Whole Exome Sequence Study of Mild Cognitive Impairment in African and European Americans; the Atherosclerosis Risk in Communities-Neurocognitive Study

Shamsed Mahmud, Hao Mei, Adrienne Tin, Jan Bressler, William A. Pruett, Myriam Fornage, Juebin Huang, Eric Boerwinkle, Thomas H. Mosley, Jeannette Simino

Research output: Contribution to journalArticlepeer-review


BACKGROUND: Mild cognitive impairment (MCI) encompasses cognitive deficits beyond normal aging that minimally impact daily functioning. Uncovering the genetic architecture of MCI, which can progress to Alzheimer's disease in some individuals, may facilitate the development of lifestyle and pharmacologic interventions to minimize cognitive impairment or prevent dementia. We conducted a whole exome sequence study of MCI in 1,144 African American (AA) and 3,358 European American (EA) participants aged 67-90 years from the Atherosclerosis Risk in Communities-Neurocognitive Study. METHODS: For both single-variant and gene-based tests, we employed seqMeta to perform race-stratified analyses of functional (nonsynonymous, splicing, stopgain, stoploss, or frameshift) variants in each sex alone and both sexes combined. Models were adjusted for age, sex (except sex-stratified models), field center, and population substructure (the first ten principal components). Logistic regression models were fit on autosomal single-variants with minor allele frequency (MAF) ≥0.01 while SKAT-O, T1 burden, and SKAT (beta weights and MAF ≤ 0.05) gene-based tests were conducted. The significance and suggestive p-value thresholds were 1.13E-06 and 2.27E-05 for single-variant tests and 2.81E-06 and 5.63E-05 for gene-based tests, respectively, after Bonferroni correction. RESULTS: The analysis sample contained 993 MCI cases and 3,509 cognitively normal participants; Table 1 contains the count for each race and sex subgroup. One significant (p-value=1.06E-7) single-variant association (chr6:51712759:T:C in PKHD1) was detected in AA males (Figure 1). This variant had MAF=0.025 in AA males but was monomorphic in EA males. Four significant gene-based associations with minor allele counts (MAC) ≥ 10 were discovered: CDC27 in AA females (SKAT-O p-value=6.63E-07), C19orf18 in AA males (SKAT-O p-value=1.26E-07), SLC16A10 in EA males and females combined (SKAT p-value=1.90E-06), and ZNF804A in EA females (T1 p-value=2.69E-07). Twenty-three suggestive single-variant and gene-based associations with MAC ≥ 10 were identified (Figure 2). CONCLUSIONS: MCI-associated genes have diverse biological functions including cell division, sodium-independent transportation of amino acids, and zinc finger binding. Our findings imply that the genetic underpinnings of MCI may differ by race and sex. External replication of our findings, as well as investigations using large samples in consortia, will provide insight into the pervasiveness of sex-specific genetic effects in dementia-related traits.

Original languageEnglish (US)
Pages (from-to)e058619
JournalAlzheimer's & dementia : the journal of the Alzheimer's Association
StatePublished - Dec 1 2021

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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