Key result
The apolipoprotein E ε4 allele was associated with lower baseline cognitive performance (p=0.02), but this effect disappeared after adjustment for education, with no difference in cognitive decline.
Why the study?
Does the apoE ε4 allele affect cognitive performance over time in non-demented elderly subjects?
Cohort (n=600)
No
Does the apoE ε4 allele affect cognitive performance over time in non-demented elderly subjects?
The apoE ε4 allele is associated with lower baseline cognitive performance in non-demented elderly subjects, but this effect disappears after adjusting for education, and cognitive performance remains stable over time regardless of apoE phenotype.
Education adjustment nullifies apoE ε4's baseline cognitive link without altering decline rates; leaves open independent effects in broader non-demented cohorts.
Background: The apolipoprotein E (apoE) ε4 allele has been shown to be a risk factor for dementia, but it is not clear to what extent apoE affects overall cognitive function in non-demented elderly subjects, or how this risk may be modified by gene–environment interactions. Objective: To examine changes in cognitive function in elderly people as a function of the apoE ε4 phenotype. Methods: A community based prospective cohort study of 600 non-demented subjects aged over 65 years living in Gironde (France) was analysed to evaluate change over time (seven years) in scores on the mini-mental state examination (MMSE). Results: Age at cohort inception was negatively associated with cognitive performance for both ε4 carriers and non-carriers (p < 0.001). The evolution of MMSE scores differed as a function of age: scores remained stable among younger subjects but decreased over time in older subjects. The ε4 allele was shown to be significantly associated with lower cognitive performance at baseline (p = 0.02). The course of cognitive performance during the follow up was the same for both ε4 carriers and non-carriers. Lower educational level was associated with lower cognitive performance at baseline (p < 0.001) and the effect of an ε4 allele on cognitive performance disappeared after adjustment for education. When incident cases of dementia were excluded, the results were unchanged except for the course of the MMSE scores, which now remained stable over time in the older subjects. Conclusions: apoE ε4 carriers show decreased MMSE scores compared with ε4 non-carriers, but the effect of apoE on cognition disappears after adjustment for education. Non-demented elderly people maintain a stable cognitive performance regardless of their apoE phenotype.
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María Winnock (2002) conducted a cohort in Cognitive performance in non-demented elderly (n=600). Apolipoprotein E ε4 allele vs. ε4 non-carriers was evaluated on Change over time in scores on the mini-mental state examination (MMSE). The apolipoprotein E ε4 allele was associated with lower baseline cognitive performance (p=0.02), but this effect disappeared after adjustment for education, with no difference in cognitive decline.
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