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. 2019 Dec;34(12):1833-1844.
doi: 10.1002/gps.5199. Epub 2019 Aug 22.

Cognitive resilience among APOE ε4 carriers in the oldest old

Kathleen M Hayden  1 , Sarah A Gaussoin  2 , Jaimie C Hunter  1 , JoAnn E Manson  3 , Bonnie C Sachs  1   4   5 , Aladdin H Shadyab  6 , Hilary A Tindle  7 , Yasmin Mossavar-Rahmani  8 , Khyobeni Mozhui  9 , Beverly M Snively  2 , Stephen R Rapp  1   10 , Susan M Resnick  11
Affiliations

Cognitive resilience among APOE ε4 carriers in the oldest old

Kathleen M Hayden et al. Int J Geriatr Psychiatry. 2019 Dec.

Abstract

Objectives: Relatively few APOE ε4+ carriers survive to old age (age 80+) without cognitive impairment (CI); thus, little is known about distinguishing characteristics of resilient APOE ε4+ carriers. Herein, we describe the sociodemographic characteristics of a large sample of resilient APOE ε4+ women from the Women's Health Initiative Memory Study (WHIMS) and compare them to noncarriers and APOE ε4+ women who developed CI before age 80.

Methods: Women were recruited for clinical trials evaluating postmenopausal hormone therapy and incidence of dementia. During posttrial follow-up, cognitive status was adjudicated annually. Among 5716 women, we compared groups by APOE ε4 status using logistic regression, covarying for treatment, demographics, lifestyle, cardiovascular and physical function, well-being, and self-rated general health.

Results: Among 557 APOE ε4+ women, those who survived to age 80+ without CI had higher baseline self-rated general health (odds ratio [OR]: 1.02; 95% confidence interval [CI], 1.01-1.04) and cognitive scores (OR: 1.18; 95% CI, 1.12-1.25) than those who did not reach age 80 without CI. Baseline high total cholesterol and low-density lipoprotein (LDL) levels were similar across APOE ε4+ groups but were higher compared with APOE ε4- women. Among women who survived to 80+ without CI, more APOE ε4+ women had a history of high total cholesterol (P = .003) and LDL cholesterol (OR: 1.01; 95% CI, 1.00-1.01). There were no differences in hypertension, diabetes, or other vascular risk factors in APOE ε4+ women compared with noncarriers.

Conclusions: Results highlight the importance of baseline cognitive function and general health for late-life cognition among ε4+ women.

Keywords: APOE ε; cognitive resilience; mild cognitive impairment; oldest old; probable dementia.

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Conflict of interest statement

Conflicts of Interest:

The authors have no conflicts to declare.

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