Age-dependent interactions of APOE isoform 4 and Alzheimer’s disease neuropathology: findings from the NACC

Abstract Alzheimer’s disease related pathologies, neurodegenerative pathologies, and vascular neuropathologies are common in older adults at death. Previous studies using the National Alzheimer’s Coordinating Center (NACC) have not investigated the association between age at death and apolipoprotein...

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Main Authors: Cellas A. Hayes, Roland J. Thorpe, Michelle C. Odden
Format: Article
Language:English
Published: BMC 2025-05-01
Series:Acta Neuropathologica Communications
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Online Access:https://doi.org/10.1186/s40478-025-02012-0
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author Cellas A. Hayes
Roland J. Thorpe
Michelle C. Odden
author_facet Cellas A. Hayes
Roland J. Thorpe
Michelle C. Odden
author_sort Cellas A. Hayes
collection DOAJ
description Abstract Alzheimer’s disease related pathologies, neurodegenerative pathologies, and vascular neuropathologies are common in older adults at death. Previous studies using the National Alzheimer’s Coordinating Center (NACC) have not investigated the association between age at death and apolipoprotein E (APOE) ε4 and the prevalence of neuropathologies found at autopsy. We used autopsy confirmed neuropathology data from the NACC to examine the interactive effects of age and APOE ε4 on various neuropathologies (N = 5,843) using modified Poisson regression to estimate the prevalence ratios. Significant interactions between APOE ε4 and age at death were observed for neuritic plaques, Braak staging, diffuse neuritic plaques, and Lewy body disease pathology, with the effect of APOE ε4 decreasing at older ages. In contrast, a significant positive interaction was found for hemorrhages/microbleeds, indicating that the association between APOE ε4 and microbleeds strengthens with increasing age. These findings suggest that future therapeutic strategies should consider both genetic risk and age to effectively target AD progression.
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spelling doaj-art-3ee697f1549d42799e0ee4bc62d960c92025-08-20T03:53:57ZengBMCActa Neuropathologica Communications2051-59602025-05-0113111310.1186/s40478-025-02012-0Age-dependent interactions of APOE isoform 4 and Alzheimer’s disease neuropathology: findings from the NACCCellas A. Hayes0Roland J. Thorpe1Michelle C. Odden2School of Medicine Department of Epidemiology and Population Health, Stanford UniversityProgram for Research on Men’s Health, Johns Hopkins Center for Health Disparities Solutions, Johns Hopkins Bloomberg School of Public HealthSchool of Medicine Department of Epidemiology and Population Health, Stanford UniversityAbstract Alzheimer’s disease related pathologies, neurodegenerative pathologies, and vascular neuropathologies are common in older adults at death. Previous studies using the National Alzheimer’s Coordinating Center (NACC) have not investigated the association between age at death and apolipoprotein E (APOE) ε4 and the prevalence of neuropathologies found at autopsy. We used autopsy confirmed neuropathology data from the NACC to examine the interactive effects of age and APOE ε4 on various neuropathologies (N = 5,843) using modified Poisson regression to estimate the prevalence ratios. Significant interactions between APOE ε4 and age at death were observed for neuritic plaques, Braak staging, diffuse neuritic plaques, and Lewy body disease pathology, with the effect of APOE ε4 decreasing at older ages. In contrast, a significant positive interaction was found for hemorrhages/microbleeds, indicating that the association between APOE ε4 and microbleeds strengthens with increasing age. These findings suggest that future therapeutic strategies should consider both genetic risk and age to effectively target AD progression.https://doi.org/10.1186/s40478-025-02012-0Alzheimer’s disease related pathologyLewy body diseaseHippocampal sclerosisNeuropathologyArteriolosclerosisInfarcts
spellingShingle Cellas A. Hayes
Roland J. Thorpe
Michelle C. Odden
Age-dependent interactions of APOE isoform 4 and Alzheimer’s disease neuropathology: findings from the NACC
Acta Neuropathologica Communications
Alzheimer’s disease related pathology
Lewy body disease
Hippocampal sclerosis
Neuropathology
Arteriolosclerosis
Infarcts
title Age-dependent interactions of APOE isoform 4 and Alzheimer’s disease neuropathology: findings from the NACC
title_full Age-dependent interactions of APOE isoform 4 and Alzheimer’s disease neuropathology: findings from the NACC
title_fullStr Age-dependent interactions of APOE isoform 4 and Alzheimer’s disease neuropathology: findings from the NACC
title_full_unstemmed Age-dependent interactions of APOE isoform 4 and Alzheimer’s disease neuropathology: findings from the NACC
title_short Age-dependent interactions of APOE isoform 4 and Alzheimer’s disease neuropathology: findings from the NACC
title_sort age dependent interactions of apoe isoform 4 and alzheimer s disease neuropathology findings from the nacc
topic Alzheimer’s disease related pathology
Lewy body disease
Hippocampal sclerosis
Neuropathology
Arteriolosclerosis
Infarcts
url https://doi.org/10.1186/s40478-025-02012-0
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AT michellecodden agedependentinteractionsofapoeisoform4andalzheimersdiseaseneuropathologyfindingsfromthenacc