0
Get Alert
Please Wait... Processing your request... Please Wait.
You must sign in to sign-up for alerts.

Please confirm that your email address is correct, so you can successfully receive this alert.

Articles   |    
Effect of Knowledge of APOE Genotype on Subjective and Objective Memory Performance in Healthy Older Adults
Tara T. Lineweaver, Ph.D.; Mark W. Bondi, Ph.D.; Douglas Galasko, M.D.; David P. Salmon, Ph.D.
Am J Psychiatry 2014;171:201-208. doi:10.1176/appi.ajp.2013.12121590
View Author and Article Information

Dr. Galasko has served on advisory panels for Elan Pharmaceuticals and Neurophage and on data and safety monitoring boards for clinical trials for Balance Pharmaceuticals, Elan Pharmaceuticals, Janssen Immunotherapy, and Pfizer. Dr. Salmon has served as a consultant for Bristol-Myers Squibb. The other authors report no financial relationships with commercial interests.

Supported by National Institute on Aging grants P50-AG 05131, R01-AG 012674, and K24-AG 026431 and an Alzheimer’s Centers of California grant from the State of California.

From the Department of Psychology, Butler University, Indianapolis; the Departments of Psychiatry and Neurosciences, University of California, San Diego; and the Psychology and Neurology Services, VA San Diego Healthcare System, San Diego.

Address correspondence to Dr. Salmon (dsalmon@ucsd.edu).

Copyright © 2014 by the American Psychiatric Association

Received December 19, 2012; Revised July 30, 2013; Accepted August 12, 2013.

Abstract

Objective  The knowledge that one carries the apolipoprotein E (APOE) ε4 allele risk factor for Alzheimer’s disease was recently found to have little short-term psychological risk. The authors investigated the impact of knowledge of carrying the risk allele on subjective ratings of memory and objective memory test performance of older adults.

Method  Using a nested case-control design, the authors administered objective verbal and visual memory tests and self-rating scales of memory function to 144 cognitively normal older adults (ages 52–89) with known APOE genotype who knew (ε4+, N=25; ε4−, N=49) or did not know (ε4+, N=25; ε4−, N=45) their genotype and genetic risk for Alzheimer’s disease prior to neuropsychological evaluation.

Results  Significant genotype-by-disclosure interaction effects were observed on several memory rating scales and tests of immediate and delayed verbal recall. Older adults who knew their ε4+ genotype judged their memory more harshly and performed worse on an objective verbal memory test than did ε4+ adults who did not know. In contrast, older adults who knew their ε4− genotype judged their memory more positively than did ε4− adults who did not know, but these groups did not differ in objective memory test performance.

Conclusions  Informing older adults that they have an APOE genotype associated with an increased risk of Alzheimer’s disease can have adverse consequences on their perception of their memory abilities and their performance on objective memory tests. The patient’s knowledge of his or her genotype and risk of Alzheimer’s disease should be considered when evaluating cognition in the elderly.

Abstract Teaser
Figures in this Article

Your Session has timed out. Please sign back in to continue.
Sign In Your Session has timed out. Please sign back in to continue.
Sign In to Access Full Content
 
Username
Password
Sign in via Athens (What is this?)
Athens is a service for single sign-on which enables access to all of an institution's subscriptions on- or off-site.
Not a subscriber?

Subscribe Now/Learn More

PsychiatryOnline subscription options offer access to the DSM-5 library, books, journals, CME, and patient resources. This all-in-one virtual library provides psychiatrists and mental health professionals with key resources for diagnosis, treatment, research, and professional development.

Need more help? PsychiatryOnline Customer Service may be reached by emailing PsychiatryOnline@psych.org or by calling 800-368-5777 (in the U.S.) or 703-907-7322 (outside the U.S.).

