title: Association of apolipoprotein E-e4 and dementia declines with age.
abstract: OBJECTIVE
  To study the association of dementia with apolipoprotein E-e4 (APOE-e4) and its interaction with age in a nonagenarian Costa Rican group (N-sample) and a general elderly contrast group (GE-sample).
  
  
  METHODS
  In both case-control studies, participants were cognitively intact or diagnosed with dementia. The N-sample (N = 112) was at least age 90 years; the GE-sample (N = 98) was at least age 65 years.
  
  
  RESULTS
  Dementia and APOE-e4 were not significantly associated in the N-sample, but were in the GE-sample. There was a significant interaction of age with APOE-e4 in the N-sample, but not in the GE-sample. Descriptively dividing the N-sample at the median (age 93 years) showed a group interaction: APOE-e4 was more associated with dementia in the younger N-sample than in the older N-sample, where six of seven APOE-e4 carriers were cognitively intact.
  
  
  CONCLUSIONS
  The results support the reduction in association of APOE-e4 with dementia in extreme old age, consistent with a survivor effect model for successful cognitive aging.
authors.affiliation: Hospital Nacional de Geriatría y Gerontología de Costa Rica, San José, Costa Rica; School of Medicine, Universidad de Costa Rica, San José, Costa Rica.
authors.forename: Daniel
authors.initials: D
authors.lastname: Valerio
authors.affiliation: Centro de Investigación en Biología Molecular y Celular, Universidad de Costa Rica, San José, Costa Rico; Escuela de Biología, Universidad de Costa Rica, San José, Costa Rica.
authors.forename: Henriette
authors.initials: H
authors.lastname: Raventos
authors.affiliation: Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY.
authors.forename: James
authors.initials: J
authors.lastname: Schmeidler
authors.affiliation: Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY; Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, New York, NY; The Joseph Sagol Neuroscience Center, Sheba Medical Center, Tel Aviv, Israel.
authors.forename: Michal S
authors.initials: MS
authors.lastname: Beeri
authors.affiliation: Centro de Investigación en Biología Molecular y Celular, Universidad de Costa Rica, San José, Costa Rico.
authors.forename: Lara Mora
authors.initials: LM
authors.lastname: Villalobos
authors.affiliation: Centro de Investigación en Biología Molecular y Celular, Universidad de Costa Rica, San José, Costa Rico.
authors.forename: Patricia
authors.initials: P
authors.lastname: Bolaños-Palmieri
authors.affiliation: Gerontology Program, Department of Human Development, Graduate School of Public Health, University of Puerto Rico Medical Sciences Campus, Rio Piedras, Puerto Rico.
authors.forename: José R
authors.initials: JR
authors.lastname: Carrión-Baralt
authors.affiliation: Centro de Investigación en Neurociencias, Universidad de Costa Rica, San José, Costa Rica.
authors.forename: Jaime
authors.initials: J
authors.lastname: Fornaguera
authors.affiliation: Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY; Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, New York, NY; Research and Development Service, James J. Peters Veterans Affairs Medical Center, Bronx, NY. Electronic address: jeremy.silverman@mssm.edu.
authors.forename: Jeremy M
authors.initials: JM
authors.lastname: Silverman
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000235:genetics* / Q000523:psychology*; D053327:Apolipoprotein E4 / Q000235:genetics*; D016022:Case-Control Studies; D003364:Costa Rica; D003704:Dementia / Q000235:genetics*; D005260:Female; D056726:Genetic Association Studies; D005838:Genotype; D006801:Humans; D008297:Male
chemical_list: D053327:Apolipoprotein E4
keywords: Successful cognitive aging; dementia risk factors; oldest-old
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