The impact of APOE ε4 on cognition in Brazilians with type 2 diabetes: exploring ethnicity effects
Rafael Lara Nohmi1, Mozania Reis de Matos1, Sueli Mieko Oba-Shinjo1
1Laboratory of Molecular and Cellular Biology (LIM 15) Department of Neurology Faculdade de Medicina FMUSP Universidade de São Paulo São Paulo São Paulo Brazil.
Introduction:
Type 2 diabetes (T2D) is associated with cognitive decline, but the role of APOE ε4 - a known Alzheimer's risk allele - in cognition among admixed populations with T2D remains unclear.
Methods:
We analyzed 883 Brazilian adults with T2D (median age 68 years) from primary care, excluding those with dementia. Cognitive function was assessed using Mini-Mental State Examination (MMSE), and APOE genotypes were determined. MMSE errors were modeled using negative binomial regression.
Results:
APOE alleles showed no association with MMSE errors overall. Older age and self-reported Black/Brown race predicted more errors, whereas higher education and physical activity predicted fewer. Sensitivity analyses indicated a possible inverse association between APOE ε4 and MMSE errors among self-reported Black/Brown participants.
Discussion:
APOE ε4 was not associated with cognition in this cohort. The suggestive protective effect observed in Black/Brown participants should be considered hypothesis-generating, underscoring the need for further research in admixed populations with T2D.
Highlights:
APOE ε4 was not linked to cognitive errors in the full T2D Brazilian cohort.Trend toward fewer MMSE errors among self-reported Black/Brown APOE ε4 carriers.Higher education, physical activity, and BMI were protective against MMSE errors.Black/Brown race and older age were associated with more MMSE errors.Results support multifactorial assessment and more studies in admixed T2D populations.
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