Dementia and Occupational Therapy - Home caregiver and senior adult woman

Women who carry the APOE e4 gene and develop early-onset Alzheimer’s disease may have quicker cognitive decline than men with these attributes, a new study has found.

Inheriting APOE e4 does not necessarily mean that someone will develop Alzheimer’s, but it is known to be the strongest risk factor gene associated with the disease. More evidence is emerging about how it may influence a person’s risk and how those risks may differ between certain groups. About 15% to 25% of the population carries APOR e4, according to the Mayo Clinic. 

In the new study, investigators analyzed data from nearly 1,000 people with early-onset Alzheimer’s and more than 2,500 participants with late-onset disease from the National Alzheimer’s Coordinating Center. The researchers looked at how long-term cognitive measures interacted with patients’ sex and APOE ε4 carrier status. 

Among both early- and late-onset patients, the APOE ε4 carriers showed accelerated overall cognitive decline when compared to non-carriers. The effect of APOE e4 was stronger for language in late-onset disease and for executive function in early-onset disease.

Notably, decline was faster for language, memory and global cognition among female participants who had early-onset disease than it was in males. In late-onset Alzheimer’s overall, the gene’s impact was greater for language, while in early onset the greater effect was for executive function.

“The specific patterns and magnitude of decline are distinct” between the early- and late-onset disease variants, the researchers concluded.

Full findings were published in the journal Alzheimer’s & Dementia.

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