Allison R. Kaup|Jasmine Nettiksimmons|Tamara B. Harris|Kaycee M. Sink|Suzanne Satterfield|Andrea Metti|Hilsa N. Ayonayon|Kristine Yaffe
Cognitive Resilience to Apolipoprotein E ?4
San Francisco VA Medical Center|University of California, San Francisco|University of California, San Francisco|National Institute on Aging|Wake Forest University|University of Tennessee Health Science Center|University of Pittsburgh|University of California, San Francisco|San Francisco VA Medical Center|University of California, San Francisco
apolipoprotein e apoe 4 established risk factor cognitive decline development dementia factors may help minimize effectsusing apoe 4 indicator high risk investigated factors associated cognitive resilience among black white older adults apoe 4 carriersparticipants included 2487 communitydwelling older aged 6980 years baseline black white adults examined 2 community clinics prospective cohort health aging body composition health abc study baseline visits occurred may 1997 june 1998 primary analytic cohort consisted 670 apoe 4 carriers 329 black 341 white participants free cognitive impairment baseline underwent repeated cognitive testing 11year followup 2008 using modified minimental state examinationwe stratified analyses race using modified minimental state examination scores assessed normative cognitive change entire cohort n 2487 classified apoe 4 carriers cognitively resilient vs nonresilient comparing cognitive trajectories entire cohort conducted bivariate analyses multivariable random forest logistic regression analyses explore factors predictive cognitive resilience apoe 4 carriersamong white apoe 4 carriers strongest predictors cognitive resilience relative order importance recent negative life events higher literacy level advanced age higher educational level time spent reading among black apoe 4 carriers strongest predictors cognitive resilience relative order importance higher literacy level higher educational level female sex absence diabetes mellitus followup logistic regression models higher literacy level adjusted odds ratio 950 95 ci 2676089 higher educational level adjusted college graduate vs less high school 381 95 ci 1131756 age adjusted 7376 vs 6972 years 201 95 ci 113363 significant independent effects predicting cognitive resilience among white apoe 4 carriers among black apoe 4 carriers higher literacy level adjusted 227 95 ci 129406 higher educational level adjusted high school graduatesome college vs less high school 286 95 ci 154549 adjusted college graduate vs less high school 252 95 ci 114562 significant independent effects predicting cognitive resiliencealthough apoe 4 carriers high risk cognitive decline findings suggest possible intervention targets including enhancement cognitive reserve improvement psychosocial health factors promote cognitive resilience among black white apoe 4 carriers