RELATIONSHIP BETWEEN APOE, MRI FINDINGS, AND COGNITIVE FUNCTION IN THE CARDIOVASCULAR HEALTH STUDY

Background and Purpose-We determined the relationship between apolipop rotein (Apo)E, MRI, and low cognitive scores. Methods-The relationship between age, education, ApoE genotype, MRI examination of the brain, subclinical and clinical cardiovascular disease, and low (<80) score o n the Modified Mini-Mental State Examination (3MSE, as modified by Ten g and Chui) was evaluated for 3469 black and white participants in the Cardiovascular Health Study (CHS) in years 5 and 6 of the study. The participants were followed for up to 3 years. Results-The prevalence o f scores <80 in years 5 and 6 of the CHS was 8.2% for participants wit hout and 20.4% for those with prior history of stroke. Age, race, and education were important determinants of low 3MSE scores, The prevalen ce of ApoE-4 (odds ratio [OR], 1.6 [1.1 to 2.1]) was directly related to scores <80, as was high ventricular volume (OR, 1.6 [1.2 to 2.3]), high white matter grade (OR, 1.4 [1.1 to 1.9]), and infarctlike lesion s (OR, 1.6 [1.2 to 2.1]) on the MRI in the multivariate analysis. A fi ve-point or greater decline in scores over up to 3 years was more ofte n observed for participants with low 3MSE scores at year 5, at older a ges, with lower education, and experiencing incident stroke (OR, 3.6 [ 1.2 to 10.6]), ApoE-4 genotype (OR, 1.8 [1.4 to 2.3]), and with MRI fi ndings of high ventricular volume (OR, 2.0 [1.5 to 2.7]), and infarctl ike lesions (OR, 1.2 [0.9 to 1.5]). Conclusions-These results demonstr ate that vascular changes on MRI, measures of brain atrophy, AgoE-4, a nd age, education, and race are associated with low cognitive scores a mong older individuals. The MRI of the brain provides valuable informa tion related to cognitive tests and decline over time. The potential e xists for using MRI measurements to identify high-risk individuals for dementia and to test potential interventions to reduce the risk of de mentia.