APOE GENOTYPE INFLUENCES FUNCTIONAL STATUS AMONG ELDERLY WITHOUT DEMENTIA

The presence of apolipoprotein-epsilon 4 (APOE-epsilon 4) significantl y increases the risk of Alzheimer's disease (AD), The association betw een APOE-epsilon 4 status and functional abilities was explored furthe r in a multicultural sample of community-dwelling, non-demented elders . The sample was limited to cognitively-intact, community-dwelling eld ers, who were free of stroke or other neurologic disability. In 218 el ders who met research criteria, the presence of APO-epsilon 4 was asso ciated with poorer functional status, apart from the effects of neurop sychological performance, gender, age, and education (OR = 2.5, 95% CI : 1.3, 4.9). In 158 subjects without an APOE-epsilon 4 allele, 50% rep orted no functional limitation; in the 60 subjects with an epsilon 4 a llele, only 28% reported no functional limitation (P < .01). The relat ionship was not explained by the distribution of co-morbidities. The a ssociation between poorer function and the presence of an APOE-epsilon 4 allele was evident in each ethnic group. In path analyses, the pres ence of an APOE-epsilon 4 allele was associated with decreased functio nal ability in non-demented elders not simply through an association w ith poorer cognitive status, but also independently. These results sug gest that the APOE-epsilon 4 genotype is associated with functional de ficit in people with normal neuropsychological profiles. (C) 1995 Wile y-Liss, Inc.