The association between APOE epsilon 4, age and outcome after head injury: A prospective cohort study

G. M. Teasdale, G. D. Murray, J. A R Nicoll*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


Previous preliminary studies have suggested that possession of the APOE epsilon 4 allele is associated with a poor outcome after head injury. This study was designed to confirm and extend those observations in a larger study with examination of additional variables. We prospectively identified admissions to a Neurosurgical Unit for head injury, collected demographic and clinical data, determined APOE genotypes and obtained follow-up information at 6 months. A total of 1094 subjects were enrolled (age range: 0-93 years, mean 37 years). Outcome was assessed using the Glasgow Outcome Scale. There was no overall association between APOE genotype and outcome, with 36% of APOE epsilon 4 carriers having an unfavourable outcome compared with 33% of non-carriers of APOE epsilon 4. However, there was evidence of an interaction between age and APOE genotype on outcome (P = 0.007) such that possession of APOE epsilon 4 reduced the prospect of a favourable outcome in children and young adults. The influence of APOE genotype in younger patients after head injury can be expressed as, at age <15 years, carriage of APOE epsilon 4 being equivalent to ageing by 25 years. This finding is consistent with experimental data suggesting that the effect of APOE genotype on outcome after head injury may be expressed through the processes of repair and recovery.

Original languageEnglish
Pages (from-to)2556-2561
Number of pages6
Issue number11
Publication statusPublished - 1 Nov 2005


  • Apolipoprotein E
  • Genetics
  • Head injury
  • Outcome
  • Traumatic brain injury


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