Mental Health Research Institute, The University of Melbourne, Parkville, Australia.
Neurology. 2012 Oct 16;79(16):1645-52. doi: 10.1212/WNL.0b013e31826e9ae6.
Although the APOE ε4 allele is associated with more rapid decline in memory in healthy older adults, the significance of elevated cerebral β-amyloid (Aβ) load for longitudinal changes in cognition is unclear.
Healthy and cognitively normal older adults (n = 141; mean age 76 years) underwent PET neuroimaging for cerebral Aβ, APOE genotyping, and cognitive assessment as part of their baseline assessment in the Australian Imaging Biomarkers and Lifestyle study. Cognitive function was reassessed 18 months later.
Linear mixed-model analyses adjusted for baseline cognitive function indicated that, relative to individuals with low cerebral Aβ, individuals with high cerebral Aβ showed significantly greater decline in working memory and verbal and visual episodic memory at 18 months. Compared with noncarriers, APOE ε4 carriers showed a greater decline in visual memory at the 18-month assessment. No interaction between APOE ε4 and cerebral Aβ load was observed for any measure of cognitive function.
In this prospective study of healthy older adults, high cerebral Aβ load was associated with greater decline in episodic and working memory over 18 months. The APOE ε4 genotype was also associated with a decline in visual memory, although the effect was less than that observed for cerebral Aβ load.
尽管载脂蛋白 E ε4 等位基因与健康老年人群记忆衰退速度加快有关，但脑β-淀粉样蛋白（Aβ）负荷升高对认知纵向变化的意义尚不清楚。
健康且认知正常的老年受试者（n=141；平均年龄 76 岁）接受了脑 Aβ 的正电子发射断层扫描（PET）神经影像学检查、APOE 基因分型和认知评估，作为其澳大利亚成像生物标志物和生活方式研究基线评估的一部分。18 个月后重新评估认知功能。
线性混合模型分析调整了基线认知功能，结果表明，与脑 Aβ 水平较低的个体相比，脑 Aβ 水平较高的个体在 18 个月时工作记忆、言语和视觉情景记忆的下降更为明显。与非携带者相比，APOE ε4 携带者在 18 个月评估时视觉记忆下降更为明显。在任何认知功能测量中，APOE ε4 和脑 Aβ 负荷之间均未观察到相互作用。
在这项针对健康老年人群的前瞻性研究中，脑 Aβ 负荷较高与 18 个月内情景记忆和工作记忆的下降有关。APOE ε4 基因型也与视觉记忆下降有关，尽管其影响小于脑 Aβ 负荷的影响。
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