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. 2008 May 6;70(19 Pt 2):1842-9.
doi: 10.1212/01.wnl.0000304038.37421.cc. Epub 2008 Apr 9.

APOE epsilon 4 allele predicts faster cognitive decline in mild Alzheimer disease

S Cosentino  1 , N Scarmeas, E Helzner, M M Glymour, J Brandt, M Albert, D Blacker, Y Stern
Affiliations

APOE epsilon 4 allele predicts faster cognitive decline in mild Alzheimer disease

S Cosentino et al. Neurology. .

Abstract

Objective: To determine whether APOE epsilon 4 predicts rate of cognitive change in incident and prevalent Alzheimer disease (AD).

Methods: Individuals were recruited from two longitudinal cohort studies-the Washington Heights and Inwood Columbia Aging Project (WHICAP; population-based) and the Predictors Study (clinic-based)--and were followed for an average of 4 years. Three samples of participants diagnosed with AD, with diverse demographic characteristics and baseline cognitive functioning, were studied: 1) 199 (48%) of the incident WHICAP cases; 2) 215 (54%) of the prevalent WHICAP cases; and 3) 156 (71%) of the individuals diagnosed with AD in the Predictors Study. Generalized estimating equations were used to test whether rate of cognitive change, measured using a composite cognitive score in WHICAP and the Mini-Mental State Examination in Predictors, varied as a function of epsilon 4 status in each sample.

Results: The presence of at least one epsilon 4 allele was associated with faster cognitive decline in the incident population-based AD group (p = 0.01). Parallel results were produced for the two prevalent dementia samples only when adjusting for disease severity or excluding the most impaired participants from the analyses.

Conclusion: APOE epsilon 4 may influence rate of cognitive decline most significantly in the earliest stages of Alzheimer disease.

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Figures

Figure 1
Figure 1. Predicted cognitive decline by ε4 status in Incident AD
Dotted line = non-carriers Solid line = ε4 carriers
See this image and copyright information in PMC

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