Another study found a significant negative correlation between platelet large cell ratio (P-LCR) and Montreal Cognitive Assessment (MoCA) scores in patients with AD carrying the APOE ε4 allele, and the rate of change in P-LCR tended to increase with disease progression, which in general means that P-LCR is associated with an increased risk of AD and increases with disease progression in AD patients (Fu et al., 2024). This evidence concerns the gene APOE and Alzheimer disease.