Is the APOE ∊4 Allele a Risk to Person-Environment Fit?

This study uses Lawton’s model of “the good life” to examine whether the Apolipoprote in E-∊4 genotype functions as a risk factor not only for specific diseases but also for a misfit between elders’ personal needs and their physical and social environments. A biracial cohort of communitydwelling elders from five North Carolina Piedmont counties was assessed annually for 10 years. Six-year survivors (N = 2,076) were genotyped for this retrospective-prospective cohort study. Compared to those in whom this allele was absent, participants with the 4 allele were not different in social or residential resources, social behavioral competence, or perceived quality of resources. Exposed elders had an excess 10-year adjusted risk of institutionalization of 1.72 (95% CI = 1.29, 2.29), totally mediated by cognitive problems. The threat of the APOE 4 genotype to person-environment fit is mediated by cognitive problems, a finding that has focused but important implications for residential decision making in late life.