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Carriers With Alzheimer's High Risk Gene Type Age Normally Until the Disease Strikes

al University assessed whether the small percentage (varying by ethnicity) of the population that carries at least one copy of APOE4 are cognitively different from non-carriers long before anyone shows signs of dementia.

The authors studied 6,560 people living in Canberra or neighboring Queanbeyan enrolled in the PATH Through Life Project, a long-term study of aging that assesses people in the age groups of 20-24, 40-44, and 60-64 years every four years for a period of 20 years. Jorm and his colleagues evaluated whether, in each age group, carriers of APOE4 (27 percent in their sample) were significantly different from non-carriers on tests of functions affected by Alzheimer's: episodic memory, working memory, mental speed, reaction time, and reading vocabulary.

Performance on all tests (except for reading vocabulary, which tends to hold up with age) declined across age groups, a sign of normal cognitive aging. However, APOE4 did not affect performance at any age. Thus the researchers conclude that at least between ages 20 and 64, people with APOE4 age normally in those central cognitive functions.

This finding suggests that APOE4 heightens the risk for Alzheimer's in old age through an additional, as-yet-unknown process that accelerates or intensifies normal changes, pushing them into the range of disease. Jorm provides an analogy. "In general, hair becomes thinner with age," he says. "However, there are some people who have an additional hereditary factor that makes them bald at an early age."

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