Apolipoprotein E and Health in Older Men: The Concord Health and Ageing in Men Project.

APOE genotype has been associated with various age-related outcomes including Alzheimers disease, frailty and mortality. In this study, the relationship between health, particularly cognitive function, and APOE was investigated in older men from the Concord Health and Ageing in Men Project (n=1616; age 76.9+/-5.5 yrs (range 70-97 yrs); Australia). Baseline characteristics and survival up to 12 years were determined. Frailty was measured using Cardiovascular Health study (CHS) criteria and Rockwood frailty index, and cognition using MiniMental State Examination (MMSE) and Addenbrookes Cognitive Examination. APOE epsilon4 was less common in the oldest men and those born in Mediterranean countries. APOE epsilon2 was beneficially associated with cholesterol, creatinine, gamma-glutamyl transaminase, glucose and HDL cholesterol while APOE epsilon4 was adversely associated with cholesterol and albumin. APOE epsilon4 was associated with a clinical diagnosis of Alzheimers disease when adjusted for age and region of birth (epsilon4 homozygotes OR 7.0; epsilon4 heterozygotes OR 2.4, P<0.05), and APOE epsilon2 had a small positive association with cognition. On multivariate regression, overall cognitive function in the entire cohort was associated with age, country of birth, education and frailty (all P<0.001). APOE was not associated with frailty or survival. In conclusion, age and region of birth influenced distribution of APOE genotype in older men. Although APOE epsilon4 was associated with Alzheimers disease, overall cognitive function in the cohort was associated more strongly with frailty than APOE genotype.