Luck Tobias, Then Francisca S, Luppa Melanie, Schroeter Matthias L, Arélin Katrin, Burkhardt Ralph, Thiery Joachim, Löffler Markus, Villringer Arno, Riedel-Heller Steffi G
Institute of Social Medicine, Occupational Health and Public Health and LIFE - Leipzig Research Center for Civilization Diseases, University of Leipzig.
Institute of Social Medicine, Occupational Health and Public Health, University of Leipzig.
Neuropsychology. 2015 May;29(3):382-387. doi: 10.1037/neu0000147. Epub 2014 Nov 3.
To test for a possible effect of the apolipoprotein E epsilon 4 (APOE ε4) allele on memory performance and executive functioning (EF) in cognitively intact elderly.
The authors studied 202 randomly selected and cognitively intact older adults (65+ years) of the Leipzig Research Center for Civilization Diseases Health Care Study. Intact global cognitive functioning was defined using a Mini-Mental Status Examination (MMSE) score ≥ 28. Performance in memory was assessed with the CERAD Word List and Constructional Praxis Recall, performance in EF with the Trail Making Test Part B (TMT-B). Multivariable linear regressions were used to evaluate the association between cognitive performance and APOE status, controlled for covariates.
Among the cognitively intact older adults, 21.3% (n = 43) were carriers of the APOE ε4 allele. Carriers did not differ significantly from noncarriers in terms of age, gender, intelligence level, or performance in memory but showed a significantly lower TMT-B performance as a measure of EF (TMT-B M time/SD = 105.6/36.2 vs. 91.9/32.7 s; Mann-Whitney U = 4,313.000; p = .009). The association between lower TMT-B performance and APOE ε4 genotype remained significant in multivariable linear regression analysis. Similar findings were found for the subsample of those 78 elderly, who reached a perfect MMSE-score of 30.
A lower EF performance in cognitively intact older APOE ε4 allele carriers might be related to an early Alzheimer's dementia (AD) prodrome. In this case, a stronger focus on first subtle changes in EF may help to improve early AD detection in those being at genetic risk.
检测载脂蛋白Eε4（APOEε4）等位基因对认知功能正常的老年人记忆表现和执行功能（EF）的可能影响。
作者研究了莱比锡文明病研究中心医疗保健研究中随机选取的202名认知功能正常的老年人（65岁及以上）。使用简易精神状态检查表（MMSE）评分≥28来定义整体认知功能完好。用CERAD单词表和结构实践回忆评估记忆表现，用连线测验B部分（TMT-B）评估EF表现。采用多变量线性回归来评估认知表现与APOE状态之间的关联，并对协变量进行控制。
在认知功能正常的老年人中，21.3%（n = 43）是APOEε4等位基因携带者。携带者在年龄、性别、智力水平或记忆表现方面与非携带者无显著差异，但作为EF指标的TMT-B表现显著较低（TMT-B平均时间/标准差 = 105.6/36.2 vs. 91.9/32.7秒；曼-惠特尼U = 4,313.000；p = .009）。在多变量线性回归分析中，较低的TMT-B表现与APOEε4基因型之间的关联仍然显著。在MMSE得分为30分的78名老年人的子样本中也发现了类似结果。
认知功能正常的老年APOEε4等位基因携带者的EF表现较低可能与早期阿尔茨海默病（AD）前驱症状有关。在这种情况下，更关注EF的首次细微变化可能有助于改善对有遗传风险人群的早期AD检测。
