Association between apolipoprotein E4 and cognitive decline in elderly adults

C.J. Packard*, R.G.J. Westendorp, D.J. Stott, M.J. Caslake, H.M. Murray, J. Sheperd, G.J. Blauw, M.B. Murphy, E.L. Bollen, B.M. Buckley, S. Cobbe, I. Ford, A. Gaw, M. Hyland, J.W. Jukema, A.M. Kamper, P W. Macfarlane, J. Jolles, IJ. Perry, B.J. SweeneyC. Twomey

*Corresponding author for this work

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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
Original languageEnglish
Pages (from-to)1777-1785
JournalAmerican Journal of Geriatric Psychiatry
Volume55
Issue number11
DOIs
Publication statusPublished - 1 Jan 2007

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