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Effect of white matter hyperintensities severity on cognitive impairment according to the presence of apolipoprotein e4 allele

Hong, Chang Hyung; Son, Sang Joon; Lee, Kang Soo; Choi, Seong Hye
Department of Psychiatry & Behavioural Sciences
OBJECTIVE: The purpose of this study was to investigate the effect of White matter hyperintensities (WMH) severity on cognitive function according to the presence of apolipoprotein E (APOE) e4 allele.

METHOD: Of the participants in the hospital-based cohort study of dementia, 5077 elderly subjects who had available data for APOE genotype and WMH severity were studied. A standardized neuropsychological battery, containing tests of language, memory, attention and frontal/executive function was used for all subjects.

RESULTS: After multivariable adjustments, logistic regression analyses showed that higher odds of having cognitive impairment in both APOE e4 carrier and non-carrier when examining the effects of WMH on frontal/executive function tests such as Stroop test (e4 non-carrier, OR=2.36 (1.83-3.03); e4 carrier: OR=2.49 (1.65-3.76)). WMH severity was not even significantly associated with memory function in APOE e4 carriers(verbal memory test: e4 non-carrier, OR=1.44 (1.13-1.84); e4 carrier, OR=1.36 (0.87-2.04)) (visuospatial memory test: e4 non-carrier, OR=1.86 (1.45-2.37); e4 carrier, OR=1.35 (0.89-2.04)).

CONCLUSIONS: Severe WMH seemed to be associated with frontal/executive dysfunction predominantly irrespective of APOE e4 allele. WMH severity did not affect memory impairment particularly in APOE ε4 carrier
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