Apolipoprotein E ε4 and cognitive function after surgery in middle-aged and elderly Danish twins
Unni Dokkedal1, Mette Wod, Mikael Thinggaard
1From the The Unit of Epidemiology, Biostatistics and Biodemography, Department of Public Health, Danish Twin Registry, Danish Aging Research Center, University of Southern Denmark (UD, MW, MT, KC, JM-F), Department of Anaesthesiology and Intensive Care Medicine, Odense University Hospital, Odense (TGH), Department of Anaesthesia, Centre of Head and Orthopaedics, Rigshospitalet, University of Copenhagen, Copenhagen (LSR), Clinical Biochemistry and Pharmacology (KC) and Clinical Genetics, Odense University Hospital, Odense, Denmark (KC, JM-F).
Apolipoprotein E (APOE) ε4 carriers do not experience worse long-term cognitive decline after surgery. However, elderly APOE ε4 carriers generally show lower cognitive function than non-carriers.
Area of Science:
- Neuroscience
- Genetics
- Gerontology
Background:
- Transient cognitive impairment is common post-anesthesia and surgery.
- Apolipoprotein E (APOE) ε4 carriers may be more susceptible to cognitive decline after major surgery.
Purpose of the Study:
- To investigate the impact of APOE ε4 on cognitive function following surgery and anesthesia.
- To determine if APOE ε4 carriers experience greater cognitive deterioration.
Main Methods:
- Observational cross-sectional and longitudinal twin cohort study of 2936 Danish twins (aged 45-92).
- Cognitive function assessed using five age-sensitive tests.
- Analyses included linear regression and intrapair comparisons of twins discordant for surgery exposure.
Main Results:
- Elderly APOE ε4 carriers (70+ years) performed significantly worse on cognitive tests than non-carriers.
- No significant impact of APOE ε4 on cognitive function after surgery was found in cross-sectional or longitudinal analyses.
- Intrapair analyses also showed no evidence of cognitive decline post-surgery in APOE ε4 carriers.
Conclusions:
- No evidence suggests APOE ε4 carriers experience more pronounced long-term cognitive deterioration after surgery.
- Elderly individuals carrying the APOE ε4 allele generally exhibit lower cognitive performance compared to non-carriers.
