ApoE and Quality of Life in Nonagenarians

作者：Parsaik Ajay K; Lapid Maria I^*; Rummans Teresa A; Cha Ruth H; Boeve Bradley F; Pankratz Vernon S; Tangalos Eric G; Petersen Ronald C

来源：Journal of the American Medical Directors Association, 2012, 13(8): 704-707.

DOI：10.1016/j.jamda.2012.06.012

• Well being
• oldest old
• apolipoprotein E

Objectives: ApoE epsilon 4 is associated with adverse health conditions that negatively impact the quality of life (QOL). The relationship between ApoE epsilon 4 and QOL has not been explored in the oldest old. Our study aimed to examine ApoE in the oldest old and explore its association with QOL.
Design: Cross-sectional cohort study.
Setting: A medium sized community in Olmsted County, Minnesota.
Participants: Individuals aged 90 to 99 years, living independently or in long term care environments.
Measurements: We collected demographic information and measured cognitive Short Test of Mental Status, Mini-Mental State Examination, Mattis Dementia Rating Scale), QOL (Linear Analogue Self Assessment), and ApoE distribution. Subjects were classified as cognitively normal, mild cognitive impairment, dementia, or dementia with stroke and/or parkinsonism (DEMSP). Regression model was used to assess the predictors of QOL.
Results: A total of 121 subjects (45 cognitively normal, 13 with mild cognitive impairment, 34 with dementia, 29 DEMSP) aged 90-99 years, 106 (87.6 %) females, were included. Frequency of ApoE epsilon 3 allele was highest (194 [80.2%]: epsilon 2/3 18, epsilon 3/3 77, epsilon 3/4 22) followed by ApoE epsilon 4 (25 [10.3%]: epsilon 2/4 3, epsilon 3/4 22) and ApoE epsilon 2 (23 [9.5%; epsilon 2/2 1, epsilon 2/3 18, epsilon 2/4 3). None of the subjects carried ApoE epsilon 4/4 genotype. QOL was similar between ApoE epsilon 4 carrier and noncarriers. Physical well-being, emotional well-being, intellectual well-being, social connectedness, and coping ability were positively associated with QOL, whereas male sex, DEMSP, pain frequency, and pain severity were negatively associated.
Conclusions: The most common ApoE in the oldest old was epsilon 3/3 genotype and epsilon 3 allele. No association was found between ApoE epsilon 4 and QOL. However, those with high physical, emotional and intellectual well being, social connectedness, and coping ability had the highest overall QOL.

• 出版日期2012-10