期刊
NEUROLOGY
卷 70, 期 19, 页码 1842-1849出版社
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1212/01.wnl.0000304038.37421.cc
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资金
- Intramural NIH HHS [Z01 AG000732] Funding Source: Medline
- NCRR NIH HHS [M01 RR000645, RR00645, M01 RR000645-260594] Funding Source: Medline
- NIA NIH HHS [R01 AG007370-18, P01 AG007232-18, L30 AG026603, R01 AG007370, T32 AG000261, R01AG007370, AG00261, T32 AG000261-08, L30 AG026603-01, P01 AG007232] Funding Source: Medline
Objective: To determine whether APOE epsilon 4 predicts rate of cognitive change in incident and prevalent Alzheimer disease (AD). Methods: Individuals were recruited from two longitudinal cohort studies-the Washington Heights and Inwood Columbia Aging Project (WHICAP; population-based) and the Predictors Study (clinic-based) -and were followed for an average of 4 years. Three samples of participants diagnosed with AD, with diverse demographic characteristics and baseline cognitive functioning, were studied: 1) 199 (48%) of the incident WHICAP cases; 2) 215 (54%) of the prevalent WHICAP cases; and 3) 156 (71%) of the individuals diagnosed with AD in the Predictors Study. Generalized estimating equations were used to test whether rate of cognitive change, measured using a composite cognitive score in WHICAP and the Mini-Mental State Examination in Predictors, varied as a function of epsilon 4 status in each sample. Results: The presence of at least one epsilon 4 allele was associated with faster cognitive decline in the incident population-based AD group (p = 0.01). Parallel results were produced for the two prevalent dementia samples only when adjusting for disease severity or excluding the most impaired participants from the analyses. Conclusion: APOE epsilon 4 may influence rate of cognitive decline most significantly in the earliest stages of Alzheimer disease.
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