@article {175,
	title = {APOE epsilon 4 allele predicts faster cognitive decline in mild Alzheimer disease.},
	journal = {Neurology},
	volume = {70},
	year = {2008},
	month = {2008 May 6},
	pages = {1842-9},
	abstract = {OBJECTIVE: To determine whether APOE epsilon 4 predicts rate of cognitive change in incident and prevalent Alzheimer disease (AD).

METHODS: Individuals were recruited from two longitudinal cohort studies-the Washington Heights and Inwood Columbia Aging Project (WHICAP; population-based) and the Predictors Study (clinic-based)--and were followed for an average of 4 years. Three samples of participants diagnosed with AD, with diverse demographic characteristics and baseline cognitive functioning, were studied: 1) 199 (48\%) of the incident WHICAP cases; 2) 215 (54\%) of the prevalent WHICAP cases; and 3) 156 (71\%) of the individuals diagnosed with AD in the Predictors Study. Generalized estimating equations were used to test whether rate of cognitive change, measured using a composite cognitive score in WHICAP and the Mini-Mental State Examination in Predictors, varied as a function of epsilon 4 status in each sample.

RESULTS: The presence of at least one epsilon 4 allele was associated with faster cognitive decline in the incident population-based AD group (p = 0.01). Parallel results were produced for the two prevalent dementia samples only when adjusting for disease severity or excluding the most impaired participants from the analyses.

CONCLUSION: APOE epsilon 4 may influence rate of cognitive decline most significantly in the earliest stages of Alzheimer disease.},
	keywords = {Aged, Aged, 80 and over, Aging, Alzheimer Disease, Apolipoprotein E4, Cognition Disorders, Cohort Studies, Disease Progression, DNA Mutational Analysis, Female, Gene Frequency, Genetic Predisposition to Disease, Genetic Testing, Genotype, Humans, Longitudinal Studies, Male, Memory Disorders, Polymorphism, Genetic, Prospective Studies, Time Factors},
	issn = {1526-632X},
	doi = {10.1212/01.wnl.0000304038.37421.cc},
	author = {Cosentino, S and Scarmeas, N. and Helzner, E and Glymour, M M and Brandt, J and Albert, M and Blacker, D and Stern, Y}
}
