APOE genotypes as a risk factor for age-dependent accumulation of cerebrovascular disease in older adults

Melissa Lamar, Lei Yu, Leah H. Rubin, Bryan D. James, Lisa L. Barnes, Jose Marcelo Farfel, Chris Gaiteri, Aron S. Buchman, David A. Bennett, Julie A. Schneider

Research output: Contribution to journalArticlepeer-review

7 Scopus citations


Introduction: Apolipoprotein E (APOE) is a susceptibility gene for late-onset Alzheimer's disease neuropathology; less is known about the relationship between APOE and cerebrovascular disease (CVD) neuropathology. Methods: We investigated associations of APOE status with arteriolosclerosis, macroinfarcts and microinfarcts, and atherosclerosis in 1383 adults (65.9–108.2 years at death) with and without dementia. Excluding ε2/ε4 carriers, multivariable regressions for each CVD-related neuropathology compared ε4 and ε2 carriers to ε3/ε3 carriers adjusting for confounders including age and Alzheimer's neuropathology. Results: Three hundred forty-two individuals (24.7%; ∼87.7 years at death; 39.9% nondemented) were ε3/ε4 or ε4/ε4, and 180 (13.0%; ∼89.9 years at death; 66.6% nondemented) were ε2/ε3 or ε2/ε2. ε4 carriers had higher odds of macroinfarcts (odds ratio = 1.41, 95% confidence interval: 1.02–1.94, P =.03), whereas ε2 carriers had higher odds of moderate-to-severe arteriolosclerosis (odds ratio = 1.68, 95% confidence interval: 1.15–2.45, P =.006) compared to ε3/ε3 carriers. Age-stratified analyses suggested that these relationships were driven by ε4 carriers <90 years at death and ε2 carriers ≥90 years at death, respectively. Discussion: APOE differentially affects type and timing of CVD-related neuropathology.

Original languageEnglish (US)
Pages (from-to)258-266
Number of pages9
JournalAlzheimer's and Dementia
Issue number2
StatePublished - Feb 2019


  • APOE ε2 allele
  • APOE ε4 allele
  • Cerebrovascular disease
  • Neuropathology
  • Oldest old

ASJC Scopus subject areas

  • Clinical Neurology
  • Geriatrics and Gerontology
  • Psychiatry and Mental health
  • Cellular and Molecular Neuroscience
  • Health Policy
  • Developmental Neuroscience
  • Epidemiology


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