17.5-90) tetapi tiada kaitan rapat secara signifikan antara genotip ApoE dan jenis-jenis demensia atau skor BPSD (p=0.20; p=0.64). Agitasi merupakan gejala yang paling kerap berlaku dan delusi menunjukkan skor NPI yang tertinggi, tetapi keduanya tiada kaitan rapat yang signifikan dengan alel ApoE. Kesimpulannya, tiada hubungan yang signifikan antara genotaip ApoE dengan keterukan atau jenis BPSD dalam kalangan pesakit demensia di Malaysia.

Kata kunci: Apolipoprotein E; demensia

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*Pengarang untuk surat-menyurat; email: elindazann@yahoo.com.my