AS615 - Investigating the biology of cognitive resilience in WHIMS “APOE E4 escapees”

Investigator Names and Contact Information

Susan Resnick (resnicks@mail.nih.gov)

Introduction/Intent

We propose to conduct a coordinated investigation in WHIMS of blood-based markers that may provide mechanistic insights into factors underlying cognitive resilience despite the presence of one or more APOE e4 genetic risk allele(s) for AD ("APOE escapees" as described by Allison Goate). We will focus on pathways that have been considered in relation to risk for AD to determine physiologic profiles at WHI baseline in women who maintain cognitive health through old age versus those who develop cognitive impairment. We will measure markers of insulin resistance, inflammation, and auto-antibody production, and perform targeted metabolomics assays, including lipodomics. Assays will be performed for 709 e4 carriers (359 women who develop impairment and 350 who remain free of cognitive impairment, excluding the e2/e4 individuals due to low number) and a similar number of individuals with the e3/e3 genotype (566 who develop impairment and 350 who remain free of cognitive impairment).

Key Questions and Contrasts:

  • Why do some women who carry an APOE e4 allele remain free of cognitive impairment after age 80?
  • Are the factors that distinguish these resilient women the same as those without an APOE e4 allele (i.e. e3/e3) who remain free of cognitive impairment after age 80 and older?

Related Papers

Associations of Alzheimer’s disease blood biomarkers with cognitive decline and incident dementia in the Women’s Health Initiative Memory Study

Approved Manuscript, Mielke, Michelle et al., 2025/11 MSID: 4745
Keywords: Alzheimer’S Disease; Blood Based Biomarkers; Abeta; Ptau; Gfap; Nfl
Related Studies: 39, 233, 244, 615, 637, 659

Plasma proteins related to inflammatory diet predict future cognitive impairment

Michael Duggan et al., 2023/2 PubMed #36737481 MSID: 4396
Dysregulation of the immune system and dietary patterns that increase inflammation can increase the risk for cognitive decline, but the mechanisms by which inflammatory nutritional habits may affect the development of cognitive impairment in aging are not well understood. To determine whether plasma proteins linked to inflammatory diet predict future cognitive impairment, we applied high-throughput proteomic assays to plasma samples from a subset (n = 1528) of Women's Health Initiative Memory St...
Keywords: Inflammation; Dementia; Alzheimer’S Disease; Proteomics; Diet
Related Studies: 39, 103, 183, 233, 244, 262, 615

Proteomic analysis of APOEε4 carriers implicates lipid metabolism, complement and lymphocyte signaling in cognitive resilience

JoAnn Manson et al., 2024/10 PubMed #39482741 MSID: 4374
Background: Apolipoprotein E (APOE) ε4 allele is the strongest genetic risk factor for late onset Alzheimer's disease (AD). This case-cohort study used targeted plasma biomarkers and large-scale proteomics to examine the biological mechanisms that allow some APOEε4 carriers to maintain normal cognitive functioning in older adulthood. Methods: APOEε4 carriers and APOEε3 homozygotes enrolled in the Women's Health Initiative Memory Study (WHIMS) from 1996 to 1999 were classified as resilient if the...
Keywords: Apolipoprotein E E4; Dementia; Cognitive Impairment; Proteomics; Metabolomics; Amyloid-Beta; Nf-Light; Inflammation
Related Studies: 615