Trends in rates and seasonal distribution of sudden infant deaths in England and Wales, 1988-92

Abstract

Differential survival between smokers and non-smokers with the e4 allele ofthe apolipoprotein E gene has been proposed to explain the inverse relation between history of cigarette smoking and Alzheimer's disease * This study shows that the inverse association between smoking history and early onset Alzheimer's disease cannot be explained by a shift in frequency ofthe apolipoprotein e4 allele * The inverse relation was significant only in subjects with a family history of dementia who carry the e4 allele * Our study suggests that clinical trials with nicotine or nicotine derivatives have the greatest chance of success in patients with familial Alzheimer's disease who carry the apolipoprotein e4 allele protected from Alzheimer's disease by continuing to smoke.The present study has no direct relevance, therefore, for the prevention of disease.Our findings may have implications, however, for the understand- ing of the pathogenesis and therapeutic strategies in Alzheimer's disease.Our study suggests that clinical trials with nicotine or nicotine derivatives have the greatest chance of success in patients with Alzheimer's disease who have a family history of dementia and carry the apolipoprotein e4 allele.