Moreover, highly exposed APOE 4 carriers failed 2.4 ± 0.54 of the 10 UPSIT items identified in one study as being most strongly related to AD [88], while APOE 2/3 and 3/3 subjects failed only 1.36 ± 0.16 such items (P = 0.01). This evidence concerns the gene APOE and Alzheimer disease.