Introduction     Diagnosis of Mild Cognitive Impairment and Alzheimer's Disease Karen L. Bell, M.D.     Treatment Strategies for Dementia and Mild Cognitive Impairment Mary Sano, Ph.D.     Treatment of Depression, Agitation, and Psychosis in Dementia Davangere P. Devanand, M.D.     Recognition of Vascular Dementia, Dementia with Lewy Bodies, and Frontotemporal Dementia Lawrence S. Honig, M.D., Ph.D.     Neuropsychology of Mild Cognitive Impairment, Alzheimer's Disease, Dementia with Lewy Bodies, and Frontotemporal Dementia Penne Sims, Ph.D.     Neuroimaging in Dementia Scott A. Small, M.D.     Genetics of Neurodegenerative Disease: Alzheimer's Disease, Frontotemporal Dementia Jennifer Williamson-Catania, M.S.     Family Patterns in Alzheimer's Disease       Genetics of Early-Onset AD       Genetics of Late-Onset AD       Genetic Testing for AD       Genetic Testing for FTD       Why Offer Testing?       Legal and Ethical Issues for Patients with Dementia Daniel G. Fish, Esq.     Posttest         Accreditation     Reference List     Acknowledgements		Genetics of Neurodegenerative Disease: Alzheimer's Disease, Frontotemporal Dementia Jennifer Williamson-Catania, M.S. Genetics of Late-Onset AD   We do not know much about the genetics of late-onset Alzheimer's disease, but we do know that the apolipoprotein E gene is a susceptibility factor and is the most commonly known genetic determinate of susceptibility to AD. The APOE gene, which is involved in cholesterol storage, transport, and metabolism, has three different forms, APOE 2, 3 and 4. The APOE-4 form of the gene is the susceptibility factor, such that an individual with an E4 allele is at a higher risk of developing the disease. We see these genes in both familial and sporadic Alzheimer's disease. There are several studies that say that genetic testing for this gene is not useful.   The kind of family that is participating in a research study is probably not the type of family that you would see if you are evaluating a patient with dementia. These are the people that come to research studies because they know that something is different about their family. However, they offer an opportunity to look at a very strong history of late-onset Alzheimer's disease. In one family, with seven siblings, five of the seven had Alzheimer's disease and one person fit the criteria for mild cognitive impairment. This is an E4 family, and everyone in the proband's generation (the proband is person 99) had two copies of the E4 gene. Their mother was also reported to have dementia, and her father and two of her sisters had Alzheimer's disease.   Everyone in the next generation will have at least one copy of the E4 gene. Since this was a research study, we did not reveal the genotyping results to the family, and they may have had genetic factors other than E4 involved.         Familial Late-Onset Alzheimer's Disease   Profile of a family in which late-onset Alzheimer's disease was prevalent. Courtesy of Jennifer Williamson-Catania, M.S.     We are currently conducting a research study looking specifically at AD in Caribbean Hispanic families, and one of these is a non-E4 late-onset family. Individuals in this family have a genotype of either APOE2/E3 or APOE3/E3. This is a very interesting family for us in terms of looking for new genes associated with Alzheimer's disease, and it is useful to be able to evaluate two generations in a study before the first generation passes away.         Caribbean Hispanic Familial Late-Onset Alzheimer's Disease   Profile of the history of Alzheimer's disease in a Caribbean Hispanic family; individuals have a genotype of either APOE2/E3 or APOE3/E3. Courtesy of Jennifer Williamson-Catania, M.S.       PREVIOUS | NEXT