Welsh-Bohmer Katheen A, Ostbye Truls, Sanders Linda, Pieper Carl F, Hayden Kathleen M, Tschanz JoAnn T, Norton Maria C
Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC 27705, USA.
Clin Neuropsychol. 2009 Jan;23(1):77-99. doi: 10.1080/13854040801894730. Epub 2008 Jun 10.
The Cache County Study of Memory in Aging (CCMS) is an epidemiological study of Alzheimer's disease (AD), mild cognitive disorders, and aging in a population of exceptionally long-lived individuals (7th to 11th decade). Observation of population members without dementia provides an opportunity for establishing the range of normal neurocognitive performance in a representative sample of the very old. We examined neurocognitive performance of the normal participants undergoing full clinical evaluations (n = 507) and we tested the potential modifying effects of apolipoprotein E (APOE) genotype, a known genetic risk factor for the later development of AD. The results indicate that advanced age and low education are related to lower test scores across nearly all of the neurocognitive measures. Gender and APOE epsilon4 both had negligible and inconsistent influences, affecting only isolated measures of memory and expressive speech (in case of gender). The gender and APOE effects disappeared once age and education were controlled. The study of this exceptionally long-lived population provides useful normative information regarding the broad range of "normal" cognition seen in advanced age. Among elderly without dementia or other cognitive impairment, APOE does not appear to exert any major effects on cognition once other demographic influences are controlled.
卡什县老年记忆研究（CCMS）是一项针对超长寿命个体（70至110岁）群体中的阿尔茨海默病（AD）、轻度认知障碍及衰老情况的流行病学研究。对无痴呆症的群体成员进行观察，为在非常老龄的代表性样本中确定正常神经认知表现范围提供了契机。我们检查了接受全面临床评估的正常参与者（n = 507）的神经认知表现，并测试了载脂蛋白E（APOE）基因型的潜在调节作用，APOE基因型是AD后期发展的已知遗传风险因素。结果表明，高龄和低教育水平与几乎所有神经认知测量的较低测试分数相关。性别和APOE ε4的影响均微不足道且不一致，仅影响记忆和表达性言语的个别测量（就性别而言）。一旦控制了年龄和教育因素，性别和APOE的影响就消失了。对这个超长寿命群体的研究提供了有关高龄人群广泛“正常”认知范围的有用规范信息。在无痴呆症或其他认知障碍的老年人中，一旦控制了其他人口统计学影响因素，APOE似乎对认知没有任何重大影响。
