Document Detail


Cerebral atrophy, apolipoprotein E varepsilon4, and rate of decline in everyday function among patients with amnestic mild cognitive impairment.
MedLine Citation:
PMID:  20813341     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Patients with amnestic mild cognitive impairment (MCI) demonstrate decline in everyday function. In this study, we investigated whether whole brain atrophy and apolipoprotein E (APOE) genotype are associated with the rate of functional decline in MCI.
METHODS: Participants were 164 healthy controls, 258 MCI patients, and 103 patients with mild Alzheimer's disease (AD), enrolled in the Alzheimer's Disease Neuroimaging Initiative. They underwent brain MRI scans, APOE genotyping, and completed up to six biannual Functional Activities Questionnaire (FAQ) assessments. Random effects regressions were used to examine trajectories of decline in FAQ across diagnostic groups, and to test the effects of ventricle-to-brain ratio (VBR) and APOE genotype on FAQ decline among MCI patients.
RESULTS: Rate of decline in FAQ among MCI patients was intermediate between that of controls and mild AD patients. Patients with MCI who converted to mild AD declined faster than those who remained stable. Among MCI patients, increased VBR and possession of any APOE varepsilon4 allele were associated with faster rate of decline in FAQ. In addition, there was a significant VBR by APOE varepsilon4 interaction such that patients who were APOE varepsilon4 positive and had increased atrophy experienced the fastest decline in FAQ.
CONCLUSIONS: Functional decline occurs in MCI, particularly among patients who progress to mild AD. Brain atrophy and APOE varepsilon4 positivity are associated with such declines, and patients who have elevated brain atrophy and are APOE varepsilon4 positive are at greatest risk of functional degradation. These findings highlight the value of genetic and volumetric MRI information as predictors of functional decline, and thus disease progression, in MCI.
Authors:
Ozioma C Okonkwo; Michael L Alosco; Beth A Jerskey; Lawrence H Sweet; Brian R Ott; Geoffrey Tremont;
Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, Non-P.H.S.    
Journal Detail:
Title:  Alzheimer's & dementia : the journal of the Alzheimer's Association     Volume:  6     ISSN:  1552-5279     ISO Abbreviation:  Alzheimers Dement     Publication Date:  2010 Sep 
Date Detail:
Created Date:  2010-09-03     Completed Date:  2010-12-20     Revised Date:  2013-05-28    
Medline Journal Info:
Nlm Unique ID:  101231978     Medline TA:  Alzheimers Dement     Country:  United States    
Other Details:
Languages:  eng     Pagination:  404-11     Citation Subset:  IM    
Copyright Information:
Copyright 2010 The Alzheimer
Affiliation:
Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA. ozioma@jhmi.edu
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MeSH Terms
Descriptor/Qualifier:
Activities of Daily Living*
Aged
Aged, 80 and over
Alzheimer Disease* / complications,  genetics,  pathology
Apolipoprotein E4 / genetics*
Atrophy / pathology
Brain / pathology*
Cerebral Ventricles / pathology
Cognition Disorders* / complications,  genetics,  pathology
Female
Humans
Magnetic Resonance Imaging / methods
Male
Neuropsychological Tests
Psychiatric Status Rating Scales
Questionnaires
Statistics as Topic
Grant Support
ID/Acronym/Agency:
U01 AG024904/AG/NIA NIH HHS; U01 AG024904-01/AG/NIA NIH HHS
Chemical
Reg. No./Substance:
0/Apolipoprotein E4
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