C-reactive protein and rate of dementia in carriers and non carriers of Apolipoprotein APOE4 genotype

Background Those with an Apolipoprotein APOE4 allele (APOE4) have lower C-reactive protein (CRP) than those without APOE4. Whether APOE4 modifies the effects of CRP on rate of all cause dementia, cognitive impairment or Alzheimerʹs disease (AD) is not established. Methods All cause dementia and cognitive impairment without dementia (CIND) was determined over five follow up visits from 1998 to 2006 in an ongoing cohort of older Latinos. The association between high sensitivity CRP and dementia/CIND, all cause dementia and Alzheimerʹs disease by APOE4 status was examined in semi-parametric survival models with covariate adjustments. Results CRP was significantly lower among those with APOE4 than in those without. Among those with APOE4, CRP was associated with lower rates of combined dementia/CIND (HR: 0.60, 95% CL: 0.20–0.91, p = 0.03) from a fully adjusted model. Among those with no APOE4, there was no effect of CRP on dementia/CIND rates (HR: 0.94, 95% CL: 0.67–1.33). Conclusions Lower CRP in those with APOE4 may reflect immune effects of the APOE4 genotype. Higher CRP in those with APOE4 may be a marker of better immune function, leading to lower rate of dementia and AD.