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The serotonin receptor gene (5-HT2A) has been reported to be a susceptible factor in behavioral and psychological symptoms of dementia (BPSD) in Alzheimer's disease (AD). However, previous results were conflicting. We aim to investigate the association of 5-HT2A T102C with BPSD in AD using a meta-analysis. Studies were collected using PubMed, Web of Science, the Cochrane Library databases, Chinese National Knowledge Infrastructure (CNKI), and Embase. Pooled odds ratios (ORs) with 95% confidence intervals (CIs) were used to assess associations. Nine studies with 1899 AD patients with/without BPSD were included in this meta-analysis. The 102C and CC genotypes were associated with psychosis in AD (102C:  p  < 0.00001, OR [95% CI] = 3.19 [2.12–4.79]; CC:  p  < 0.00001, OR [95% CI] = 7.24 [3.60–14.59]). The TT genotype was significantly associated with hallucinations, aberrant motor behavior, and psychosis in AD (hallucinations:  p  = 0.001, OR [95% CI] = 0.52 [0.36–0.77]; aberrant motor behavior:  p  = 0.03, OR [95% CI] = 0.58 [0.35–0.95]; and psychosis:  p  = 0.002, OR [95% CI] = 0.34 [0.17–0.67]). No association was observed between T102C alleles or genotypes and delusions, agitation/aggression, depression, and apathy ( p  > 0.05). Thus, the 5HT2A T102C might be a susceptible factor for hallucinations, aberrant motor behavior, and psychosis in AD. The potential mechanism of this polymorphism in BPSD in AD requires further exploration.

The Association between 5HT2A T102C and Behavioral and Psychological Symptoms of Dementia in Alzheimer’s Disease: A Meta-Analysis