P3–030: APOE–4 is associated with faster cognitive decline in a multiethnic incident Alzheimer's disease cohort
Year: 2006
Type: article
Study design: Observational Study
Abstract: Disease course and rate of cognitive decline vary significantly across individuals diagnosed with AD. This clinical heterogeneity is likely driven by a combination of genetic and environmental factors. While e4 has been established as a risk factor for developing AD, the extent to which it impacts the course of the disease is unclear. Conflicting results in the literature may reflect methodological limitations related to analyzing prevalent AD cases; examination of incident AD cases may facilitate evaluation of cognitive decline across individuals in that all participants are followed from a common early point of disease onset. To determine the effect of APOE status on rate of cognitive decline in a multiethnic, incident AD sample. APOE genotyping was available for 184 individuals diagnosed with AD during a longitudinal (mean post–incidence f/u = 3.86 years; maximum = 11.35 years), community based, multiethnic (Hispanic = 59%; African American = 33%; and Caucasian = 8%) study. A standardized composite cognitive score was calculated across individual cognitive domains. GEE models were used to examine the association between rate of cognitive decline and APOE status (e4 present or absent). Results of APOE genotyping were: 4/4 (n = 7), 4/– (n = 58), and –/– (n = 119). After controlling for age, gender, education, ethnicity, and baseline cognitive performance, composite cognitive scores declined by approximately 6% of a sd/year following diagnosis. However, the presence of at least one e4 allele significantly increased the rate of decline, with scores in the e4 group declining an additional 4% of a standard deviation each year (p = .03). The association between the e4 allele and faster decline was significant in domains of language (6%; p = .05), memory (5%; p = .03), and abstract reasoning (5%; p = .04), whereas differential rates of decline did not exist for executive speed and visuospatial skills. In this multiethnic sample, the presence of at least one e4 allele increased the rate of cognitive decline following AD incidence suggesting that e4 may be associated with a more aggressive disease course.
Source: Alzheimer s & Dementia
Institution: Columbia University Irving Medical Center
Language: English
Subfield: Psychiatry and Mental health
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W3021608580