S Kalmijn1, E J Feskens, L J Launer, D Kromhout. 1. Department of Chronic Diseases and Environmental Epidemiology, National Institute of Public Health and the Environment, Bilthoven, Netherlands. kalmijn@epib.fgg.eur.nl
Abstract
BACKGROUND AND PURPOSE: Cerebrovascular disease and the apolipoprotein e4 (APOE*4) allele are both important risk factors for cognitive decline. We investigated the combined effect of APOE*4 and cerebrovascular disease on cognitive decline. METHODS: Data are from a cohort of 353 men, aged 69 to 89 years at baseline, living in Zutphen, Netherlands. The 30-point Mini-Mental State Examination (MMSE) was used to measure cognitive decline (drop of > 2 points) from 1990 to 1993 (14% of the sample). Odds ratios (OR [95% confidence interval]) for cognitive decline were adjusted for age, education, and baseline MMSE score. RESULTS: Compared with those without APOE*4 and without a history of cerebrovascular disease, the adjusted OR was 4.7 (1.7 to 12.7) for subjects without APOE*4 but with cerebrovascular disease, 3.3 (1.6 to 6.8) for those with APOE*4 and no cerebrovascular disease, and 17.2 (2.7 to 110.0) for those with both risk factors. The risk for cerebrovascular disease and APOE*4 combined was more than expected from the separate effects. The combined risk of coronary heart disease and APOE*4 was 6.1 (1.7 to 22.3). The analysis of cardiovascular risk factors showed that the risk of cognitive decline was highest in subjects with both APOE*4 and a high cholesterol level, high fibrinogen level, normal blood pressure, or diabetes mellitus. CONCLUSIONS: Cerebrovascular disease and APOE*4 may have a synergistic effect on cognitive decline.
BACKGROUND AND PURPOSE:Cerebrovascular disease and the apolipoprotein e4 (APOE*4) allele are both important risk factors for cognitive decline. We investigated the combined effect of APOE*4 and cerebrovascular disease on cognitive decline. METHODS: Data are from a cohort of 353 men, aged 69 to 89 years at baseline, living in Zutphen, Netherlands. The 30-point Mini-Mental State Examination (MMSE) was used to measure cognitive decline (drop of > 2 points) from 1990 to 1993 (14% of the sample). Odds ratios (OR [95% confidence interval]) for cognitive decline were adjusted for age, education, and baseline MMSE score. RESULTS: Compared with those without APOE*4 and without a history of cerebrovascular disease, the adjusted OR was 4.7 (1.7 to 12.7) for subjects without APOE*4 but with cerebrovascular disease, 3.3 (1.6 to 6.8) for those with APOE*4 and no cerebrovascular disease, and 17.2 (2.7 to 110.0) for those with both risk factors. The risk for cerebrovascular disease and APOE*4 combined was more than expected from the separate effects. The combined risk of coronary heart disease and APOE*4 was 6.1 (1.7 to 22.3). The analysis of cardiovascular risk factors showed that the risk of cognitive decline was highest in subjects with both APOE*4 and a high cholesterol level, high fibrinogen level, normal blood pressure, or diabetes mellitus. CONCLUSIONS:Cerebrovascular disease and APOE*4 may have a synergistic effect on cognitive decline.
Authors: Katherine J Bangen; Jayandra J Himali; Alexa S Beiser; Daniel A Nation; David J Libon; Caroline S Fox; Sudha Seshadri; Philip A Wolf; Ann C McKee; Rhoda Au; Lisa Delano-Wood Journal: J Alzheimers Dis Date: 2016-07-06 Impact factor: 4.472
Authors: Katherine J Bangen; Alexa Beiser; Lisa Delano-Wood; Daniel A Nation; Melissa Lamar; David J Libon; Mark W Bondi; Sudha Seshadri; Philip A Wolf; Rhoda Au Journal: J Stroke Cerebrovasc Dis Date: 2013-04-17 Impact factor: 2.136