Interaction of Apolipoprotein E epsilon4 and Education on Cognitive Decline in Korean Elders

ABSTRACT

OBJECTIVES: This study aimed to test potential modifying effects of education on the association between apolipoprotein E epsilon4 (Apo E4) and cognitive decline. METHODS: A community cohort(N=683) aged 65 or over completed the Korean version of Mini-Mental State Examination(MMSE-K) at baseline and two years later(1999-2001). Apo E polymorphisms were genotyped, and classified into that with or without Apo E4. Educational levels were categorized into people with or without education. Covariates included demographic(age, gender), life style(smoking, alcohol drinking), clinical (depression, sleep disorder, vascular risk factors) characteristics. RESULTS: The association between Apo E4 and cognitive decline was significant only in the old persons with no education. The interaction term between education and Apo E4 on cognitive decline was significant (p=0.040). CONCLUSION: Elders with no education might be more vulnerable to the impact of Apo E4 on cognitive decline, which suggests gene-environment interaction.