Abstract
Objectives: Relatively few APOE ε4+ carriers survive to old age (age 80+) without cognitive impairment (CI); thus, little is known about distinguishing characteristics of resilient APOE ε4+ carriers. Herein, we describe the sociodemographic characteristics of a large sample of resilient APOE ε4+ women from the Women's Health Initiative Memory Study (WHIMS) and compare them to noncarriers and APOE ε4+ women who developed CI before age 80. Methods: Women were recruited for clinical trials evaluating postmenopausal hormone therapy and incidence of dementia. During posttrial follow-up, cognitive status was adjudicated annually. Among 5716 women, we compared groups by APOE ε4 status using logistic regression, covarying for treatment, demographics, lifestyle, cardiovascular and physical function, well-being, and self-rated general health. Results: Among 557 APOE ε4+ women, those who survived to age 80+ without CI had higher baseline self-rated general health (odds ratio [OR]: 1.02; 95% confidence interval [CI], 1.01-1.04) and cognitive scores (OR: 1.18; 95% CI, 1.12-1.25) than those who did not reach age 80 without CI. Baseline high total cholesterol and low-density lipoprotein (LDL) levels were similar across APOE ε4+ groups but were higher compared with APOE ε4− women. Among women who survived to 80+ without CI, more APOE ε4+ women had a history of high total cholesterol (P =.003) and LDL cholesterol (OR: 1.01; 95% CI, 1.00-1.01). There were no differences in hypertension, diabetes, or other vascular risk factors in APOE ε4+ women compared with noncarriers. Conclusions: Results highlight the importance of baseline cognitive function and general health for late-life cognition among ε4+ women.
Original language | English (US) |
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Pages (from-to) | 1833-1844 |
Number of pages | 12 |
Journal | International Journal of Geriatric Psychiatry |
Volume | 34 |
Issue number | 12 |
DOIs | |
State | Published - Dec 1 2019 |
Keywords
- APOE ε
- cognitive resilience
- mild cognitive impairment
- oldest old
- probable dementia
ASJC Scopus subject areas
- Geriatrics and Gerontology
- Psychiatry and Mental health