FIGURE 1. Scores on the Capacity Scale of the Metamemory in Adulthood Questionnaire for Participants With (ε4+ ) or Without (ε4−) the APOE ε4 Allele Who Knew (Informed) or Did Not Know (Not Informed) Their APOE Genotypea

a Error bars represent standard deviation.

FIGURE 2. Memory Functioning Questionnaire Scores for Participants With (ε4+ ) or Without (ε4−) the APOE ε4 Allele Who Knew (Informed) or Did Not Know (Not Informed) Their APOE Genotypea

a Error bars represent standard deviation.

FIGURE 3. Scores on Immediate and Delayed Recall From the Logical Memory Subtest for Participants With (ε4+ ) or Without (ε4−) the APOE ε4 Allele Who Knew (Informed) or Did Not Know (Not Informed) Their APOE Genotypea

a Error bars represent standard deviation.

Anchor for Jump
TABLE 1.Demographic and Clinical Characteristics of Participants With (ε4+ ) or Without (ε4−) the APOE ε4 Allele Who Knew (Informed) or Did Not Know (Not Informed) Their APOE Genotypea
Table Footer Note

a No significant differences between groups on any variable.

Anchor for Jump
TABLE 2.Scores on the Metamemory in Adulthood Questionnaire and Memory Functioning Questionnaire and on Verbal and Visual Memory Tests for Participants With (ε4+ ) or Without (ε4−) the APOE ε4 Allele Who Knew (Informed) or Did Not Know (Not Informed) Their APOE Genotype
Table Footer Note

a Significantly different between groups, p<0.05.

+

References

Corder  EH;  Saunders  AM;  Strittmatter  WJ;  Schmechel  DE;  Gaskell  PC;  Small  GW;  Roses  AD;  Haines  JL;  Pericak-Vance  MA:  Gene dose of apolipoprotein E type 4 allele and the risk of Alzheimer’s disease in late onset families.  Science 1993; 261:921–923
[CrossRef] | [PubMed]
 
Saunders  AM;  Strittmatter  WJ;  Schmechel  D;  George-Hyslop  PH;  Pericak-Vance  MA;  Joo  SH;  Rosi  BL;  Gusella  JF;  Crapper-MacLachlan  DR;  Alberts  MJ;  Hulette  C;  Crain  B;  Goldgaber  D;  Roses  AD:  Association of apolipoprotein E allele epsilon 4 with late-onset familial and sporadic Alzheimer’s disease.  Neurology 1993; 43:1467–1472
[CrossRef] | [PubMed]
 
Strittmatter  WJ;  Weisgraber  KH;  Huang  DY;  Dong  LM;  Salvesen  GS;  Pericak-Vance  MA;  Schmechel  DE;  Saunders  AM;  Goldgaber  D;  Roses  AD:  Binding of human apolipoprotein E to synthetic amyloid beta peptide: isoform-specific effects and implications for late-onset Alzheimer disease.  Proc Natl Acad Sci USA 1993; 90:8098–8102
[CrossRef] | [PubMed]
 
Green  RC;  Roberts  JS;  Cupples  LA;  Relkin  NR;  Whitehouse  PJ;  Brown  T;  Eckert  SL;  Butson  M;  Sadovnick  AD;  Quaid  KA;  Chen  C;  Cook-Deegan  R;  Farrer  LA; REVEAL Study Group:  Disclosure of APOE genotype for risk of Alzheimer’s disease.  N Engl J Med 2009; 361:245–254
[CrossRef] | [PubMed]
 
Kane  RA;  Kane  RL:  Effect of genetic testing for risk of Alzheimer’s disease.  N Engl J Med 2009; 361:298–299
[CrossRef] | [PubMed]
 
LaRue  A;  Small  G;  McPherson  S;  Komo  S;  Matsuyama  SS;  Jarvik  LF:  Subjective memory loss in age-associated memory impairment: family history and neuropsychological correlates.  Neuropsychol Dev Cogn B Aging Neuropsychol Cogn 1996; 3:132–140
[CrossRef]
 
