Wu Hao, Gu Xingzhong, Liu Shuai, Wang Pan, Lu Hui, Guan Yalin, Shi Zhihong, Ji Yong
Department of Neurology, Tianjin Huanhu Hospital, Tianjin, China.
Clinical College of Neurology, Neurosurgery and Neurorehabilitation, Tianjin Medical University, Tianjin, China.
Int J Geriatr Psychiatry. 2025 Jan;40(1):e70045. doi: 10.1002/gps.70045.
Apolipoprotein E (ApoE) ε4 genotype is a well-known risk factor for Alzheimer's disease (AD). However, its effect on predicting cognitive decline in individuals without dementia and its association with age are unclear.
To investigate the relationship between ApoE polymorphism and risk of cognitive decline and dementia incidence in the elderly without dementia.
This population-based prospective study was conducted between 2011 and 2016. The study involved 767 dementia-free individuals who had undergone ApoE genotype analysis, were aged ≥ 60 years, and lived in rural China. Participants were divided into three ApoE groups: E3 (genotype 3/3), E4 (genotypes 3/4 and 4/4), and E2 (genotype 2/3) groups.
After 5 years, 666 (86.8%) individuals were followed up. The rate of change in MMSE score was faster in the E4 group than in the E3 and E2 groups (5.0 ± 4.4 vs. 3.5 ± 3.8 vs. 3.9 ± 3.9, p = 0.001), after adjusting for age, sex, educational level and baseline MMSE scores, especially in the 70-79 years age group. In the same age group, the incidence rate of dementia was higher in the E4 group than in the E3 group (OR = 2.850; 95% CI: 1.146-7.090). After adjusting for age, sex, hypertensive status, educational level, marital status, engagement in social activities, and past history of stroke, the ApoE ε4 allele remained an independent risk factor for dementia incidence (OR = 3.070; 95% CI: 1.162-8.110) in individuals aged 70-79 years after follow-up.
ApoE ε4 carriers with age ≥ 60 years had faster cognitive decline. The ApoE ε4 allele was an independent risk factor for dementia incidence in extremely old individuals.
载脂蛋白E（ApoE）ε4基因型是阿尔茨海默病（AD）的一个众所周知的危险因素。然而，其对预测无痴呆个体认知功能下降的作用及其与年龄的关系尚不清楚。
探讨ApoE基因多态性与无痴呆老年人认知功能下降风险及痴呆发病率之间的关系。
这项基于人群的前瞻性研究于2011年至2016年进行。该研究纳入了767名无痴呆个体，他们接受了ApoE基因型分析，年龄≥60岁，居住在中国农村。参与者被分为三个ApoE组：E3（基因型3/3）、E4（基因型3/4和4/4）和E2（基因型2/3）组。
5年后，对666名（86.8%）个体进行了随访。在调整年龄、性别、教育水平和基线MMSE评分后，E4组的MMSE评分变化率比E3组和E2组更快（5.0±4.4 vs. 3.5±3.8 vs. 3.9±3.9，p = 0.001），尤其是在70 - 79岁年龄组。在同一年龄组中，E4组的痴呆发病率高于E3组（OR = 2.850；95% CI：1.146 - 7.090）。在随访后，对年龄、性别、高血压状态、教育水平、婚姻状况、社会活动参与情况和既往中风史进行调整后，ApoE ε4等位基因仍然是70 - 79岁个体痴呆发病率的独立危险因素（OR = 3.070；95% CI：1.162 - 8.110）。
年龄≥60岁的ApoE ε4携带者认知功能下降更快。ApoE ε4等位基因是高龄个体痴呆发病率的独立危险因素。
