Association Between Apolipoprotein E4 and Cognitive Decline in Elderly Adults

Chris J. Packard; Rudi G.J. Westendorp; David J. Stott; Muriel J. Caslake; Heather M. Murray; James Shepherd; Gerard J. Blauw; Michael B. Murphy; Edward L.E.M. Bollen; Brendan M. Buckley; Stuart M. Cobbe; Ian Ford; Allan Gaw; Michael Hyland; J. Wouter Jukema; Adriaan M. Kamper; Peter W. Macfarlane; Jellemer Jolles; Ivan J. Perry; Brian J. Sweeney; Cillian Twomey

doi:10.1111/j.1532-5415.2007.01415.x

Association Between Apolipoprotein E₄ and Cognitive Decline in Elderly Adults

Chris J. Packard^*, Rudi G.J. Westendorp, David J. Stott, Muriel J. Caslake, Heather M. Murray, James Shepherd, Gerard J. Blauw, Michael B. Murphy, Edward L.E.M. Bollen, Brendan M. Buckley, Stuart M. Cobbe, Ian Ford, Allan Gaw, Michael Hyland, J. Wouter Jukema, Adriaan M. Kamper, Peter W. Macfarlane, Jellemer Jolles, Ivan J. Perry, Brian J. SweeneyCillian Twomey

^*Corresponding author for this work

School of Psychology

Research output: Contribution to journal › Article › peer-review

Abstract

OBJECTIVE: To determine the influence of apolipoprotein E on cognitive decline in a cohort of elderly men and women.DESIGN: Prospective study.SETTING: Scotland, Ireland, and the Netherlands.PARTICIPANTS: Five thousand eight hundred four subjects aged 70 to 82 from the Prospective Study of Pravastatin in the Elderly at Risk (PROSPER).MEASUREMENTS: Subjects were assessed at baseline and over a mean 3.2‐year (range 0.7–4.2) follow‐up for memory (Picture‐Word Recall), speed of information processing (Stroop and Letter‐Digit Coding), global cognitive function (Mini‐Mental State Examination), and activities of daily living.RESULTS: At baseline, subjects with apolipoprotein E4 versus those without E4 had poorer memory performance (mean score difference −0.20 (95% confidence interval (CI)=−0.31 to −0.09) for immediate recall and −0.32 (95% CI=−0.48 to −0.16) for delayed recall and slower information processing (difference in Stroop, 2.79 seconds, (95% CI=1.20–4.28); Letter‐Digit score, −0.36, (95% CI=−0.77–0.05). Subjects with apolipoprotein E4 showed a greater decline in immediate (−0.22, 95% CI=−0.33 to −0.11) and delayed (−0.30, 95% CI=−0.46 to −0.15) memory scores but no significant change in speed of information processing (Stroop, P=.17; Letter‐Digit, P=.06). Memory scores decreased 2.5% from baseline in those without E4, 4.3% in E4 heterozygotes (P=.01 for immediate and P=.03 for delayed, vs no E4) and 8.9% to 13.8% in E4 homozygotes (P=.04 for immediate and P=.004 for delayed, vs heterozygotes). Apolipoprotein E4 was associated with greater decline in instrumental activities of daily living (P<.001). Cognitive decline was not associated with lipoprotein levels.CONCLUSION: Findings in PROSPER indicate that E4 is associated with more‐rapid cognitive decline and may, therefore, predispose to dementia.

Original language	English
Pages (from-to)	1777-1785
Number of pages	0
Journal	Journal of the American Geriatrics Society
Volume	55
Issue number	11
Early online date	29 Oct 2007
DOIs	https://doi.org/10.1111/j.1532-5415.2007.01415.x
Publication status	Published - Nov 2007

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10.1111/j.1532-5415.2007.01415.x

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Packard, C. J., Westendorp, R. G. J., Stott, D. J., Caslake, M. J., Murray, H. M., Shepherd, J., Blauw, G. J., Murphy, M. B., Bollen, E. L. E. M., Buckley, B. M., Cobbe, S. M., Ford, I., Gaw, A., Hyland, M., Jukema, J. W., Kamper, A. M., Macfarlane, P. W., Jolles, J., Perry, I. J., ... Twomey, C. (2007). Association Between Apolipoprotein E₄ and Cognitive Decline in Elderly Adults. Journal of the American Geriatrics Society, 55(11), 1777-1785. https://doi.org/10.1111/j.1532-5415.2007.01415.x

