Interaction between APOE genotype and diabetes in cognitive decline

Mitsuru Shinohara, Yoshitaka Tashiro, Kaoru Suzuki, Akio Fukumori, Guojun Bu, Naoyuki Sato

Research output: Contribution to journalArticlepeer-review

4 Scopus citations


Introduction: Although diabetes and apolipoprotein E (apoE) are both significant risk factors for dementia, including Alzheimer's disease, it remains to be clarified how they are related to each other in contributing to the risk of dementia. Methods: By reviewing the National Alzheimer's Coordinating Center (NACC) clinical records, we investigated whether diabetes affects cognitive decline depending on APOE genotype and their potential relationships with neuropathology. Results: A significant interaction between diabetes and APOE genotype exists, where diabetes affected cognitive decline in APOE3 carriers and APOE2 carriers, but not APOE4 carriers. Moreover, the presence of vascular pathology was increased by diabetes in APOE3 carriers, while APOE4 carriers nearly reached plateau levels irrespective of diabetes. Discussion: Diabetes accelerates cognitive decline, in part, through accelerating vascular impairment in non-APOE ε4 carriers, but such effects are negligible in APOE4 carriers, who themselves are already vulnerable to vascular impairment.

Original languageEnglish (US)
Article numbere12006
JournalAlzheimer's and Dementia: Diagnosis, Assessment and Disease Monitoring
Issue number1
StatePublished - Jan 2020


  • APOE
  • Alzheimer's disease
  • cognitive decline
  • dementia
  • diabetes

ASJC Scopus subject areas

  • Clinical Neurology
  • Psychiatry and Mental health


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