Older people who carry the apolipoprotein E epsilon-4 allele (APOE e4) gene experience a significantly faster decline in cognitive function, particularly after the age of 70, research released on Monday by the National Health Research Institutes said.
Pathological changes associated with dementia often begin years before symptoms appear, making early identification of people at a higher risk a key challenge for formulating preventive medicine and healthy aging policies, said Chung Yu-chu (鍾宇筑), a postdoctoral researcher at the institute’s Center for Neuropsychiatric Research.
Chung said 17.3 percent of people in Taiwan carry the APOE e4 allele, far lower than the roughly 60 percent reported among the Caucasian populations in Europe and North America, but there are few studies that have focused on Asian populations.
Photo courtesy of the National Health Research Institutes
To address the gap, the institute conducted a six-year study tracking cognitive changes in 4,392 adults aged 55 or older with normal cognitive function.
The study found that cognitive function declines with age regardless of genetic background, but the decline is significantly faster among people who carry the APOE e4 gene.
The effect is more pronounced in people with the e4 allele, Chung said.
The divergence in the rate of decline becomes particularly evident after the age of 70, suggesting that the impact of the APOE e4 allele accumulates over time, she said.
The APOE protein helps regulate lipid levels in the bloodstream and plays a role in metabolizing and clearing harmful proteins, making it the most common genetic risk factor for late-onset Alzheimer’s disease, she said.
Studies have shown that people who carry two e4 alleles might develop the disease about seven to 10 years earlier than expected, she said.
By age 65, most already show abnormal amyloid plaque buildup in the brain, with many beginning to exhibit signs of cognitive decline, she said.
Identifying people at risk before symptoms emerge while cognitive function is still intact could enable early intervention and preventive strategies, Chung said.
The study also found no clear evidence during the observation period that other non-APOE genetic risk factors had a measurable impact on cognitive decline, she added.
The study, “APOE e4 and Accelerated Cognitive Decline Among Cognitively Healthy Middle-Aged and Older Adults,” was published on March 6 on the JAMA Network Open.
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