McPherson  S;  La Rue  A;  Fitz  A;  Matsuyama  S;  Jarvik  LF:  Self-reports of memory problems in relatives of patients with probable Alzheimer’s disease.  Int Psychogeriatr 1995; 7:367–376
[CrossRef] | [PubMed]
 
Weaver Cargin  J;  Collie  A;  Masters  C;  Maruff  P:  The nature of cognitive complaints in healthy older adults with and without objective memory decline.  J Clin Exp Neuropsychol 2008; 30:245–257
[CrossRef] | [PubMed]
 
Bandura  A:  Social Foundations of Thought and Action: A Social Cognitive Theory .  New York,  Prentice-Hall, 1986
 
Levy  B:  Improving memory in old age through implicit self-stereotyping.  J Pers Soc Psychol 1996; 71:1092–1107
[CrossRef] | [PubMed]
 
Desrichard  O;  Kopetz  C:  A threat in the elder: the impact of task instructions, self-efficacy, and performance expectations on memory performance in the elderly.  Eur J Soc Psychol 2005; 35:537–552
[CrossRef]
 
Seeman  T;  McAvay  G;  Merrill  S;  Albert  M;  Rodin  J:  Self-efficacy beliefs and change in cognitive performance: MacArthur Studies of Successful Aging.  Psychol Aging 1996; 11:538–551
[CrossRef] | [PubMed]
 
Mattis  S:  Dementia Rating Scale (DRS) .  Odessa, Fla,  Psychological Assessment Resources, 1988
 
Monsch  AU;  Bondi  MW;  Salmon  DP;  Butters  N;  Thal  LJ;  Hansen  LA;  Wiederholt  WC;  Cahn  DA;  Klauber  MR:  Clinical validity of the Mattis Dementia Rating Scale in detecting dementia of the Alzheimer type: a double cross-validation and application to a community-dwelling sample.  Arch Neurol 1995; 52:899–904
[CrossRef] | [PubMed]
 
Yesavage  JA;  Brink  TL;  Rose  TL;  Lum  O;  Huang  V;  Adey  M;  Leirer  VO:  Development and validation of a geriatric depression screening scale: a preliminary report.  J Psychiatr Res 1982–1983; 17:37–49
[CrossRef]
 
Wechsler  D:  The Wechsler Memory Scale–Revised .  San Antonio, Tex,  Psychological Corp, 1987
 
Osterrieth  PA:  Le test de copie d’une figure complexe.  Arch Psychol 1944; 30:206–356
 
Stern  RA;  Singer  EA;  Duke  LM;  Singer  NG;  Morey  CE;  Daughtrey  EW;  Kaplan  E:  The Boston Qualitative Scoring System for the Rey-Osterreith Complex Figure: description and interrater reliability.  Clin Neuropsychol 1994; 8:309–322
[CrossRef]
 
Dixon  RA;  Hultsch  DF;  Hertzog  C:  The Metamemory in Adulthood (MIA) questionnaire.  Psychopharmacol Bull 1988; 24:671–688
[PubMed]
 
Gilewski  MJ;  Zelinski  EM:  Memory Functioning Questionnaire (MFQ).  Psychopharmacol Bull 1988; 24:665–670
[PubMed]
 
Gilewski  MJ;  Zelinski  EM;  Schaie  KW:  The Memory Functioning Questionnaire for assessment of memory complaints in adulthood and old age.  Psychol Aging 1990; 5:482–490
[CrossRef] | [PubMed]
 
Hultsch  DF;  Hertzog  C;  Dixon  RA:  Age differences in metamemory: resolving the inconsistencies.  Can J Psychol 1987; 41:193–208
[CrossRef] | [PubMed]
 
Alladi  S;  Arnold  R;  Mitchell  J;  Nestor  PJ;  Hodges  JR:  Mild cognitive impairment: applicability of research criteria in a memory clinic and characterization of cognitive profile.  Psychol Med 2006; 36:507–515
[CrossRef] | [PubMed]
 
