Neurology: Differential effects of apolipoprotein e and modifiable risk factors on hippocampal volume loss and memory decline in the elderly

Prospective studies have shown that each _ Both increase the risk of cognitive decline, especially in episodic memory, brain shrinkage, especially in the hippocampus, and ultimately Alzheimer's disease (AD) dementia .

Prospective studies have shown that each _ Both increase the risk of cognitive decline, especially in episodic memory, brain shrinkage, especially in the hippocampus, and ultimately Alzheimer's disease (AD) dementia .

Although subtle, Aβ accumulation can occur up to 30 years before clinical classification of dementia, providing an opportunity to implement strategies to reduce this risk

The Cardiovascular Risk Factors, Aging and Incidence of Dementia (CAIDE) risk score is a well-validated dementia risk score that includes age, gender, APOE ε4 status, education, hypertension, body mass index (BMI) , hypercholesterolemia Symptoms and physical inactivity

Given the central role of brain Aβ on AD risk, and the observation that age and APOE ε4 increase AD dementia risk by affecting Aβ accumulation, modifiable risk factors included in the CAIDE risk score may increase or amplify the risk of Aβ by increasing or amplifying age or APOE ε4 carry.

We conducted a prospective study to determine cardiovascular risk factors, aging, dementia incidence (caide) risk score and hippocampal volume (hv) loss and episodic memory (em) decline in cognitively normal (cn) older adults.

Australian Imaging, Biomarkers and Life>
.

The researchers calculated each participant's (CAIDE) risk score (age, sex, apolipoprotein E-type (apoe) ε4 status, education level, hypertension, body mass index (bmi), hypercholesterolemia, physical inactivity ) and modifiable (CAIDE) risk scores (caide-mr; education, hypertension, bmi, hypercholesterolemia, physical inactivity)

Australian Imaging, Biomarkers and Life>

• The interaction of aβ group × caide × time had a significant effect on HV loss (β (se) = 0.
  04(0.
  01) ; p < .
  000) , but not on EM decline (β (se) = -2.
  33(9.
  96) ; p = .
  98)
  .
  
• Decomposition revealed a significant caide × time interaction only for Aβ participants
  .
  
• Considering the variable/invariant caide components separately, a significant aβ × caide × time interaction was observed for EM decline only (β (se) = 3.
  03(1.
  18) ; p = .
  01)
  .
  
• Significant caide-score × time interactions were observed only in Aβ participants
  .
  
• Both apoeε4 and age × time had significant interaction effects on HV loss and EM decline in both groups
  .
  
• Exploratory analysis of aβ-cn participants revealed a significant interaction between BMI × time and EM decline (β(se) = -3.
  30(1.
  43); p = .
  02)
  .
  

The interaction of aβ group × caide × time had a significant effect on HV loss (β (se) = 0.
04(0.
01) ; p < .
000) , but not on EM decline (β (se) = -2.
33(9.
96) ; p = .
98)
.

The interaction of aβ group × caide × time had a significant effect on HV loss (β (se) = 0.
04(0.
01) ; p < .
000) , but not on EM decline (β (se) = -2.
33(9.
96) ; p = .
98)
.

Decomposition revealed a significant caide × time interaction only for Aβ participants

These results are in line with studies showing that increasing age, APOE ε4 is associated with increased rates of HV loss and EM decline

Source: Rosenich E, Bransby L, Yassi N, et al.

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