Problems meeting basic needs moderate the association between the APOE epsilon4 allele and cognitive decline.

OBJECTIVES

The ApolipoproteinE epsilon4 (APOE epsilon4) allele influences cognitive decline (CD) in some but not in all individuals. The purpose of this study was to investigate whether problems meeting basic needs (BN) (e.g., having enough money to meet needs, having enough money for emergencies, having adequate housing, and having enough heat) influences the relationship between the APOE epsilon4 allele and CD. We predicted that problems meeting BN would have a greater influence on CD among those with the APOE epsilon4 allele than those without the allele.

METHODS

Participants consisted of community-dwelling older adults from the Duke Established Populations for Epidemiologic Studies of the Elderly (EPESE). Data were drawn from Waves 1 and 2, which were 3 years apart. Cognitive functioning was assessed at both waves so that change in cognitive status was examined over time, and cognitive status was controlled at baseline. Genotyping, however, was not obtained until Wave 3.

RESULTS

The APOE epsilon4 allele and problems meeting BN independently predicted CD. Importantly, the influence of BN on CD was greater for individuals with the APOE epsilon4 allele compared to those without the allele. Other indicators of socioeconomic status (e.g., education, income) did not interact with the APOE epsilon4 allele in predicting CD.

CONCLUSIONS

There is a synergistic effect of perceived problems meeting BN and the APOE epsilon4 allele on jointly influencing cognitive functioning. Although genetic risk factors are not easily modifiable, resource deprivation may be more amenable to interventions, which may reduce risk for CD.