{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,15]],"date-time":"2026-04-15T05:04:47Z","timestamp":1776229487005,"version":"3.50.1"},"reference-count":30,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2025,12,30]],"date-time":"2025-12-30T00:00:00Z","timestamp":1767052800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,12,30]],"date-time":"2025-12-30T00:00:00Z","timestamp":1767052800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100000049","name":"National Institute on Aging","doi-asserted-by":"publisher","award":["R01 AG017917"],"award-info":[{"award-number":["R01 AG017917"]}],"id":[{"id":"10.13039\/100000049","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000049","name":"National Institute on Aging","doi-asserted-by":"publisher","award":["R01 AG033678"],"award-info":[{"award-number":["R01 AG033678"]}],"id":[{"id":"10.13039\/100000049","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000049","name":"National Institute on Aging","doi-asserted-by":"publisher","award":["R01 AG034374"],"award-info":[{"award-number":["R01 AG034374"]}],"id":[{"id":"10.13039\/100000049","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000049","name":"National Institute on Aging","doi-asserted-by":"publisher","award":["R01 AG060376"],"award-info":[{"award-number":["R01 AG060376"]}],"id":[{"id":"10.13039\/100000049","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["agsjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J American Geriatrics Society"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>\n                      Health and financial literacy decline in aging, but it is unclear why. In this study, we hypothesized that older people who are carriers of the\n                      <jats:italic>APOE<\/jats:italic>\n                      \u03b54 allele exhibit a steeper decline in literacy over time.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Participants were 851 community\u2010dwelling older adults without dementia at analytic baseline (188 \u03b54 carriers and 663 noncarriers). Literacy was assessed at baseline and each year thereafter for up to 14\u2009years.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      In a linear mixed\u2010effects model adjusted for age, gender, and education, \u03b54 was associated with a lower starting level of literacy (\n                      <jats:italic>b<\/jats:italic>\n                      \u2009=\u2009\u22123.60, SE\n                      <jats:italic>b<\/jats:italic>\n                      \u2009=\u20091.00,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) and, critically, a roughly 40% steeper decline in literacy over time (\n                      <jats:italic>b<\/jats:italic>\n                      \u2009=\u2009\u22120.41, SE\n                      <jats:italic>b<\/jats:italic>\n                      \u2009=\u20090.14,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.004). The association between \u03b54 and literacy decline persisted after adjusting for global cognition at baseline (\n                      <jats:italic>b<\/jats:italic>\n                      \u2009=\u2009\u22120.35, SE\n                      <jats:italic>b<\/jats:italic>\n                      \u2009=\u20090.14,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.012) and among a subgroup of participants with no cognitive impairment at baseline (\n                      <jats:italic>b<\/jats:italic>\n                      \u2009=\u2009\u22120.34, SE\n                      <jats:italic>b<\/jats:italic>\n                      \u2009=\u20090.14,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.016).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\u03b54 contributes to literacy decline among older adults, presumably due in part to the accumulation of neuropathologies associated with \u03b54. We discuss the potential clinical implications of \u03b54\u2010related literacy decline.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jgs.70291","type":"journal-article","created":{"date-parts":[[2025,12,31]],"date-time":"2025-12-31T07:49:30Z","timestamp":1767167370000},"page":"1121-1125","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["<scp>\n                      <i>APOE<\/i>\n                    <\/scp>\n                    \u03b54 and Decline in Health and Financial Literacy in Advanced Age"],"prefix":"10.1111","volume":"74","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2802-3370","authenticated-orcid":false,"given":"Christopher C.","family":"Stewart","sequence":"first","affiliation":[{"name":"Department of Neurology Indiana University School of Medicine  Indianapolis Indiana USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lei","family":"Yu","sequence":"additional","affiliation":[{"name":"Rush Alzheimer's Disease Center Rush University Medical Center  Chicago Illinois USA"},{"name":"Department of Neurological Sciences Rush University Medical Center  Chicago Illinois USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alifiya","family":"Kapasi","sequence":"additional","affiliation":[{"name":"Rush Alzheimer's Disease Center Rush University Medical Center  Chicago Illinois USA"},{"name":"Department of Pathology Rush University Medical Center  Chicago Illinois USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David A.","family":"Bennett","sequence":"additional","affiliation":[{"name":"Rush Alzheimer's Disease Center Rush University Medical Center  Chicago Illinois USA"},{"name":"Department of Neurological Sciences Rush University Medical Center  Chicago Illinois USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Patricia A.","family":"Boyle","sequence":"additional","affiliation":[{"name":"Rush Alzheimer's Disease Center Rush University Medical Center  Chicago Illinois USA"},{"name":"Department of Psychiatry and Behavioral Sciences Rush University Medical Center  Chicago Illinois USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,12,30]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1525\u20101497.2006.00540.x"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1257\/jel.52.1.5"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1525\u20101497.2004.40153.x"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.165.17.1946"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1093\/geroni\/igac010"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1017\/S1474747215000232"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/bsl.634"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11606\u2010008\u20100566\u20104"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1017\/s1474747222000154"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1287\/mnsc.2015.2293"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jagp.2021.02.042"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.neuron.2020.10.008"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1093\/geronb\/gbw054"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.3233\/JAD\u2010179939"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.34.7.939"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.2174\/156720512801322663"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1159\/000339094"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471\u20102318\u201012\u201030"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1136\/jech\u20102018\u2010210977"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1097\/MLR.0000000000000932"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40520\u2010019\u201001259\u20107"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.3233\/JAD\u2010161132"},{"key":"e_1_2_9_24_1","doi-asserted-by":"publisher","DOI":"10.3390\/brainsci7060056"},{"key":"e_1_2_9_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.neurobiolaging.2013.10.074"},{"key":"e_1_2_9_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1474\u20104422(18)30251\u20105"},{"key":"e_1_2_9_27_1","doi-asserted-by":"publisher","DOI":"10.1097\/wad.0000000000000334"},{"key":"e_1_2_9_28_1","doi-asserted-by":"publisher","DOI":"10.1001\/archneur.1993.00540080076020"},{"key":"e_1_2_9_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.tics.2011.10.001"},{"key":"e_1_2_9_30_1","doi-asserted-by":"publisher","DOI":"10.1162\/jocn_a_00281"},{"key":"e_1_2_9_31_1","doi-asserted-by":"publisher","DOI":"10.1159\/000342778"}],"container-title":["Journal 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