@article{36446b6f213246e6b25911aa6a0b9e21,

title = "Association Between Apolipoprotein E4 and Cognitive Decline in Elderly Adults",

abstract = "OBJECTIVE: To determine the influence of apolipoprotein E on cognitive decline in a cohort of elderly men and women.DESIGN: Prospective study.SETTING: Scotland, Ireland, and the Netherlands.PARTICIPANTS: Five thousand eight hundred four subjects aged 70 to 82 from the Prospective Study of Pravastatin in the Elderly at Risk (PROSPER).MEASUREMENTS: Subjects were assessed at baseline and over a mean 3.2‐year (range 0.7–4.2) follow‐up for memory (Picture‐Word Recall), speed of information processing (Stroop and Letter‐Digit Coding), global cognitive function (Mini‐Mental State Examination), and activities of daily living.RESULTS: At baseline, subjects with apolipoprotein E4 versus those without E4 had poorer memory performance (mean score difference −0.20 (95% confidence interval (CI)=−0.31 to −0.09) for immediate recall and −0.32 (95% CI=−0.48 to −0.16) for delayed recall and slower information processing (difference in Stroop, 2.79 seconds, (95% CI=1.20–4.28); Letter‐Digit score, −0.36, (95% CI=−0.77–0.05). Subjects with apolipoprotein E4 showed a greater decline in immediate (−0.22, 95% CI=−0.33 to −0.11) and delayed (−0.30, 95% CI=−0.46 to −0.15) memory scores but no significant change in speed of information processing (Stroop, P=.17; Letter‐Digit, P=.06). Memory scores decreased 2.5% from baseline in those without E4, 4.3% in E4 heterozygotes (P=.01 for immediate and P=.03 for delayed, vs no E4) and 8.9% to 13.8% in E4 homozygotes (P=.04 for immediate and P=.004 for delayed, vs heterozygotes). Apolipoprotein E4 was associated with greater decline in instrumental activities of daily living (P<.001). Cognitive decline was not associated with lipoprotein levels.CONCLUSION: Findings in PROSPER indicate that E4 is associated with more‐rapid cognitive decline and may, therefore, predispose to dementia.",

author = "Packard, {Chris J.} and Westendorp, {Rudi G.J.} and Stott, {David J.} and Caslake, {Muriel J.} and Murray, {Heather M.} and James Shepherd and Blauw, {Gerard J.} and Murphy, {Michael B.} and Bollen, {Edward L.E.M.} and Buckley, {Brendan M.} and Cobbe, {Stuart M.} and Ian Ford and Allan Gaw and Michael Hyland and Jukema, {J. Wouter} and Kamper, {Adriaan M.} and Macfarlane, {Peter W.} and Jellemer Jolles and Perry, {Ivan J.} and Sweeney, {Brian J.} and Cillian Twomey",

year = "2007",

month = nov,

doi = "10.1111/j.1532-5415.2007.01415.x",

language = "English",

volume = "55",

pages = "1777--1785",

journal = "Journal of the American Geriatrics Society",

issn = "0002-8614",

publisher = "Wiley-Blackwell Publishing Ltd",

number = "11",

}

Packard, CJ, Westendorp, RGJ, Stott, DJ, Caslake, MJ, Murray, HM, Shepherd, J, Blauw, GJ, Murphy, MB, Bollen, ELEM, Buckley, BM, Cobbe, SM, Ford, I, Gaw, A, Hyland, M, Jukema, JW, Kamper, AM, Macfarlane, PW, Jolles, J, Perry, IJ, Sweeney, BJ & Twomey, C 2007, 'Association Between Apolipoprotein E₄ and Cognitive Decline in Elderly Adults', Journal of the American Geriatrics Society, vol. 55, no. 11, pp. 1777-1785. https://doi.org/10.1111/j.1532-5415.2007.01415.x

TY - JOUR

T1 - Association Between Apolipoprotein E4 and Cognitive Decline in Elderly Adults

AU - Packard, Chris J.

AU - Westendorp, Rudi G.J.

AU - Stott, David J.

AU - Caslake, Muriel J.

AU - Murray, Heather M.

AU - Shepherd, James

AU - Blauw, Gerard J.

AU - Murphy, Michael B.

AU - Bollen, Edward L.E.M.

AU - Buckley, Brendan M.

AU - Cobbe, Stuart M.

AU - Ford, Ian

AU - Gaw, Allan

AU - Hyland, Michael

AU - Jukema, J. Wouter

AU - Kamper, Adriaan M.

AU - Macfarlane, Peter W.

AU - Jolles, Jellemer

AU - Perry, Ivan J.

AU - Sweeney, Brian J.

