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Association between apolipoprotein E4 and cognitive decline in elderly adults.
J Am Geriatr Soc 2007; 55(11):1777-85JA

Abstract

OBJECTIVE

To determine the influence of apolipoprotein E on cognitive decline in a cohort of elderly men and women.

DESIGN

Prospective study.

SETTING

Scotland, Ireland, and the Netherlands.

PARTICIPANTS

Five thousand eight hundred four subjects aged 70 to 82 from the Prospective Study of Pravastatin in the Elderly at Risk (PROSPER).

MEASUREMENTS

Subjects were assessed at baseline and over a mean 3.2-year (range 0.7-4.2) follow-up for memory (Picture-Word Recall), speed of information processing (Stroop and Letter-Digit Coding), global cognitive function (Mini-Mental State Examination), and activities of daily living.

RESULTS

At baseline, subjects with apolipoprotein E(4) versus those without E(4) had poorer memory performance (mean score difference -0.20 (95% confidence interval (CI)=-0.31 to -0.09) for immediate recall and -0.32 (95% CI=-0.48 to -0.16) for delayed recall and slower information processing (difference in Stroop, 2.79 seconds, (95% CI=1.20-4.28); Letter-Digit score, -0.36, (95% CI=-0.77-0.05). Subjects with apolipoprotein E(4) showed a greater decline in immediate (-0.22, 95% CI=-0.33 to -0.11) and delayed (-0.30, 95% CI=-0.46 to -0.15) memory scores but no significant change in speed of information processing (Stroop, P=.17; Letter-Digit, P=.06). Memory scores decreased 2.5% from baseline in those without E(4), 4.3% in E(4) heterozygotes (P=.01 for immediate and P=.03 for delayed, vs no E(4)) and 8.9% to 13.8% in E(4) homozygotes (P=.04 for immediate and P=.004 for delayed, vs heterozygotes). Apolipoprotein E(4) was associated with greater decline in instrumental activities of daily living (P<.001). Cognitive decline was not associated with lipoprotein levels.

CONCLUSION

Findings in PROSPER indicate that E(4) is associated with more-rapid cognitive decline and may, therefore, predispose to dementia.

Authors+Show Affiliations

Department of Vascular Biochemistry, University of Glasgow, Glasgow, Scotland. chris.packard@clinmed.gla.ac.ukNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

17979899

Citation

Packard, Chris J., et al. "Association Between Apolipoprotein E4 and Cognitive Decline in Elderly Adults." Journal of the American Geriatrics Society, vol. 55, no. 11, 2007, pp. 1777-85.
Packard CJ, Westendorp RG, Stott DJ, et al. Association between apolipoprotein E4 and cognitive decline in elderly adults. J Am Geriatr Soc. 2007;55(11):1777-85.
Packard, C. J., Westendorp, R. G., Stott, D. J., Caslake, M. J., Murray, H. M., Shepherd, J., ... Twomey, C. (2007). Association between apolipoprotein E4 and cognitive decline in elderly adults. Journal of the American Geriatrics Society, 55(11), pp. 1777-85.
Packard CJ, et al. Association Between Apolipoprotein E4 and Cognitive Decline in Elderly Adults. J Am Geriatr Soc. 2007;55(11):1777-85. PubMed PMID: 17979899.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Association between apolipoprotein E4 and cognitive decline in elderly adults. AU - Packard,Chris J, AU - Westendorp,Rudi G J, AU - Stott,David J, AU - Caslake,Muriel J, AU - Murray,Heather M, AU - Shepherd,James, AU - Blauw,Gerard J, AU - Murphy,Michael B, AU - Bollen,Edward L E M, AU - Buckley,Brendan M, AU - Cobbe,Stuart M, AU - Ford,Ian, AU - Gaw,Allan, AU - Hyland,Michael, AU - Jukema,J Wouter, AU - Kamper,Adriaan M, AU - Macfarlane,Peter W, AU - Jolles,Jellemer, AU - Perry,Ivan J, AU - Sweeney,Brian J, AU - Twomey,Cillian, AU - ,, PY - 2007/11/6/pubmed PY - 2007/12/7/medline PY - 2007/11/6/entrez SP - 1777 EP - 85 JF - Journal of the American Geriatrics Society JO - J Am Geriatr Soc VL - 55 IS - 11 N2 - OBJECTIVE: To determine the influence of apolipoprotein E on cognitive decline in a cohort of elderly men and women. DESIGN: Prospective study. SETTING: Scotland, Ireland, and the Netherlands. PARTICIPANTS: Five thousand eight hundred four subjects aged 70 to 82 from the Prospective Study of Pravastatin in the Elderly at Risk (PROSPER). MEASUREMENTS: Subjects were assessed at baseline and over a mean 3.2-year (range 0.7-4.2) follow-up for memory (Picture-Word Recall), speed of information processing (Stroop and Letter-Digit Coding), global cognitive function (Mini-Mental State Examination), and activities of daily living. RESULTS: At baseline, subjects with apolipoprotein E(4) versus those without E(4) had poorer memory performance (mean score difference -0.20 (95% confidence interval (CI)=-0.31 to -0.09) for immediate recall and -0.32 (95% CI=-0.48 to -0.16) for delayed recall and slower information processing (difference in Stroop, 2.79 seconds, (95% CI=1.20-4.28); Letter-Digit score, -0.36, (95% CI=-0.77-0.05). Subjects with apolipoprotein E(4) showed a greater decline in immediate (-0.22, 95% CI=-0.33 to -0.11) and delayed (-0.30, 95% CI=-0.46 to -0.15) memory scores but no significant change in speed of information processing (Stroop, P=.17; Letter-Digit, P=.06). Memory scores decreased 2.5% from baseline in those without E(4), 4.3% in E(4) heterozygotes (P=.01 for immediate and P=.03 for delayed, vs no E(4)) and 8.9% to 13.8% in E(4) homozygotes (P=.04 for immediate and P=.004 for delayed, vs heterozygotes). Apolipoprotein E(4) was associated with greater decline in instrumental activities of daily living (P<.001). Cognitive decline was not associated with lipoprotein levels. CONCLUSION: Findings in PROSPER indicate that E(4) is associated with more-rapid cognitive decline and may, therefore, predispose to dementia. SN - 1532-5415 UR - https://www.unboundmedicine.com/medline/citation/17979899/Association_between_apolipoprotein_E4_and_cognitive_decline_in_elderly_adults_ L2 - https://doi.org/10.1111/j.1532-5415.2007.01415.x DB - PRIME DP - Unbound Medicine ER -