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We examined the effects of\n                      <jats:italic>APOE<\/jats:italic>\n                      \u03b54 allele on cognition in biomarker\u2010confirmed late mild cognitive impairment (LMCI) and mild AD subjects in the Japanese Alzheimer's Disease Neuroimaging Initiative (J\u2010ADNI) and North American ADNI (NA\u2010ADNI).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The \u201cearly AD\u201d (ie, combined LMCI and mild AD) cohort of 649 subjects from J\u2010ADNI and NA\u2010ADNI were selected based on positivity of A\u03b2 confirmed by amyloid positron emission tomography (PET) or cerebrospinal fluid testing. The rates of cognitive decline in the Mini Mental State Examination (MMSE), the Clinical Dementia Rating Sum of Boxes (CDR\u2010SB), and the Alzheimer's Disease Assessment Scale\u2010cognitive subscale 13 (ADAS\u2010Cog) from baseline were examined using mixed\u2010effects model. The effect of \u03b54 on time to conversion to dementia was also analyzed in LMCI using the Kaplan\u2010Meier estimator and log\u2010rank test.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The rates of cognitive decline were not significantly different between \u03b54 carriers and \u03b54 non\u2010carriers in the total early AD cohort, which were affected neither by region nor by the number of \u03b54 alleles. In LMCI, \u03b54 carriers showed almost the same progression rates as \u03b54 non\u2010carriers, except for a significantly faster decline in MMSE (\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0=\u00a0.0282). Time to conversion to demenita was not significantly different between \u03b54 carriers and \u03b54 non\u2010carriers. In \u03b54\u2010positive mild AD, the rates of decline in MMSE (\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0=\u00a0.003) and CDR\u2010SB (\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0=\u00a0.0071) were slower than those in \u03b54 non\u2010carriers.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>DISCUSSION<\/jats:title>\n                    <jats:p>\n                      The\n                      <jats:italic>APOE<\/jats:italic>\n                      \u03b54 allele had little effect on the rates of cognitive decline in the overall biomarker\u2010confirmed early AD, regardless of region and number of \u03b54 alleles, with a slight variability in different clinical stages, the \u03b54 allele being slightly accelerative in LMCI, while decelerative in mild AD.\n                    <\/jats:p>\n                  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