OBJECTIVES: To assess the influence of education on the association between apolipoprotein E and cognitive change. DESIGN: Prospective cohort. PARTICIPANTS: HMO-based sample of 2168 non-demented community-dwelling elderly followed over 6 years. MEASUREMENTS: Generalized estimating equations were used with the difference between baseline and follow-up cognitive abilities screening instrument (CASI) as the outcome variable. RESULTS: At follow-up, 6% of the sample had a decline of 1.5 S.D. or greater on the CASI. Compared to individuals without an APOE4 allele, individuals with a single APOE4 allele did not have greater CASI decline. By contrast, individuals with two APOE4 alleles experienced greater decline in cognitive performance and the magnitude of that decline decreased as years of educational attainment increased. These relationships held after adjusting for age, gender, ethnicity, depression, diabetes, and history of vascular disease. CONCLUSION: Lower education was associated with steep 4-year cognitive decline for APOE4 homozygotes but not for APOE4 heterozygotes. Potentially modifiable host factors such as education could influence the association of high-risk genotypes and cognitive decline.
OBJECTIVES: To assess the influence of education on the association between apolipoprotein E and cognitive change. DESIGN: Prospective cohort. PARTICIPANTS: HMO-based sample of 2168 non-demented community-dwelling elderly followed over 6 years. MEASUREMENTS: Generalized estimating equations were used with the difference between baseline and follow-up cognitive abilities screening instrument (CASI) as the outcome variable. RESULTS: At follow-up, 6% of the sample had a decline of 1.5 S.D. or greater on the CASI. Compared to individuals without an APOE4 allele, individuals with a single APOE4 allele did not have greater CASI decline. By contrast, individuals with two APOE4 alleles experienced greater decline in cognitive performance and the magnitude of that decline decreased as years of educational attainment increased. These relationships held after adjusting for age, gender, ethnicity, depression, diabetes, and history of vascular disease. CONCLUSION: Lower education was associated with steep 4-year cognitive decline for APOE4 homozygotes but not for APOE4 heterozygotes. Potentially modifiable host factors such as education could influence the association of high-risk genotypes and cognitive decline.
Authors: D J Lehmann; H Refsum; E Nurk; D R Warden; G S Tell; S E Vollset; K Engedal; H A Nygaard; A D Smith Journal: J Neurol Neurosurg Psychiatry Date: 2006-04-04 Impact factor: 10.154
Authors: Steve R Makkar; Darren M Lipnicki; John D Crawford; Nicole A Kochan; Erico Castro-Costa; Maria Fernanda Lima-Costa; Breno Satler Diniz; Carol Brayne; Blossom Stephan; Fiona Matthews; Juan J Llibre-Rodriguez; Jorge J Llibre-Guerra; Adolfo J Valhuerdi-Cepero; Richard B Lipton; Mindy J Katz; Andrea Zammit; Karen Ritchie; Sophie Carles; Isabelle Carriere; Nikolaos Scarmeas; Mary Yannakoulia; Mary Kosmidis; Linda Lam; Ada Fung; Wai Chi Chan; Antonio Guaita; Roberta Vaccaro; Annalisa Davin; Ki Woong Kim; Ji Won Han; Seung Wan Suh; Steffi G Riedel-Heller; Susanne Roehr; Alexander Pabst; Mary Ganguli; Tiffany F Hughes; Erin P Jacobsen; Kaarin J Anstey; Nicolas Cherbuin; Mary N Haan; Allison E Aiello; Kristina Dang; Shuzo Kumagai; Kenji Narazaki; Sanmei Chen; Tze Pin Ng; Qi Gao; Ma Shwe Zin Nyunt; Kenichi Meguro; Satoshi Yamaguchi; Hiroshi Ishii; Antonio Lobo; Elena Lobo Escolar; Concepción De la Cámara; Henry Brodaty; Julian N Trollor; Yvonne Leung; Jessica W Lo; Perminder Sachdev Journal: Arch Gerontol Geriatr Date: 2020-07-13 Impact factor: 3.250