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The apolipoprotein E4 allele (APOE epsilon 4) and atherosclerosis are risk factors for cognitive decline. We investigated whether the effects of APOE epsilon 4 and atherosclerosis on cognitive decline are independent. A population-based follow-up study was performed on 838 subjects who were non-demented at baseline. The Mini Mental State Examination (MMSE) score at follow-up was studied as a function of APOE epsilon 4 and atherosclerosis. Mild, non-significant effects on the MMSE score were found for atherosclerosis in the absence of APOE epsilon 4 and for APOE epsilon 4 in the absence of atherosclerosis. APOE epsilon 4 carriers with two or more indicators of atherosclerosis positive, had a significantly lower MMSE score at follow-up (mean difference -0.7 points; 95% confidence interval -1.1 to -0.2) relative to non-APOE epsilon 4 carriers with no evidence of atherosclerosis. Our findings suggest that the consequences of APOE epsilon 4 and atherosclerosis are not independent, and that particularly APOE epsilon 4 carriers with atherosclerosis are at increased risk of cognitive decline.

Original publication

DOI

10.1007/978-3-7091-6467-9_3

Type

Journal article

Journal

Journal of neural transmission. Supplementum

Publication Date

01/1998

Volume

53

Pages

17 - 29

Addresses

Department of Epidemiology and Biostatistics, Erasmus University Medical School, Rotterdam, The Netherlands.

Keywords

Humans, Arteriosclerosis, Apolipoproteins E, Follow-Up Studies, Cognition Disorders, Psychiatric Status Rating Scales, Genotype, Aged, Middle Aged, Netherlands, Female, Male