<i>APOE ε4 does not predict mortality, cognitive decline, or dementia in the oldest old</i>

Juva, Kati; Verkkoniemi, Auli; Viramo, Petteri; Polvikoski, Tuomo; Kainulainen, Katariina; Kontula, Kimmo; Sulkava, Raimo

doi:10.1212/wnl.54.2.412

Cited by 99 publications

(85 citation statements)

References 21 publications

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“…Consistent with our results, most studies have shown a strong relationship between APOE4ϩ status and dementia incidence in participants with cognitive impairment, 30 -32 but not all studies have found the relationship. 33,34 We found memory impairment to be an important factor leading to higher rates of incident dementia, particularly AD. Participants with aMCI progressed to dementia at a high rate of 31% per year, whereas participants with OCI progressed to dementia at nearly 40% per year.…”

Section: Resultsmentioning

confidence: 86%

Incidence of dementia in oldest-old with amnestic MCI and other cognitive impairments

Peltz¹,

Corrada²,

Berlau³

et al. 2011

Neurology

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Objective: To examine the incidence of dementia among the oldest-old people with normal cognition and different types of cognitive impairment.Methods: This study included 395 participants without dementia (mean age 93.3 years) from The 90ϩ Study, a prospective, population-based study of aging and dementia in people aged 90 years and older. The participants had evaluations for dementia every 6 months, and their average follow-up was 2.5 years. We examined the incidence of all-cause dementia in participants stratified into 4 cognitive groups: normal, amnestic mild cognitive impairment (aMCI), nonamnestic mild cognitive impairment (naMCI), and other cognitive impairment (OCI).Results: Dementia incidence was highest for participants with aMCI (31.4% per year) and OCI (39.9% per year). Participants with naMCI had an incidence of 14.1% per year, and participants with normal cognition had an incidence of 8.4% per year. Dementia incidence was associated with increasing age in both normal and cognitively impaired participants; however, an APOE4 allele was associated with a higher dementia incidence only in participants with baseline cognitive impairment. Conclusions:The risk of developing dementia in the oldest-old is high and increases to higher rates when cognitive impairment is present. Similar to results of studies in younger elderly individuals, cognitive impairment and increasing age were related to increased dementia incidence. High dementia incidence rates in the oldest-old individuals, particularly when cognitively impaired, emphasize the need to further study cognitive impairment and dementia in this rapidly expanding age group. Neurology Less than 1% of people aged 65-70 years develop dementia each year, 1 and incidence approximately doubles with every 5 years of increasing age.2 A previous study of the current cohort 3 found that the doubling of incidence extends to ages 90 and older (the oldest-old), with 13% of 90-to 94-year-old, 21% of 95-to 99-year-old, and 41% of 100-year-old individuals developing dementia each year. Hence, dementia incidence is very high in the oldest-old, the fastest growing age group in the United States. 4Compared with normal individuals, cognitively impaired individuals, particularly those with memory impairments, have an increased risk of developing dementia. Population studies have found that approximately 6%-15% of 80-year-old individuals with mild cognitive impairment (MCI) develop dementia each year compared with 1%-2% per year of elderly individuals with normal cognition.5-8 Few studies have examined dementia incidence in oldest-old individuals with different types of cognitive impairment.This study examined the incidence of dementia in the oldest-old stratified into 4 groups: normal, amnestic mild cognitive impairment (aMCI), nonamnestic mild cognitive impairment

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Section: Resultsmentioning

confidence: 86%

Incidence of dementia in oldest-old with amnestic MCI and other cognitive impairments

Peltz¹,

Corrada²,

Berlau³

et al. 2011

Neurology

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“…Although the association of APOE e4 with incident MCI has not been reported in the oldest old, the impact of the e4 allele on dementia risk is thought to be minimal or absent in the oldest old. 32 In the 901 study, APOE e4 carrier status (vs e3e3) was associated with dementia in cross-sectional but not in prospective analyses. 33 The frequency of an APOE e4 allele was only 8.1% in the incident cohort, compared to 18.8% in the present study.…”

Section: -19mentioning

confidence: 93%

Risk and protective factors for cognitive impairment in persons aged 85 years and older

et al. 2015

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Objective: To determine risk and protective factors for mild cognitive impairment (MCI) among persons 85 years and older.Methods: Participants in the population-based prospective Mayo Clinic Study of Aging were comprehensively evaluated at baseline and at 15 monthly intervals to determine incident MCI. At baseline, lifestyle factors in midlife and late life were assessed by self-reported questionnaire; vascular and comorbid conditions were abstracted from participants' medical records.Results: Of 256 participants who were cognitively normal at enrollment (median age 87.3 years, Individuals aged 85 years and older are the most rapidly growing group in the United States and worldwide.1 Studies of the oldest old are difficult to conduct and to interpret. Persons aged 90 years and older typically have sensory losses, difficulty providing valid and reliable information, high comorbidity, and a high prevalence of dementia 2 ; most are typically women. Often, factors associated with risk of cognitive impairment at younger ages are no longer predictive, raising the possibility that multiple coexisting diseases might be more predictive than solitary diseases. Because many individuals aged 90 years and older already have early stages of mild cognitive impairment (MCI), studies are often cross-sectional and can only assess risk of dementia or Alzheimer disease (AD). Furthermore, potential interventions at these ages may have limited long-term benefit. The goal of this study was to identify risk and protective factors for incident MCI among cognitively normal persons aged 85-89 years at enrollment to the Mayo Clinic Study of Aging (MCSA).METHODS Study cohort at baseline. Participants were randomly selected from among Olmsted County, Minnesota, residents for participation in the MCSA. Details of the study design and methodology have been published. 3,4 Briefly, residents aged 70-89 years were identified using the medical records linkage system of the Rochester Epidemiology Project (REP).5 Eligible participants wereFrom the Divisions

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“…Studies that found a positive correlation between severity of dementia and mortality were not exclusively based on an observation interval of more than 5 years. Yet, two studies had a shorter period of observation [25,32] and neither of them showed a signifi cant correlation between severity of the disorder and mortality risk. Aevarsson et al [20] observed that patients with a mild AD tended to have a higher mortality only at the end of a 7-year observation interval.…”

Section: Specifi C Characteristics Of the Disordersmentioning

confidence: 99%

Mortality in Dementia

Guehne

Riedel‐Heller

Angermeyer³

2005

Neuroepidemiology

101

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The objective of this work is to provide a review of the mortality risk in dementia and potential influencing factors. In order to do so, studies on mortality in dementia based on population-based samples of the last 15 years published in PubMed, Web of Science and PSYNDEXplus were considered. Without exception, all types of dementia are associated with a considerably increased mortality risk. Moreover, the risk of death rises with advancing severity of the disorder. Often, a more favorable course of the disease can be found in Alzheimer’s disease. Further questions, such as the influence of age and sex, cannot be answered conclusively. Very little information can be found on aspects concerning comorbidity, APOE polymorphism or depressive symptomatology.

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APOE ε4 does not predict mortality, cognitive decline, or dementia in the oldest old

Cited by 99 publications

References 21 publications

Incidence of dementia in oldest-old with amnestic MCI and other cognitive impairments

Incidence of dementia in oldest-old with amnestic MCI and other cognitive impairments

Risk and protective factors for cognitive impairment in persons aged 85 years and older

Mortality in Dementia

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