Predictors of Brain Function in the Oldest-Old

A US longitudinal observational cohort study suggests that APOE*2 allele and lower pulse pressure predicts resistance to amyloid-beta (Aβ) deposition in advanced aging. Of 100 participants, mean age at last cognitive evaluation was 92.0 years (range 86-100). Mean follow-up time from baseline to last measured Aβ status was 12.3 years and to last cognitive evaluation was 14.1 years. The APOE*2 allele predicted last Aβ status (n=34 Aβ-negative vs. n=66 Aβ-positive). Baseline cognition predicted cognitive status (n=30 unimpaired vs. n=70 impaired). Predictors of cognitive status among Aβ-positive participants only (n=14 normal cognition vs. n=52 impaired) were baseline cognitive test scores and smoking history, never having smoked (OR 10.84), and Raven’s PM test (a measure of non-verbal cognitive ability, OR 1.33) were significant predictors of unimpaired cognition. Baseline pulse pressure predicted longitudinal Aβ increase, lower baseline pulse pressure was protective against Aβ increase over time; paid work engagement and life satisfaction predicted less cognitive decline. Multiple neuropathological abnormalities are very common at advanced ages. The findings suggest that pulse pressure may be a modifiable risk factor for brain function in the oldest-old. Source: https://n.neurology.org/