AU - Twomey, Cillian

PY - 2007/11

Y1 - 2007/11

N2 - OBJECTIVE: To determine the influence of apolipoprotein E on cognitive decline in a cohort of elderly men and women.DESIGN: Prospective study.SETTING: Scotland, Ireland, and the Netherlands.PARTICIPANTS: Five thousand eight hundred four subjects aged 70 to 82 from the Prospective Study of Pravastatin in the Elderly at Risk (PROSPER).MEASUREMENTS: Subjects were assessed at baseline and over a mean 3.2‐year (range 0.7–4.2) follow‐up for memory (Picture‐Word Recall), speed of information processing (Stroop and Letter‐Digit Coding), global cognitive function (Mini‐Mental State Examination), and activities of daily living.RESULTS: At baseline, subjects with apolipoprotein E4 versus those without E4 had poorer memory performance (mean score difference −0.20 (95% confidence interval (CI)=−0.31 to −0.09) for immediate recall and −0.32 (95% CI=−0.48 to −0.16) for delayed recall and slower information processing (difference in Stroop, 2.79 seconds, (95% CI=1.20–4.28); Letter‐Digit score, −0.36, (95% CI=−0.77–0.05). Subjects with apolipoprotein E4 showed a greater decline in immediate (−0.22, 95% CI=−0.33 to −0.11) and delayed (−0.30, 95% CI=−0.46 to −0.15) memory scores but no significant change in speed of information processing (Stroop, P=.17; Letter‐Digit, P=.06). Memory scores decreased 2.5% from baseline in those without E4, 4.3% in E4 heterozygotes (P=.01 for immediate and P=.03 for delayed, vs no E4) and 8.9% to 13.8% in E4 homozygotes (P=.04 for immediate and P=.004 for delayed, vs heterozygotes). Apolipoprotein E4 was associated with greater decline in instrumental activities of daily living (P<.001). Cognitive decline was not associated with lipoprotein levels.CONCLUSION: Findings in PROSPER indicate that E4 is associated with more‐rapid cognitive decline and may, therefore, predispose to dementia.

AB - OBJECTIVE: To determine the influence of apolipoprotein E on cognitive decline in a cohort of elderly men and women.DESIGN: Prospective study.SETTING: Scotland, Ireland, and the Netherlands.PARTICIPANTS: Five thousand eight hundred four subjects aged 70 to 82 from the Prospective Study of Pravastatin in the Elderly at Risk (PROSPER).MEASUREMENTS: Subjects were assessed at baseline and over a mean 3.2‐year (range 0.7–4.2) follow‐up for memory (Picture‐Word Recall), speed of information processing (Stroop and Letter‐Digit Coding), global cognitive function (Mini‐Mental State Examination), and activities of daily living.RESULTS: At baseline, subjects with apolipoprotein E4 versus those without E4 had poorer memory performance (mean score difference −0.20 (95% confidence interval (CI)=−0.31 to −0.09) for immediate recall and −0.32 (95% CI=−0.48 to −0.16) for delayed recall and slower information processing (difference in Stroop, 2.79 seconds, (95% CI=1.20–4.28); Letter‐Digit score, −0.36, (95% CI=−0.77–0.05). Subjects with apolipoprotein E4 showed a greater decline in immediate (−0.22, 95% CI=−0.33 to −0.11) and delayed (−0.30, 95% CI=−0.46 to −0.15) memory scores but no significant change in speed of information processing (Stroop, P=.17; Letter‐Digit, P=.06). Memory scores decreased 2.5% from baseline in those without E4, 4.3% in E4 heterozygotes (P=.01 for immediate and P=.03 for delayed, vs no E4) and 8.9% to 13.8% in E4 homozygotes (P=.04 for immediate and P=.004 for delayed, vs heterozygotes). Apolipoprotein E4 was associated with greater decline in instrumental activities of daily living (P<.001). Cognitive decline was not associated with lipoprotein levels.CONCLUSION: Findings in PROSPER indicate that E4 is associated with more‐rapid cognitive decline and may, therefore, predispose to dementia.

U2 - 10.1111/j.1532-5415.2007.01415.x

DO - 10.1111/j.1532-5415.2007.01415.x

M3 - Article

SN - 0002-8614

VL - 55

SP - 1777

EP - 1785

JO - Journal of the American Geriatrics Society

JF - Journal of the American Geriatrics Society

IS - 11

ER -

Association Between Apolipoprotein E4 and Cognitive Decline in Elderly Adults

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Association Between Apolipoprotein E₄ and Cognitive Decline in Elderly Adults