Onset of Memory Loss in Alzheimer's Tied to APOE Status
Evans, Jeff, Clinical Psychiatry News
A divergence in the age-related memory performance of individuals according to their apolipoprotein e4 allele status begins around the age of 55-60 years in neuropsychologic testing, according to a longitudinal analysis of 815 individuals.
The divergence in memory performance may "date the onset of cognitive decline due to Alzheimer's disease for the first time," said Dr. Richard J. Caselli, who reported the findings with his colleagues in the July 16 issue of the New England Journal of Medicine.
"We're following people before they're changing and have captured the change point," said Dr. Caselli of the Mayo Clinic, Scottsdale, Ariz., noting that one might be able to detect Alzheimer's disease-related changes even earlier with imaging or at a pathologic, microscopic level.
Dr. Caselli and his associates followed 498 noncarriers of the apolipoprotein e4 (APOE e4) allele and 79 homozygous APOE e4 and 238 heterozygous APOE e4 carriers during a period of about 5 years in either the Arizona APOE cohort or the Arizona Alzheimer's Disease Center cohort. The patients' ages ranged from 21 to 97 years. All of the e4 heterozygotes carried an APOE e3 allele, rather than an e2 allele, which is known to be protective against Alzheimer's disease (N. Engl. J. Med. 2009;361:255-63).
In analyses that isolated the longitudinal aspect of age on cognitive measures in cross-sectional and longitudinal data, the researchers found that APOE e4 carriers had significantly greater predicted decline on the Auditory-Verbal Learning Test--the primary end point of the study--beginning in their 50s, compared with the predicted annual decline of noncarriers beginning in their 70s. …