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How can elderly apolipoprotein E ε4 carriers remain free from dementia?

Abstract

Apolipoprotein E (APOE) ε4 is a major risk factor for Alzheimer's disease (AD) and dementia, but not all ε4 carriers develop dementia. We sought to identify factors that may play a role in modifying the risk of dementia due to ε4. A cognitively intact cohort (n = 932, age ≥ 75) was followed for 9 years to detect incident dementia cases. At baseline, information on education, leisure activities, and vascular risk factors was collected, and APOE was genotyped. During the follow-up, 324 subjects developed dementia, including 247 AD cases. The hazard ratio (HR, 95% confidence interval [95% CI]) of dementia related to the ε4 was 1.39 (1.11-1.76), while the risk was reduced when ε4 carriers had high education, no vascular risk factors, or high score of leisure activities. Among ε4 carriers, the multiadjusted HRs of dementia that were associated with high education, high level of leisure activities, and absence of vascular risk factors were 0.59 (0.40-0.87), 0.49 (0.29-0.85), and 0.61 (0.41-0.90), respectively. The ε4 carriers with these factors had about 1.2 years delayed time to dementia onset compared with those without these factors. High education, active leisure activities, or maintaining vascular health seems to reduce the risk of dementia related to APOE ε4. The ε4 carriers with these characteristics appear to have similar dementia-free survival time to non-ε4 carriers.

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  • Authors+Show Affiliations

    ,

    Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden.

    , , , , ,

    Source

    Neurobiology of aging 34:1 2013 Jan pg 13-21

    MeSH

    Aged
    Aged, 80 and over
    Aging
    Alzheimer Disease
    Apolipoprotein E4
    Dementia
    Educational Status
    Female
    Genotype
    Humans
    Kaplan-Meier Estimate
    Leisure Activities
    Longitudinal Studies
    Male
    Proportional Hazards Models
    Risk Factors
    Vascular Diseases

    Pub Type(s)

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

    Language

    eng

    PubMed ID

    22503000

    Citation

    Ferrari, Camilla, et al. "How Can Elderly Apolipoprotein E Ε4 Carriers Remain Free From Dementia?" Neurobiology of Aging, vol. 34, no. 1, 2013, pp. 13-21.
    Ferrari C, Xu WL, Wang HX, et al. How can elderly apolipoprotein E ε4 carriers remain free from dementia? Neurobiol Aging. 2013;34(1):13-21.
    Ferrari, C., Xu, W. L., Wang, H. X., Winblad, B., Sorbi, S., Qiu, C., & Fratiglioni, L. (2013). How can elderly apolipoprotein E ε4 carriers remain free from dementia? Neurobiology of Aging, 34(1), pp. 13-21. doi:10.1016/j.neurobiolaging.2012.03.003.
    Ferrari C, et al. How Can Elderly Apolipoprotein E Ε4 Carriers Remain Free From Dementia. Neurobiol Aging. 2013;34(1):13-21. PubMed PMID: 22503000.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - How can elderly apolipoprotein E ε4 carriers remain free from dementia? AU - Ferrari,Camilla, AU - Xu,Wei-Li, AU - Wang,Hui-Xin, AU - Winblad,Bengt, AU - Sorbi,Sandro, AU - Qiu,Chengxuan, AU - Fratiglioni,Laura, Y1 - 2012/04/11/ PY - 2011/10/19/received PY - 2012/03/04/revised PY - 2012/03/07/accepted PY - 2012/4/17/entrez PY - 2012/4/17/pubmed PY - 2013/4/24/medline SP - 13 EP - 21 JF - Neurobiology of aging JO - Neurobiol. Aging VL - 34 IS - 1 N2 - Apolipoprotein E (APOE) ε4 is a major risk factor for Alzheimer's disease (AD) and dementia, but not all ε4 carriers develop dementia. We sought to identify factors that may play a role in modifying the risk of dementia due to ε4. A cognitively intact cohort (n = 932, age ≥ 75) was followed for 9 years to detect incident dementia cases. At baseline, information on education, leisure activities, and vascular risk factors was collected, and APOE was genotyped. During the follow-up, 324 subjects developed dementia, including 247 AD cases. The hazard ratio (HR, 95% confidence interval [95% CI]) of dementia related to the ε4 was 1.39 (1.11-1.76), while the risk was reduced when ε4 carriers had high education, no vascular risk factors, or high score of leisure activities. Among ε4 carriers, the multiadjusted HRs of dementia that were associated with high education, high level of leisure activities, and absence of vascular risk factors were 0.59 (0.40-0.87), 0.49 (0.29-0.85), and 0.61 (0.41-0.90), respectively. The ε4 carriers with these factors had about 1.2 years delayed time to dementia onset compared with those without these factors. High education, active leisure activities, or maintaining vascular health seems to reduce the risk of dementia related to APOE ε4. The ε4 carriers with these characteristics appear to have similar dementia-free survival time to non-ε4 carriers. SN - 1558-1497 UR - https://www.unboundmedicine.com/medline/citation/22503000/How_can_elderly_apolipoprotein_E_ε4_carriers_remain_free_from_dementia L2 - https://linkinghub.elsevier.com/retrieve/pii/S0197-4580(12)00195-9 DB - PRIME DP - Unbound Medicine ER -