Midlife cardiovascular risk factors, ApoE, and cognitive decline in elderly male twins
Midlife cardiovascular risk factors, ApoE, and cognitive decline in elderly male twins
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DOI：
10.1212/wnl.50.6.1580
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发表时间：
1998-06-01
期刊：
影响因子：
9.9
通讯作者：
Schellenberg, GD
中科院分区：
文献类型：
--
作者：
Carmelli, D;Swan, GE;Schellenberg, GD
目的：探讨载脂蛋白E*4 （ApoE*4）等位基因与中年心血管危险因素在认知能力下降中的联合作用。方法：数据来自国家心肺和血液研究所的双胞胎研究，这是一项对二战男性退伍军人双胞胎的纵向心血管流行病学研究，目前已进行了27年的随访。研究对象的平均年龄分别为48岁、58岁和63岁，评估心血管危险因素，包括血压和血糖水平。目前研究的参与者是410名双胞胎个体，他们的认知功能在63岁和73岁时被测量了两次。根据年龄、教育程度、基线评分和心血管疾病发生率调整神经心理测试考试成绩的十年变化得分。结果：对于整个样本，我们观察到在10年的随访中，认知表现显著下降（p < 0.01）。ApoE*4携带者的中年高血糖表现下降幅度最大，也大于单独影响的综合预期。中年高血压和ApoE*4均与精神运动速度测试成绩的过度下降有关。然而，它们的联合效应并不比单独效应加起来的预期效果大。结论：ApoE*4与中年心血管危险因素可能对认知功能下降有协同作用。这种影响可能是由于ApoE*4受试者的血管或退行性损伤更大。
Objective: To investigate the combined effect of the apolipoprotein E epsilon 4 (ApoE*4) allele and midlife cardiovascular risk factors on cognitive decline. Methods: Data are from the National Heart, Lung, and Blood Institute Twin Study-a longitudinal cardiovascular epidemiologic study of World War II male veteran twins currently in its 27th year of follow-up. Subjects were assessed for cardiovascular risk factors, including BP and glucose levels, at mean ages 48, 58, and 63 years. Participants in the current study are 410 individual twin subjects for whom cognitive function was measured twice, at ages 63 and 73 years. Ten-year change scores in performance on neuropsychological test examinations were adjusted for age, education, baseline score, and incident cardiovascular disease. Results: For the sample as a whole, we observed a significant decline (p < 0.01) in cognitive performance over the 10 years of follow-up. ApoE*4 carriers with midlife hyperglycemia experienced the greatest decline in performance, which was also greater than expected from the separate effects combined. Midlife hypertension and ApoE*4, were each associated with excess decline in performance on tests of psychomotor speed. Their joint effect, however, was not greater than expected from the separate effects combined. Conclusions: ApoE*4 and midlife cardiovascular risk factors may have a synergistic effect on decline in cognitive function. This effect may be due to greater vascular or degenerative damage among subjects with ApoE*4.