Role of APOE ε4 Allele and Incident Stroke on Cognitive Decline and Mortality
Role of APOE ε4 Allele and Incident Stroke on Cognitive Decline and Mortality
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DOI：
10.1097/wad.0000000000000173
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发表时间：
2016-10-01
影响因子：
2.1
通讯作者：
Evans, Denis A.
中科院分区：
文献类型：
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作者：
Rajan, Kumar B.;Aggarwal, Neelum T.;Evans, Denis A.
背景：载脂蛋白E（APOE）等位基因和卒中增加认知功能下降的风险。然而，该协会的APOE β 4等位基因之前和之后中风还没有很好地understood.Methods：使用前瞻性样本的3444（66%的非洲裔美国人，61%的女性，平均年龄= 71.9岁）的参与者，我们研究了认知能力下降相对于中风之间的APOE β 4等位基因和没有。在未患中风的受试者中，与非携带者相比，E14等位基因与认知能力下降增加相关（0.080对0.036单位/年; P < 0.0001）。在不携带E14等位基因的参与者中，与卒中前相比，卒中后认知功能下降显著增加（0.115 vs. 0.039单位/年; P < 0.0001）。有趣的是，中风前后的认知能力下降在那些携带E14等位基因的人中没有显著差异（0.091对0.102单位/年; P = 0.32）。认知功能差与卒中风险增高相关（风险比= 1.41，95%可信区间，1.25-1.58），但APOE β 4等位基因与卒中风险增高无关（P = 0.66）。APOE ε 4等位基因，认知功能，和中风事件与mortality.Conclusions：中风与认知能力下降的关联似乎不同的APOE ε 4等位基因的存在，但没有这样的相互作用，观察到死亡率。
Background: The apolipoprotein E (APOE) epsilon 4 allele and stroke increase the risk of cognitive decline. However, the association of the APOE epsilon 4 allele before and after stroke is not well understood.Methods: Using a prospective sample of 3444 (66% African Americans, 61% females, mean age = 71.9 y) participants, we examined cognitive decline relative to stroke among those with and without the APOE epsilon 4 allele.Results: In our sample, 505 (15%) had incident stroke. Among participants without stroke, the epsilon 4 allele was associated with increased cognitive decline compared to noncarriers (0.080 vs. 0.036 units/year; P < 0.0001). Among participants without the epsilon 4 allele, cognitive decline increased significantly after stroke compared to before stroke (0.115 vs. 0.039 units/year; P < 0.0001). Interestingly, cognitive decline before and after stroke was not significantly different among those with the epsilon 4 allele (0.091 vs. 0.102 units/year; P = 0.32). Poor cognitive function was associated with higher risk of stroke (hazard ratio = 1.41, 95% confidence interval, 1.25-1.58), but the APOE epsilon 4 allele was not (P = 0.66). The APOE epsilon 4 allele, cognitive function, and incident stroke were associated with mortality.Conclusions: The association of stroke with cognitive decline appears to differ by the presence of the APOE epsilon 4 allele, but no such interaction was observed for mortality.