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In the Japanese population, sporadic late-onset Alzheimer's disease (LOAD) cases had significantly higher frequencies of the A allele of alpha 1-antichymotrypsin (ACT) gene as well as the epsilon 4 allele of apolipoprotein E (APOE) gene than controls. The odds ratio for LOAD in APOE4 carriers with the ACT-A allele was more than six times that in APOE4 carriers without the ACT-A allele (21.1 vs 3.2). These results indicate that the ACT-A allele is a risk modifier for LOAD in APOE4 carriers.

Senile dementia of Alzheimer’s type (SDAT) is characterized by progressive deficits of multiple cognitive functions in elderly more than 65 years of age. The APOE-ε4 allele has been shown to be a risk factor for SDAT. To investigate the genetic interactions between SDAT and the APOE/APOC1/APOC2 gene cluster located at 19q13.2, we genotyped these genes in patients with SDAT and nondemented controls. Although allelic associations were found between the APOC1 locus and SDAT (p = 0.0022) as well as between the APOE locus and SDAT (p < 0.0001), no associations were detected between the APOC2 locus and SDAT. And the association between the APOE and APOC1 locus in SDAT was statistically more significant than that in controls (p < 0.001). Estimation of the haplotype frequencies indicated that the association between the APOE/APOC1 haplotype and SDAT was more significant than linkage disequilibrium between the APOE and APOC1 locus (p < 0.01). These results suggest that genetic interaction between the APOE and APOC1 gene could modify a risk factor of APOE-ε4 for SDAT. The APOE/APOC1 locus was estimated to be responsible for 54.8% of SDAT in the Japanese population.

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