APOE ε4 allele predicts faster cognitive decline in mild Alzheimer disease
APOE ε4 allele predicts faster cognitive decline in mild Alzheimer disease
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DOI：
10.1212/01.wnl.0000304038.37421.cc
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发表时间：
2008-05-06
期刊：
影响因子：
9.9
通讯作者：
Stern, Y.
中科院分区：
文献类型：
--
作者：
Cosentino, S.;Scarmeas, N.;Stern, Y.
目的：为了确定是否APOE β 4预测的认知变化率的事件和流行的阿尔茨海默病（AD）的方法：个人被招募从两个纵向队列研究-华盛顿高地和Inwood哥伦比亚老龄化项目（WHICAP;人口为基础的）和预测研究（临床为基础的）-并随访平均4年。研究了三个被诊断为AD的参与者样本，这些参与者具有不同的人口统计学特征和基线认知功能：1）199（48%）例WHICAP病例; 2）215（54%）例流行WHICAP病例; 3）156（71%）例在预测研究中被诊断为AD的个体。广义估计方程被用来测试是否认知变化率，测量使用复合认知评分在WHICAP和微型精神状态检查的预测，变化作为一个函数，在每个sample.Results的状态：至少有一个等位基因的存在下，与更快的认知能力下降的事件人群为基础的AD组（p = 0.01）。平行的结果，只有当调整疾病的严重程度或排除最受损的参与者的analysis.Conclusion：APOE β 4可能影响率的认知能力下降最显着的阿尔茨海默病的早期阶段的两个流行的痴呆症样本。
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.