Premium
P3‐595: CARDIOVASCULAR MODIFIERS OF THE ASSOCIATION BETWEEN EXERCISE AND RISK FOR MILD COGNITIVE IMPAIRMENT: THE MYHAT STUDY
Author(s) -
Hughes Tiffany F.,
Liu Anran,
Sun Zhaowen,
Jacobsen Erin P.,
Chang Chung-Chou,
Ganguli Mary
Publication year - 2018
Publication title -
alzheimer's and dementia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 6.713
H-Index - 118
eISSN - 1552-5279
pISSN - 1552-5260
DOI - 10.1016/j.jalz.2018.06.1961
Subject(s) - medicine , dementia , clinical dementia rating , cognitive impairment , coronary artery disease , diabetes mellitus , cognitive decline , physical therapy , cardiology , disease , proportional hazards model , gerontology , endocrinology
Background:Studies indicate sex and ethno-regional differences in the association between APOE-ε4 carriage on AD development, with females and Asians having greater risk, and Black individuals at lower risk compared to Whites. Still unclear is whether such sex differences vary between ethnicities and if these relationships are age-dependent. We therefore examined the association between APOE-e4 carriage and cognitive performance and decline, and the moderating effects of age, sex, and ethnicity. Methods: Individual participant data meta-analysis was used to synthesise longitudinal data for 23,573 individuals aged 54-100 years from 16 cohorts located in 15 countries. Pooled regression coefficients estimated differences between APOE-ε4 carriers and non-carriers, and between APOE-ε4 homozygotes and heterozygotes, in cognitive performance and decline on MMSE and four cognitive domains: memory, language, processing speed, and executive functioning after adjusting for appropriate confounding variables. Interaction terms and stratified analyses were incorporated to examine the moderating effects of sex, age (below and above 70 years), and ethnicity, on the APOE-ε4-cognition association. Results:Carriers and homozygotes displayed lower MMSE and Memory scores compared to non-carriers and heterozygotes respectively. Carriers also displayed faster MMSE/Memory decline, and age-related cognitive decline (i.e., faster cognitive decline at higher ages) compared to non-carriers (MMSE, language). Faster age-related cognitive decline observed in carriers and homozygotes was greater in males than females (for MMSE, Memory, Language, and Processing Speed). Male homozygotes displayed faster MMSE and Memory decline compared to female homozygotes, with the memory effect specific to those aged above 70. A larger decrement in memory performance among APOE-ε4 homozygotes, and more rapid language decline among carriers, was found in Asians compared to Whites under 70 years. Finally, the negative effects of APOE-ε4 carriage on MMSE and Memory performance were significantly smaller in Blacks compared to Whites (see Table 1). Conclusions:The faster cognitive decline, and age-related cognitive decline observed among carriers, and the dose-dependent nature of this relationship is consistent with evidence of accelerated cognitive decline among APOE-ε4 carriers. Unlike previous research, APOE-ε4-mediated cognitive decline was stronger in males than females. Finally, ethno-regional analyses were consistent with published findings of higher and lower AD risk among Asian and Black APOE-ε4 carriers, respectively.