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Apolipoprotein E and cognitive change in an elderly population

B T Hyman1, T Gomez-Isla, M Briggs

  • 1Neurology Service, Massachusetts General Hospital, Boston, MA 02114, USA.

Annals of Neurology
|July 1, 1996
PubMed
Summary

The apolipoprotein E (apoE) epsilon 4 allele slightly increases cognitive impairment risk, while apoE epsilon 2 offers protection. However, many with apoE E4/4 reach old age cognitively unimpaired, limiting genotyping

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Area of Science:

  • Neuroscience
  • Genetics
  • Epidemiology

Background:

  • The apolipoprotein E (apoE) epsilon 4 allele is linked to increased Alzheimer's disease risk, while the epsilon 2 allele is underrepresented.
  • Understanding the impact of apoE genotypes on cognitive function in the general elderly population is crucial for risk assessment.

Purpose of the Study:

  • To investigate the association between apolipoprotein E (apoE) genotypes (epsilon 4 and epsilon 2) and the risk of cognitive impairment in older adults.
  • To determine the predictive value of apoE genotyping for cognitive decline over a 4- to 7-year period.

Main Methods:

  • A population-based sample of 1,899 individuals aged 65+ was studied.
  • Multiple regression and logistic regression analyses were used to assess the effects of apoE genotypes on cognitive performance, specifically delayed recall.

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  • Cognitive impairment risk was evaluated based on apoE epsilon 4 and epsilon 2 allele presence.

    • Main Results:

    • Both apoE epsilon 4 and apoE epsilon 2 alleles significantly predicted performance on a delayed recall task.
    • The odds ratio for cognitive impairment was approximately 1.37 for apoE epsilon 4 and 0.53 for apoE epsilon 2.
    • These effects were more pronounced in women, yet 85% of elderly individuals with the apoE E4/4 genotype remained cognitively unimpaired.

    Conclusions:

    • Apolipoprotein E (apoE) genotyping has a modest effect on predicting cognitive impairment in the general elderly population.
    • Despite carrying the apoE epsilon 4 allele, many individuals maintain cognitive function into old age.
    • ApoE genotyping is likely to have limited utility as a diagnostic or prognostic tool for cognitive decline.