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Updated: May 29, 2026

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Anxiety affects cognition differently in healthy apolipoprotein E ε4 homozygotes and non-carriers
Cynthia M Stonnington1, Dona E C Locke, Amylou C Dueck
1Dept. of Psychiatry and Psychology, Section of Biostatistics, and Dept of Neurology, Mayo Clinic, Arizona, USA. stonnington.cynthia@mayo.edu
Abstract:
It is not known whether apolipoprotein E ε4-an Alzheimer disease susceptibility gene-influences the effects of state-anxiety on executive functioning in healthy individuals. In a prospective cohort study of 185 cognitively normal individuals, there were ε4 homozygotes, heterozygotes, and non-carriers, who did not differ in age, sex, years of education, cognitive test scores, psychotropic medications, and state- or trait-anxiety. However, higher anxiety was associated with significantly worse Trails B performance in the ε4 homozygotes, as compared with ε4 non-carriers. The association of executive-functioning difficulties and anxiety appears more likely to occur in persons who are most at risk for subsequent cognitive decline.
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