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Using PD registry data, we retrospectively investigated a total of 253 patients with PD who underwent the Mini-Mental State Exam\u00a0(MMSE) two or more times\u00a0at least 5\u00a0years apart, were aged over 40\u00a0years, and free of dementia at the time of enrollment. We performed group-based trajectory modeling to identify patterns of cognitive change using the MMSE. Kaplan\u2013Meier survival analysis was used to investigate the role of the <jats:italic>APOE<\/jats:italic> genotype in cognitive and motor progression. Trajectory analysis divided patients into four groups: early fast decline, fast decline, gradual decline, and stable groups with annual MMSE scores decline of \u2212\u00a02.8, \u2212\u00a01.8, \u2212\u00a00.6, and \u2212\u00a00.1 points per year, respectively. The frequency of <jats:italic>APOE<\/jats:italic> \u03b54 was higher in patients in the early fast decline and fast decline groups (50.0%) than those in the stable group (20.1%) (<jats:italic>p<\/jats:italic>\u2009=\u20090.007). <jats:italic>APOE<\/jats:italic> \u03b54, in addition to older age at onset, depressive mood, and higher H&amp;Y stage, was associated with the cognitive decline rate, but no <jats:italic>APOE<\/jats:italic> genotype was associated with motor progression. <jats:italic>APOE<\/jats:italic> genotype could be used to predict the cognitive trajectory in PD.<\/jats:p>","DOI":"10.1038\/s41598-021-86483-w","type":"journal-article","created":{"date-parts":[[2021,4,9]],"date-time":"2021-04-09T10:07:47Z","timestamp":1617962867000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":41,"title":["The role of APOE in cognitive trajectories and motor decline in Parkinson\u2019s disease"],"prefix":"10.1038","volume":"11","author":[{"given":"Sungyang","family":"Jo","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seon-Ok","family":"Kim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kye Won","family":"Park","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seung Hyun","family":"Lee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yun Su","family":"Hwang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sun Ju","family":"Chung","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,4,9]]},"reference":[{"key":"86483_CR1","doi-asserted-by":"publisher","first-page":"580","DOI":"10.1001\/jamaneurol.2013.2110","volume":"70","author":"KF Pedersen","year":"2013","unstructured":"Pedersen, K. 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