In Blacks with Alzheimer's Gene, Higher Education May Be Protective

31 October 2019

New York, NY, USA  Education may erase the risk of cognitive decline associated with the APOE e4 gene – the biggest genetic risk factor for late-onset Alzheimer’s disease – in older non-Hispanic black people, according to a new study by researchers at Columbia University Vagelos College of Physicians and Surgeons.

The study was published online (pre-press) in the Journal of Alzheimer’s Disease.

“There’s frustratingly little we can do to lessen the risk of Alzheimer’s disease, but education appears to be one of the few interventions that we know works,” says first author Jet M.J. Vonk, PhD, a postdoctoral research scientist in the Taub Institute for Research on Alzheimer's Disease and the Aging Brain at Columbia University Vagelos College of Physicians and Surgeons.

Does Education Preserve Cognitive Ability for All Older Adults?

Several studies, mainly in non-Hispanic white people, have shown that the higher one’s level of education, the lower one’s risk of dementia – even among those who are genetically at higher risk for Alzheimer’s, such as carriers of the APOE e4 gene.

Even before Alzheimer’s is diagnosed, older individuals with the APOE e4 gene have, on average, poorer cognitive function than non-carriers.

But none of these studies had focused on non-Hispanic blacks, a population with fewer years of education and higher rates of APOE e4 and dementia than non-Hispanic whites.

The researchers looked at 849 non-Hispanic Blacks (average age of 69 years) of various educational levels who were enrolled in a multicenter study investigating genetic and environmental factors that influence Alzheimer’s onset. None of the participants had dementia, though about 38% carried the APOE e4 gene.

The participants underwent comprehensive neuropsychological testing to evaluate memory and cognition.

Education After High School Provides a Safeguard

Overall, among individuals with more than a high school degree, APOE e4 carriers performed just as well on two key memory tests as non-carriers, an effect that was particularly pronounced in women. “This suggests that education can buffer the effects of the APOE e4 gene on episodic memory retention and working memory, which are usually the first types of memory to be affected in people with Alzheimer’s,” says Vonk.

The findings do not have any implications for clinical practice. “The important point is that education is a modifiable risk factor for cognitive decline. It’s something that we can target with public policies that increase access to higher education,” says Vonk.

The current study focused on the effects of formal education through high school and college. “We also hope to examine which other social and environmental factors later in life, from your 20s through your 60s, may help buffer cognitive decline associated with the APOE e4 gene in this population,” Vonk says.

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NOTES FOR EDITORS
Full study: “Education Moderates the Relation Between APOE e4 and Memory in Nondemented Non-Hispanic Black Older Adults” by JMJ Vonk, MA Rentería, MA Medina, MA Pericak-Vance, GS Byrd, J Haines, AM Brickman, JJ Manly (10.3233/JAD-190415), published online in the Journal of Alzheimer’s Disease in advance of the publication of Volume 72, Issue 2. The article is online at: content.iospress.com/articles/journal-of-alzheimers-disease/jad190415.

Jet Vonk, PhD, is also a visiting scholar at the Julius Center for Health Sciences and Primary Care at Utrecht University in the Netherlands.

The research was supported by grants from the National Institutes of Health (R01 AG028786) and by an Alzheimer Nederland fellowship.

The authors reported the following competing interests: Dr. Brickman has consulted for Keystone Heart, Regeneron Pharmaceuticals, and Cognition Therapeutics; has shares in Mars Holding Limited (a shareholder of Venus Medtech, Inc.), and has a patent (US patent number 9867566) and a patent pending (US publication number 20180228422) for methods and systems for evaluating age-related memory loss.

Photo credit: Erik Kottier

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Helen Garey, MPH
Science Writer, Media Relations
Columbia University Irving Medical Center
+1 917.514.1317
hbg3@cumc.columbia.edu

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Columbia University Irving Medical Center provides international leadership in basic, preclinical, and clinical research; medical and health sciences education; and patient care. The medical center trains future leaders and includes the dedicated work of many physicians, scientists, public health professionals, dentists, and nurses at the Vagelos College of Physicians and Surgeons, the Mailman School of Public Health, the College of Dental Medicine, the School of Nursing, the biomedical departments of the Graduate School of Arts and Sciences, and allied research centers and institutions. Columbia University Irving Medical Center is home to the largest medical research enterprise in New York City and State and one of the largest faculty medical practices in the Northeast. For more information, visit: cuimc.columbia.edu or columbiadoctors.org.

About the Journal of Alzheimer's Disease
Now in its 22nd year of publication, the Journal of Alzheimer's Disease (JAD) is an international multidisciplinary journal to facilitate progress in understanding the etiology, pathogenesis, epidemiology, genetics, behavior, treatment, and psychology of Alzheimer's disease. The journal publishes research reports, reviews, short communications, book reviews, and letters-to-the-editor. Groundbreaking research that has appeared in the journal includes novel therapeutic targets, mechanisms of disease, and clinical trial outcomes. JAD has a 2018 Journal Impact Factor of 3.517 according to Journal Citation Reports (Web of Science Group, 2019) and is published by IOS Press. j-alz.com