@article{03060399457a4b2d99c398a4ea9dd330,
title = "Cognitive resilience among APOE ε4 carriers in the oldest old",
abstract = "Objectives: Relatively few APOE ε4+ carriers survive to old age (age 80+) without cognitive impairment (CI); thus, little is known about distinguishing characteristics of resilient APOE ε4+ carriers. Herein, we describe the sociodemographic characteristics of a large sample of resilient APOE ε4+ women from the Women's Health Initiative Memory Study (WHIMS) and compare them to noncarriers and APOE ε4+ women who developed CI before age 80. Methods: Women were recruited for clinical trials evaluating postmenopausal hormone therapy and incidence of dementia. During posttrial follow-up, cognitive status was adjudicated annually. Among 5716 women, we compared groups by APOE ε4 status using logistic regression, covarying for treatment, demographics, lifestyle, cardiovascular and physical function, well-being, and self-rated general health. Results: Among 557 APOE ε4+ women, those who survived to age 80+ without CI had higher baseline self-rated general health (odds ratio [OR]: 1.02; 95% confidence interval [CI], 1.01-1.04) and cognitive scores (OR: 1.18; 95% CI, 1.12-1.25) than those who did not reach age 80 without CI. Baseline high total cholesterol and low-density lipoprotein (LDL) levels were similar across APOE ε4+ groups but were higher compared with APOE ε4− women. Among women who survived to 80+ without CI, more APOE ε4+ women had a history of high total cholesterol (P =.003) and LDL cholesterol (OR: 1.01; 95% CI, 1.00-1.01). There were no differences in hypertension, diabetes, or other vascular risk factors in APOE ε4+ women compared with noncarriers. Conclusions: Results highlight the importance of baseline cognitive function and general health for late-life cognition among ε4+ women.",
keywords = "APOE ε, cognitive resilience, mild cognitive impairment, oldest old, probable dementia",
author = "Hayden, {Kathleen M.} and Gaussoin, {Sarah A.} and Hunter, {Jaimie C.} and Manson, {Jo Ann E.} and Sachs, {Bonnie C.} and Shadyab, {Aladdin H.} and Tindle, {Hilary A.} and Yasmin Mossavar-Rahmani and Khyobeni Mozhui and Snively, {Beverly M.} and Rapp, {Stephen R.} and Resnick, {Susan M.}",
note = "Funding Information: The Women's Health Initiative (WHI) program is funded by the National Heart, Lung, and Blood Institute, National Institutes of Health, U.S. Department of Health and Human Services through contracts HHSN268201600018C, HHSN268201600001C, HHSN268201600002C, HHSN268201600003C, and HHSN268201600004C. The Women's Health Initiative Memory Study (WHIMS) was funded in part by Wyeth Pharmaceuticals, St. Davids, PA. The WHIMS Extension was funded by the National Institute on Aging contract HHSN26820044221C and WHIMS-ECHO is funded by the National Institute on Aging, Contracts HHSN271201100004C, HHSN26820044221C, HHSN271201100004C. Drs Hayden, Rapp, and Sachs receive additional funding from National Institute of Aging P30 AG049638. We also wish to acknowledge the contributions of the WHI investigators: Program office: Jacques Rossouw, Shari Ludlam, Joan McGowan, Leslie Ford, and Nancy Geller (National Heart, Lung, and Blood Institute, Bethesda, Maryland). Clinical Coordinating Center: Garnet Anderson, Ross Prentice, Andrea LaCroix, and Charles Kooperberg (Fred Hutchinson Cancer Research Center, Seattle, WA). Investigators and Academic Centers: JoAnn E. Manson (Brigham and Women's Hospital, Harvard Medical School, Boston, MA); Barbara V. Howard (MedStar Health Research Institute/Howard University, Washington, DC); Marcia L. Stefanick (Stanford Prevention Research Center, Stanford, CA); Rebecca Jackson (The Ohio State University, Columbus, OH); Cynthia A. Thomson (University of Arizona, Tucson/Phoenix, AZ); Jean Wactawski-Wende (University at Buffalo, Buffalo, NY); (University of Florida, Gainesville/Jacksonville, FL) Marian Limacher; Jennifer Robinson (University of Iowa, Iowa City/Davenport, IA); Lewis Kuller (University of Pittsburgh, Pittsburgh, PA); Sally Shumaker (Wake Forest University School of Medicine, Winston-Salem, NC); Robert Brunner (University of Nevada, Reno, NV); Karen L. Margolis (University of Minnesota, Minneapolis, MN). Women's Health Initiative Memory Study: Steve Rapp and Mark Espeland (Wake Forest University School of Medicine Winston-Salem, NC). For a list of all the investigators who have contributed to WHI science, please visit: https://www.whi.org/researchers/Documents%20%20Write%20a%20Paper/WHI%20Investigator%20Long%20List.pdf Publisher Copyright: {\textcopyright} 2019 John Wiley & Sons, Ltd.",
year = "2019",
month = dec,
day = "1",
doi = "10.1002/gps.5199",
language = "English (US)",
volume = "34",
pages = "1833--1844",
journal = "International Journal of Geriatric Psychiatry",
issn = "0885-6230",
publisher = "John Wiley and Sons Ltd",
number = "12",
}