Rabin  LA;  Paré  N;  Saykin  AJ;  Brown  MJ;  Wishart  HA;  Flashman  LA;  Santulli  RB:  Differential memory test sensitivity for diagnosing amnestic mild cognitive impairment and predicting conversion to Alzheimer’s disease.  Neuropsychol Dev Cogn B Aging Neuropsychol Cogn 2009; 16:357–376
[CrossRef] | [PubMed]
 
Seeman  TE;  Rodin  J;  Albert  M:  Self-efficacy and cognitive performance in high-functioning older individuals: MacArthur Studies of Successful Aging.  J Aging Health 1993; 5:455–474
[CrossRef]
 
Bandura  A:  Self-Efficacy: The Exercise of Control .  New York,  WH Freeman, 1997
 
Gardiner  M;  Luszcz  MA;  Bryan  J:  The manipulation and measurement of task-specific memory self-efficacy in younger and older adults.  Int J Behav Dev 1997; 21:209–227
[CrossRef]
 
Cohen  GL;  Garcia  J;  Purdie-Vaughns  V;  Apfel  N;  Brzustoski  P:  Recursive processes in self-affirmation: intervening to close the minority achievement gap.  Science 2009; 324:400–403
[CrossRef] | [PubMed]
 
Miyake  A;  Kost-Smith  LE;  Finkelstein  ND;  Pollock  SJ;  Cohen  GL;  Ito  TA:  Reducing the gender achievement gap in college science: a classroom study of values affirmation.  Science 2010; 330:1234–1237
[CrossRef] | [PubMed]
 
Sperling  RA;  Aisen  PS;  Beckett  LA;  Bennett  DA;  Craft  S;  Fagan  AM;  Iwatsubo  T;  Jack  CR  Jr;  Kaye  J;  Montine  TJ;  Park  DC;  Reiman  EM;  Rowe  CC;  Siemers  E;  Stern  Y;  Yaffe  K;  Carrillo  MC;  Thies  B;  Morrison-Bogorad  M;  Wagster  MV;  Phelps  CH:  Toward defining the preclinical stages of Alzheimer’s disease: recommendations from the National Institute on Aging-Alzheimer’s Association workgroups on diagnostic guidelines for Alzheimer’s disease.  Alzheimers Dement 2011; 7:280–292
[CrossRef] | [PubMed]
 
References Container
+
+

Self-Assessment Quiz

Did you know? You can add a subscription now to earn CME Credits!

1.
Among cognitively normal older adults with an APOE ɛ4 genotype, putting them at increased risk of Alzheimer's disease, how did performance on an objective verbal memory test differ between those informed versus uninformed of the risk genotype?
2.
Which subscale on a memory functioning assessment was most sensitive to disclosure of increased risk from an APOE ε4 genotype?
3.
How did disclosing an APOE ε4 genotype to a cognitively normal elderly adult affect self-reported depression on the Geriatric Depression Scale?
Submit a Comments
Please read the other comments before you post yours. Contributors must reveal any conflict of interest.
Comments are moderated and will appear on the site at the discertion of APA editorial staff.

* = Required Field
(if multiple authors, separate names by comma)
Example: John Doe



Web of Science® Times Cited: 2

Related Content
See Also...
Articles
Books
Textbook of Traumatic Brain Injury, 2nd Edition > Chapter 39.  >
Textbook of Traumatic Brain Injury, 2nd Edition > Chapter 3.  >
Textbook of Traumatic Brain Injury, 2nd Edition > Chapter 39.  >
Textbook of Traumatic Brain Injury, 2nd Edition > Chapter 3.  >
Textbook of Traumatic Brain Injury, 2nd Edition > Chapter 3.  >
Topic Collections
Psychiatric News
Read more at Psychiatric News >>