Cognitive resilience among APOE ?4 carriers in the oldest old.

ABSTRACT: OBJECTIVES:Relatively few APOE ?4+ carriers survive to old age (age 80+) without cognitive impairment (CI); thus, little is known about distinguishing characteristics of resilient APOE ?4+ carriers. Herein, we describe the sociodemographic characteristics of a large sample of resilient APOE ?4+ women from the Women's Health Initiative Memory Study (WHIMS) and compare them to noncarriers and APOE ?4+ 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 ?4 status using logistic regression, covarying for treatment, demographics, lifestyle, cardiovascular and physical function, well-being, and self-rated general health. RESULTS:Among 557 APOE ?4+ 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 ?4+ groups but were higher compared with APOE ?4- women. Among women who survived to 80+ without CI, more APOE ?4+ 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 ?4+ women compared with noncarriers. CONCLUSIONS:Results highlight the importance of baseline cognitive function and general health for late-life cognition among ?4+ women.

SUBMITTER: Hayden KM 

PROVIDER: S-EPMC7143252 | biostudies-literature | 2019 Dec

REPOSITORIES: biostudies-literature