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Fourteen-year longitudinal study of vascular risk factors, APOE genotype, and cognition: the ARIC MRI Study.

TitleFourteen-year longitudinal study of vascular risk factors, APOE genotype, and cognition: the ARIC MRI Study.
Publication TypeJournal Article
Year of Publication2009
AuthorsKnopman DS, Mosley TH, Catellier DJ, Coker LH
Corporate AuthorsAtherosclerosis Risk in Communities Study Brain MRI Study
JournalAlzheimers Dement
Volume5
Issue3
Pagination207-14
Date Published2009 May
ISSN1552-5279
KeywordsAged, Apolipoprotein E4, Cholesterol, Cognition Disorders, Diabetes Mellitus, Female, Genotype, Humans, Hypertension, Language Tests, Linear Models, Logistic Models, Longitudinal Studies, Magnetic Resonance Imaging, Male, Middle Aged, Multivariate Analysis, Neuropsychological Tests, Odds Ratio, Risk Factors, Stroke
Abstract

BACKGROUND: Strokes, vascular risk factors, and apolipoprotein E (APOE) genotype are associated with cognitive decline in the elderly, but definitive evidence that these affect cognition as early as middle age is limited.

OBJECTIVE: We describe the relationships of APOE genotype, stroke, and vascular risk factors with cognitive change over a 14-year follow-up in the Atherosclerosis Risk in Communities (ARIC) Study cohort recruited while in middle age.

METHODS: Participants included a subset of the ARIC Study who underwent assessments of cognitive function and vascular risk factors. Four cognitive assessments were performed between 1990-1992 and 2004-2006. Cognitive assessments included the Delayed Word Recall (DWR) Test, the Digit Symbol Substitution (DSS) Test, and the Word Fluency (WF) Test. Vascular risk factors were assessed during the baseline visit in 1990-1992. Incident stroke was recorded over the 14 years of follow-up.

RESULTS: There were 1130 participants (mean age, 59 +/- 4.3 [SD] years; 62% women; 52% African-American) with longitudinal data. In multivariate, random-effects linear models adjusted for age, education, gender, and race, the risk factors diabetes and APOE epsilon4 genotype were independently associated with a decline in performance on the DSS test (both P

CONCLUSIONS: The vascular risk factors diabetes and hypertension, a history of stroke itself, and APOE epsilon4 genotype independently contribute to cognitive decline in late middle age and early elderly years.

DOI10.1016/j.jalz.2009.01.027
Alternate JournalAlzheimers Dement
PubMed ID19362884
Grant ListN01-HC-55015 / HC / NHLBI NIH HHS / United States
N01-HC-55016 / HC / NHLBI NIH HHS / United States
N01-HC-55018 / HC / NHLBI NIH HHS / United States
N01-HC-55019 / HC / NHLBI NIH HHS / United States
N01-HC-55020 / HC / NHLBI NIH HHS / United States
N01-HC-55021 / HC / NHLBI NIH HHS / United States
N01-HC-55022 / HC / NHLBI NIH HHS / United States
R01- HL 70825 / HL / NHLBI NIH HHS / United States