Down's syndrome (DS) patients develop the characteristic features of Alzheimer's disease (AD) by their fourth decade, some of them exhibiting an AD-type dementia. We studied the apolipoprotein E (APOE) allele distribution in a population of 41 DS patients comprising 19.5% of demented, compared to 35 control subjects. No statistical difference was observed, but the epsilon2 allele may delay the age of dementia. As described in other studies, the impact of the different APOE alleles in DS is modest. However the compilation of all published studies on AD-type dementia in DS suggests that the epsilon2 allele has a protective effect. In delaying the age of onset, the epsilon2 allele would have a similar action in AD-type dementia in DS and in AD families with amyloid precursor protein (APP) mutations.