Risk factors for cognitive decline in healthy older adults (original) (raw)

2000, Neurobiology of Aging

Epidemiology (n=120) were demented at the time of their final examination. Of these 92 met neuropathological criteria for AD. Forty-six sisters met neuropathological criteria for AD, but were not demented at their last assessment. The 2X sisters who were demented, but did not fulfill AD neuropathologlc criteria, had a variety of pathologies, including cerebral infarcts, dementia with Lewy bodies, hydrocephalus and hippocampal sclerosis. APOE-•4,when adjurted for age, education and other variables, was associated with an elevated risk for meeting neuropathologic criteria for AD(OR=S.R. 95% CI: 2.7-12. I). Individuals with one or more ~4 alleles who fulfilled AD neuropathological criteria had a significant increase in dementia risk (OR=6.1,95% Cl: 2.7-13.6) compared to those who neither fulfilled AD neuropathologic criteria nor had t4 alleles. By contrast, in a similar comparison, individuals with ~4 alleles who did not meet AD neuropathologlc criteria were not at increased risk for dementia (OR=O.6, 95% Cl: 0.1-3.2). A series of analyses demonstrated strong associations between the presence of ~4 alleles and the severity of neurofibrillay tangles and senile plaques in the hippocampus and neocmtex. The findmgs indicate a strong association between APOE-~4 genotypea and an increased severity of Alrheimer neuropathol?gy regardless of clinical outcome, but do not provide support for an a?socntion between APOE-~4 and dementia resulting from other pathologler.