Predicting memory decline in normal elderly: Genetics, MRI, and cognitive reserve

Abstract Major predictors of Alzheimer's disease (AD) include apolipoprotein E (APOE)-ε4, hippocampal atrophy on magnetic resonance imaging (MRI), and memory dysfunction prior to diagnosis. We examined 159 normal elderly subjects with MRI and the California Verbal Learning Test (CVLT); 84 retur...

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Bibliographic Details
Published in:Neurobiology of aging 2007-11, Vol.28 (11), p.1644-1656
Main Authors: Tupler, Larry A, Krishnan, K. Ranga R, Greenberg, Daniel L, Marcovina, Santica M, Payne, Martha E, MacFall, James R, Charles, H. Cecil, Doraiswamy, P. Murali
Format: Article
Language:English
Subjects:
Aged
Aged, 80 and over
Alzheimer's disease
Apolipoprotein E
Apolipoprotein E4 - metabolism
California Verbal Learning Test
Cerebral volume
Cognition - physiology
Cross-Sectional Studies
Female
Follow-Up Studies
Hippocampus
Humans
Internal Medicine
Magnetic Resonance Imaging - methods
Male
Memory
Memory - physiology
Memory Disorders - diagnosis
Memory Disorders - genetics
Memory Disorders - metabolism
Middle Aged
Morphometry
MRI
Neurology
Neuropsychological Tests
Normal aging
Predictive Value of Tests
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Summary:Abstract Major predictors of Alzheimer's disease (AD) include apolipoprotein E (APOE)-ε4, hippocampal atrophy on magnetic resonance imaging (MRI), and memory dysfunction prior to diagnosis. We examined 159 normal elderly subjects with MRI and the California Verbal Learning Test (CVLT); 84 returned for longitudinal follow-up 5 years later. Analyses at baseline revealed significant variance in hippocampal volume accounted for by cerebral volume and age but not by APOE isoform. However, interactions involving APOE isoform and laterality were observed. As hypothesized, an APOE × time interaction was revealed for CVLT long-delay free recall: APOE-ε3/4 subjects had significantly poorer performance than APOE-ε3/3 subjects at follow-up. Forward stepwise multiple regression analysis predicting follow-up long-delay free recall selected baseline recall, followed by number of APOE-ε4 alleles, followed by left-hippocampal volume. Age and sex did not enter into the model. We conclude that APOE-ε4 predicts longitudinal memory decline in healthy controls and that MRI morphometry of hippocampus adds slightly to predictive value.
ISSN:0197-4580
1558-1497
DOI:10.1016/j.neurobiolaging.2006.07.001