Hao Wu, Xingzhong Gu, Shuai Liu, Pan Wang, Hui Lu, Yalin Guan, Zhihong Shi, Yong Ji
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Participants were divided into three ApoE groups: E3 (genotype 3/3), E4 (genotypes 3/4 and 4/4), and E2 (genotype 2/3) groups.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusions: </strong>ApoE ε4 carriers with age ≥ 60 years had faster cognitive decline. 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引用次数: 0
摘要
背景：载脂蛋白E (ApoE) ε4基因型是众所周知的阿尔茨海默病（AD）的危险因素。然而，它在预测非痴呆个体认知能力下降方面的作用及其与年龄的关系尚不清楚。目的：探讨ApoE多态性与老年非痴呆患者认知能力下降及痴呆发病率的关系。方法：这项基于人群的前瞻性研究于2011年至2016年进行。该研究涉及767名无痴呆的个体，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。结果：5年后随访666例（86.8%）。在调整年龄、性别、教育程度和基线MMSE评分后，E4组的MMSE评分变化率快于E3和E2组（5.0±4.4 vs. 3.5±3.8 vs. 3.9±3.9,p = 0.001），特别是在70-79岁年龄组。同一年龄组中，E4组痴呆发病率高于E3组(OR = 2.850；95% ci: 1.146-7.090)。在调整了年龄、性别、高血压状况、教育程度、婚姻状况、社会活动参与和卒中史等因素后，ApoE ε4等位基因仍然是痴呆发病的独立危险因素(OR = 3.070；95% CI: 1.162-8.110)，随访后年龄在70-79岁的个体。结论：年龄≥60岁的ApoE ε4携带者认知能力下降较快。ApoE ε4等位基因是极老年人痴呆发病的独立危险因素。
ApoE Genotype, Age, and Cognitive Decline in Old Chinese Individuals Without Dementia: A Population-Based Study With Five-Year Follow-Up.
Background: 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.
Objective: To investigate the relationship between ApoE polymorphism and risk of cognitive decline and dementia incidence in the elderly without dementia.
Methods: 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.
Results: 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.
Conclusions: 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.
期刊介绍：
The rapidly increasing world population of aged people has led to a growing need to focus attention on the problems of mental disorder in late life. The aim of the Journal is to communicate the results of original research in the causes, treatment and care of all forms of mental disorder which affect the elderly. The Journal is of interest to psychiatrists, psychologists, social scientists, nurses and others engaged in therapeutic professions, together with general neurobiological researchers.
The Journal provides an international perspective on the important issue of geriatric psychiatry, and contributions are published from countries throughout the world. Topics covered include epidemiology of mental disorders in old age, clinical aetiological research, post-mortem pathological and neurochemical studies, treatment trials and evaluation of geriatric psychiatry services.
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