title: APOE Genotypes Associate With Cognitive Performance but Not Cerebral Structure: Diabetes Heart Study MIND.
abstract: Dementia is a debilitating illness with a disproportionate burden in patients with type 2 diabetes (T2D). Among the contributors, genetic variation at the apolipoprotein E locus (APOE) is posited to convey a strong effect. This study compared and contrasted the association of APOE with cognitive performance and cerebral structure in the setting of T2D.
  
  
  
  European Americans from the Diabetes Heart Study (DHS) MIND (n = 754) and African Americans from the African American (AA)-DHS MIND (n = 517) were examined. The cognitive battery assessed executive function, memory, and global cognition, and brain MRI was performed.
  
  
  
  In European Americans and African Americans, the APOE E4 risk haplotype group was associated with poorer performance on the modified Mini-Mental Status Examination (P < 0.017), a measure of global cognition. In contrast to the literature, the APOE E2 haplotype group, which was overrepresented in these participants with T2D, was associated with poorer Rey Auditory Verbal Learning Test performance (P < 0.032). Nominal associations between APOE haplotype groups and MRI-determined cerebral structure were observed.
  
  
  
  Compared with APOE E3 carriers, E2 and E4 carriers performed worse in the cognitive domains of memory and global cognition. Identification of genetic contributors remains critical to understanding new pathways to prevent and treat dementia in the setting of T2D.
authors.affiliation: Department of Biochemistry, Wake Forest School of Medicine, Winston-Salem, NC nallred@wakehealth.edu.|Center for Genomics and Personalized Medicine Research, Wake Forest School of Medicine, Winston-Salem, NC.
authors.forename: Nicholette D
authors.initials: ND
authors.lastname: Palmer Allred
authors.affiliation: Center for Genomics and Personalized Medicine Research, Wake Forest School of Medicine, Winston-Salem, NC.|Molecular Genetics and Genomics Program, Wake Forest School of Medicine, Winston-Salem, NC.
authors.forename: Laura M
authors.initials: LM
authors.lastname: Raffield
authors.affiliation: Department of Biological Sciences, Clemson University, Clemson, SC.
authors.forename: Joycelyn C
authors.initials: JC
authors.lastname: Hardy
authors.affiliation: Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, NC.
authors.forename: Fang-Chi
authors.initials: FC
authors.lastname: Hsu
authors.affiliation: Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, NC.
authors.forename: Jasmin
authors.initials: J
authors.lastname: Divers
authors.affiliation: Center for Genomics and Personalized Medicine Research, Wake Forest School of Medicine, Winston-Salem, NC.
authors.forename: Jianzhao
authors.initials: J
authors.lastname: Xu
authors.affiliation: Department of Biochemistry, Wake Forest School of Medicine, Winston-Salem, NC.
authors.forename: S Carrie
authors.initials: SC
authors.lastname: Smith
authors.affiliation: Section on Gerontology and Geriatric Medicine, Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, NC.
authors.forename: Christina E
authors.initials: CE
authors.lastname: Hugenschmidt
authors.affiliation: Department of Radiology, Wake Forest School of Medicine, Winston-Salem, NC.
authors.forename: Benjamin C
authors.initials: BC
authors.lastname: Wagner
authors.affiliation: Department of Radiology, Wake Forest School of Medicine, Winston-Salem, NC.
authors.forename: Christopher T
authors.initials: CT
authors.lastname: Whitlow
authors.affiliation: Section on Gerontology and Geriatric Medicine, Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, NC.
authors.forename: Kaycee M
authors.initials: KM
authors.lastname: Sink
authors.affiliation: Department of Radiology, Wake Forest School of Medicine, Winston-Salem, NC.
authors.forename: Joseph A
authors.initials: JA
authors.lastname: Maldjian
authors.affiliation: Section on Gerontology and Geriatric Medicine, Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, NC.
authors.forename: Jeff D
authors.initials: JD
authors.lastname: Williamson
authors.affiliation: Department of Biochemistry, Wake Forest School of Medicine, Winston-Salem, NC.|Center for Genomics and Personalized Medicine Research, Wake Forest School of Medicine, Winston-Salem, NC.
authors.forename: Donald W
authors.initials: DW
authors.lastname: Bowden
authors.affiliation: Section on Nephrology, Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, NC.
authors.forename: Barry I
authors.initials: BI
authors.lastname: Freedman
mesh_terms: D000368:Aged; D001057:Apolipoproteins E / Q000235:genetics*; D001921:Brain / Q000000981:diagnostic imaging / Q000473:pathology* / Q000503:physiopathology; D003071:Cognition / Q000502:physiology*; D003072:Cognition Disorders / Q000150:complications / Q000235:genetics*; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000235:genetics* / Q000473:pathology / Q000523:psychology*; D005260:Female; D056726:Genetic Association Studies; D005838:Genotype; D006579:Heterozygote; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008568:Memory / Q000502:physiology; D008875:Middle Aged; D009483:Neuropsychological Tests
chemical_list: D001057:Apolipoproteins E