Problems meeting basic needs moderate the association between the APOE ϵ4 allele and cognitive decline

Abstract

Objectives: The ApolipoproteinE ε4 (APOE ε4) allele influences cognitive decline (CD) in some but not in all individuals. The purpose of this study was to investigate whether problems meeting basic needs (BN) (e.g., having enough money to meet needs, having enough money for emergencies, having adequate housing, and having enough heat) influences the relationship between the APOE ε4 allele and CD. We predicted that problems meeting BN would have a greater influence on CD among those with the APOE ε4 allele than those without the allele. Methods: Participants consisted of community-dwelling older adults from the Duke Established Populations for Epidemiologic Studies of the Elderly (EPESE). Data were drawn from Waves 1 and 2, which were 3 years apart. Cognitive functioning was assessed at both waves so that change in cognitive status was examined over time, and cognitive status was controlled at baseline. Genotyping, however, was not obtained until Wave 3. Results: The APOE ε4 allele and problems meeting BN independently predicted CD. Importantly, the influence of BN on CD was greater for individuals with the APOE ε4 allele compared to those without the allele. Other indicators of socioeconomic status (e.g., education, income) did not interact with the APOE ε4 allele in predicting CD. Conclusions: There is a synergistic effect of perceived problems meeting BN and the APOE ε4 allele on jointly influencing cognitive functioning. Although genetic risk factors are not easily modifiable, resource deprivation may be more amenable to interventions, which may reduce risk for CD.