title: Is the apolipoprotein e genotype a biomarker for mild cognitive impairment? Findings from a nationally representative study.
abstract: OBJECTIVE
  Although the ε4 allele of the apolipoprotein E (APOE) genotype is a known risk factor for Alzheimer's dementia (AD), prior findings on whether it is also a risk factor for mild cognitive impairment (MCI) have been inconsistent. We tested two contrasting explanations: (a) an ε4-AD specificity hypothesis, and (b) a measurement insensitivity hypothesis.
  
  
  METHODS
  The frequency of the ε4 allele was investigated in older adults (mean age > 70) with various types of cognitive impairment (including MCI) and various types of dementia (including AD) with the aging, demographics, and memory study (ADAMS) of the National Institute on Aging's Health and Retirement Study (HRS). The ADAMS controls sources of Type I and Type II error that are posited in the ε4-AD specificity hypothesis and the measurement insensitivity hypothesis, and it is the only nationally representative data set on aging and cognitive impairment.
  
  
  RESULTS
  ε4 was a reliable predictor of MCI, with a frequency of 32% in MCI subjects versus 20% in healthy control subjects. This link was specific to MCI because ε4 was not a risk factor for other forms of cognitive impairment without dementia.
  
  
  CONCLUSIONS
  The results support the measurement insensitivity hypothesis rather than the ε4-AD specificity hypothesis and are consistent with recent research showing modest reductions in cognitive performance among normal functioning ε4 carriers.
authors: Department of Human Development, Cornell University, Ithaca, NY 14853, USA. cb299@cornell.edu
authors: Charles J
authors: CJ
authors: Brainerd
authors: Valerie F
authors: VF
authors: Reyna
authors: Ronald C
authors: RC
authors: Petersen
authors: Glenn E
authors: GE
authors: Smith
authors: Emily S
authors: ES
authors: Taub
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000235:genetics*; D000704:Analysis of Variance; D053327:Apolipoprotein E4 / Q000235:genetics*; D060825:Cognitive Dysfunction / Q000150:complications / Q000235:genetics*; D003704:Dementia / Q000235:genetics; D005260:Female; D005787:Gene Frequency; D005819:Genetic Markers; D005820:Genetic Testing; D005838:Genotype; D006801:Humans; D008297:Male; D054561:National Institute on Aging (U.S.); D009483:Neuropsychological Tests; D012016:Reference Values; D015203:Reproducibility of Results; D012307:Risk Factors; D014481:United States
chemical_list: D053327:Apolipoprotein E4; D005819:Genetic Markers