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Individual Growth Curve Analysis of APOE  4–Associated Cognitive Decline in Alzheimer Disease
Brian D. Hoyt, PhD;
Paul J. Massman, PhD;
Christopher Schatschneider, PhD;
Norma Cooke, PhD;
Rachelle S. Doody, MD, PhD
Arch Neurol. 2005;62:454-459.
Background The apolipoprotein E  4 (APOE 4) allele is associated with an increased risk of developing Alzheimer disease (AD). However, findings regarding an association between the APOE 4 allele and the rate of decline in AD have been mixed.
Objective To examine the relationship between the APOE 4 allele and the rate of cognitive and functional decline in AD using individual growth curve analyses.
Design Longitudinal cohort study.
Setting Alzheimer Disease Research Center at Baylor College of Medicine.
Patients A total of 189 patients meeting NINCDS-ADRDA (National Institute of Neurological and Communicative Disorders and Stroke–Alzheimer's Disease and Related Disorders Association) criteria for probable AD at baseline who underwent annual follow-up evaluations for at least 2 years.
Main Outcome Measures Individual growth curve parameters derived from baseline and follow-up performance on global and specific measures of cognitive and functional abilities.
Results Patients with 2 APOE 4 alleles exhibited a slower rate of decline on measures of global cognitive functioning and functional abilities. No significant association was detected between the APOE 4 allele and the rate of decline on measures of specific cognitive functions.
Conclusions Although the APOE 4 allele is associated with an increased risk of developing AD, it seems that having 2 APOE 4 alleles is associated with a slower clinical course. These findings are consistent with hypotheses that the biological processes contributing to the onset of AD are different from those involved in determining its clinical course.
Author Affiliations: Department of Psychology, University of Houston, Houston, Tex (Drs Hoyt and Massman); Division of Psychosocial Medicine, National Jewish Medical and Research Center, Denver, Colo (Dr Hoyt); Department of Neurology, Baylor College of Medicine, Houston (Drs Massman, Cook, and Doody); and Department of Psychology, Florida State University, Tallahassee (Dr Schatschneider).
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