Abstract
Background: The apolipoprotein E (APOE) ϵ4 allele and stroke increase the risk of cognitive decline. However, the association of the APOE ϵ4 allele before and after stroke is not well understood. Methods: Using a prospective sample of 3444 (66% African Americans, 61% females, mean age=71.9 y) participants, we examined cognitive decline relative to stroke among those with and without the APOE ϵ4 allele. Results: In our sample, 505 (15%) had incident stroke. Among participants without stroke, the ϵ4 allele was associated with increased cognitive decline compared to noncarriers (0.080 vs. 0.036 units/year; P<0.0001). Among participants without the ϵ4 allele, cognitive decline increased significantly after stroke compared to before stroke (0.115 vs. 0.039 units/year; P<0.0001). Interestingly, cognitive decline before and after stroke was not significantly different among those with the ϵ4 allele (0.091 vs. 0.102 units/year; P=0.32). Poor cognitive function was associated with higher risk of stroke (hazard ratio=1.41, 95% confidence interval, 1.25-1.58), but the APOE ϵ4 allele was not (P=0.66). The APOE ϵ4 allele, cognitive function, and incident stroke were associated with mortality. Conclusions: The association of stroke with cognitive decline appears to differ by the presence of the APOE ϵ4 allele, but no such interaction was observed for mortality.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 318-323 |
| Number of pages | 6 |
| Journal | Alzheimer Disease and Associated Disorders |
| Volume | 30 |
| Issue number | 4 |
| DOIs | |
| State | Published - Jan 1 2016 |
| Externally published | Yes |
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Keywords
- APOE
- cognitive decline
- mortality
- stroke
ASJC Scopus subject areas
- Clinical Psychology
- Gerontology
- Geriatrics and Gerontology
- Psychiatry and Mental health
Cite this
Role of APOE ϵ4 Allele and Incident Stroke on Cognitive Decline and Mortality. / Rajan, Kumar; Aggarwal, Neelum T.; Schneider, Julie A.; Wilson, Robert S.; Everson-Rose, Susan A.; Evans, Denis A.
In: Alzheimer Disease and Associated Disorders, Vol. 30, No. 4, 01.01.2016, p. 318-323.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Role of APOE ϵ4 Allele and Incident Stroke on Cognitive Decline and Mortality
AU - Rajan, Kumar
AU - Aggarwal, Neelum T.
AU - Schneider, Julie A.
AU - Wilson, Robert S.
AU - Everson-Rose, Susan A.
AU - Evans, Denis A.
PY - 2016/1/1
Y1 - 2016/1/1
N2 - Background: The apolipoprotein E (APOE) ϵ4 allele and stroke increase the risk of cognitive decline. However, the association of the APOE ϵ4 allele before and after stroke is not well understood. Methods: Using a prospective sample of 3444 (66% African Americans, 61% females, mean age=71.9 y) participants, we examined cognitive decline relative to stroke among those with and without the APOE ϵ4 allele. Results: In our sample, 505 (15%) had incident stroke. Among participants without stroke, the ϵ4 allele was associated with increased cognitive decline compared to noncarriers (0.080 vs. 0.036 units/year; P<0.0001). Among participants without the ϵ4 allele, cognitive decline increased significantly after stroke compared to before stroke (0.115 vs. 0.039 units/year; P<0.0001). Interestingly, cognitive decline before and after stroke was not significantly different among those with the ϵ4 allele (0.091 vs. 0.102 units/year; P=0.32). Poor cognitive function was associated with higher risk of stroke (hazard ratio=1.41, 95% confidence interval, 1.25-1.58), but the APOE ϵ4 allele was not (P=0.66). The APOE ϵ4 allele, cognitive function, and incident stroke were associated with mortality. Conclusions: The association of stroke with cognitive decline appears to differ by the presence of the APOE ϵ4 allele, but no such interaction was observed for mortality.
AB - Background: The apolipoprotein E (APOE) ϵ4 allele and stroke increase the risk of cognitive decline. However, the association of the APOE ϵ4 allele before and after stroke is not well understood. Methods: Using a prospective sample of 3444 (66% African Americans, 61% females, mean age=71.9 y) participants, we examined cognitive decline relative to stroke among those with and without the APOE ϵ4 allele. Results: In our sample, 505 (15%) had incident stroke. Among participants without stroke, the ϵ4 allele was associated with increased cognitive decline compared to noncarriers (0.080 vs. 0.036 units/year; P<0.0001). Among participants without the ϵ4 allele, cognitive decline increased significantly after stroke compared to before stroke (0.115 vs. 0.039 units/year; P<0.0001). Interestingly, cognitive decline before and after stroke was not significantly different among those with the ϵ4 allele (0.091 vs. 0.102 units/year; P=0.32). Poor cognitive function was associated with higher risk of stroke (hazard ratio=1.41, 95% confidence interval, 1.25-1.58), but the APOE ϵ4 allele was not (P=0.66). The APOE ϵ4 allele, cognitive function, and incident stroke were associated with mortality. Conclusions: The association of stroke with cognitive decline appears to differ by the presence of the APOE ϵ4 allele, but no such interaction was observed for mortality.
KW - APOE
KW - cognitive decline
KW - mortality
KW - stroke
UR - http://www.scopus.com/inward/record.url?scp=84995470040&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84995470040&partnerID=8YFLogxK
U2 - 10.1097/WAD.0000000000000173
DO - 10.1097/WAD.0000000000000173
M3 - Article
C2 - 27849638
AN - SCOPUS:84995470040
VL - 30
SP - 318
EP - 323
JO - Alzheimer Disease and Associated Disorders
JF - Alzheimer Disease and Associated Disorders
SN - 0893-0341
IS - 4
ER -