Apolipoprotein E genotype, atherosclerosis, and cognitive decline: the Rotterdam Study.
The apolipoprotein E4 allele (APOE epsilon 4) and atherosclerosis are risk factors for cognitive decline. We investigated whether the effects of APOE epsilon 4 and atherosclerosis on cognitive decline are independent. A population-based follow-up study was performed on 838 subjects who were non-demented at baseline. The Mini Mental State Examination (MMSE) score at follow-up was studied as a function of APOE epsilon 4 and atherosclerosis. Mild, non-significant effects on the MMSE score were found for atherosclerosis in the absence of APOE epsilon 4 and for APOE epsilon 4 in the absence of atherosclerosis. APOE epsilon 4 carriers with two or more indicators of atherosclerosis positive, had a significantly lower MMSE score at follow-up (mean difference -0.7 points; 95% confidence interval -1.1 to -0.2) relative to non-APOE epsilon 4 carriers with no evidence of atherosclerosis. Our findings suggest that the consequences of APOE epsilon 4 and atherosclerosis are not independent, and that particularly APOE epsilon 4 carriers with atherosclerosis are at increased risk of cognitive decline.
Department of Epidemiology and Biostatistics, Erasmus University Medical School, Rotterdam, The Netherlands.
A J
AJ
Slooter
C M
CM
van Duijn
M L
ML
Bots
A
A
Ott
M B
MB
Breteler
J
J
De Voecht
A
A
Wehnert
P
P
de Knijff
L M
LM
Havekes
D E
DE
Grobbee
C
C
Van Broeckhoven
A
A
Hofman
D000368:Aged; D001057:Apolipoproteins E / Q000235:genetics*; D001161:Arteriosclerosis / Q000235:genetics* / Q000523:psychology*; D003072:Cognition Disorders / Q000235:genetics* / Q000523:psychology*; D005260:Female; D005500:Follow-Up Studies; D005838:Genotype; D006801:Humans; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D011569:Psychiatric Status Rating Scales
D001057:Apolipoproteins E