Molecular pathology selected abstracts
August 2024—Alzheimer disease is genetically intricate and involves rare and common genetic variants. Early-onset autosomal dominant Alzheimer disease (ADAD) is caused by mutations in the APP, PSEN1, and PSEN2 genes, while variants in numerous other genes contribute to the risk of developing late-onset Alzheimer disease, with APOE considered the most significant risk factor. APOE4 homozygotes face a lifetime risk of Alzheimer disease dementia of up to 60 percent by age 85, significantly higher than that of heterozygotes or noncarriers of the gene. The predictability of outcomes in APOE4 homozygotes has not been previously studied, limiting the application of statistical methods used in ADAD for APOE4 research. The predictable sequence of pathological, biomarker, and clinical changes in ADAD and Down syndrome has offered insights into Alzheimer disease pathophysiology.