{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T20:27:38Z","timestamp":1790886458244,"version":"4.1.0"},"reference-count":37,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"10","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Stroke"],"published-print":{"date-parts":[[2000,10]]},"abstract":"<jats:p>\n            <jats:italic>Background and Purpose<\/jats:italic>\n            \u2014Stroke and apolipoprotein E \u03b54 (ApoE \u03b54) are individually important risk factors for cognitive decline, including Alzheimer disease. It has been suggested that ApoE \u03b54 multiplies the risk for cognitive decline following stroke. In a population-based sample, using well-defined sensitive cognitive measures, this study investigates whether cognitive decline following stroke is worse for patients who carry the ApoE \u03b54 allele.\n          <\/jats:p>\n          <jats:p>\n            <jats:italic>Methods<\/jats:italic>\n            \u2014Subjects were participants in the Longitudinal Aging Study Amsterdam (LASA). The sample consisted of 1224 subjects, aged 62 to 85 years, who participated in the 3-year follow-up examination and for whom ApoE and stroke data were complete. We assessed cognitive decline using the Mini-Mental State Examination, the Auditory Verbal Learning Test (memory: immediate and delayed recall), and the Coding Task (information processing speed). The effects of stroke and ApoE \u03b54 on cognitive decline were evaluated with ANOVA and multiple logistic regression analysis, adjusted for age, sex, education, and baseline cognition.\n          <\/jats:p>\n          <jats:p>\n            <jats:italic>Results<\/jats:italic>\n            \u2014A synergistic effect modification for stroke and ApoE \u03b54 on cognitive decline was not observed. Unexpectedly, instead, stroke patients carrying the \u03b54 allele demonstrated a nonsignificantly lowered risk for Mini-Mental State Examination decline (OR=0.3; 95% CI 0.1 to 1.1). ApoE \u03b54 was associated with declines in information processing speed (OR=1.5; 95% CI 1.1 to 2.1) and small declines for immediate and delayed recall.\n          <\/jats:p>\n          <jats:p>\n            <jats:italic>Conclusions<\/jats:italic>\n            \u2014Stroke and ApoE \u03b54 may impair cognition through distinct nonsynergistic mechanisms. The slowing of information processing speed for ApoE \u03b54 carriers was more evident than impairment in memory.\n          <\/jats:p>","DOI":"10.1161\/01.str.31.10.2431","type":"journal-article","created":{"date-parts":[[2011,6,17]],"date-time":"2011-06-17T20:08:03Z","timestamp":1308341283000},"page":"2431-2436","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":66,"title":["Stroke and Apolipoprotein E \u03b54 Are Independent Risk Factors for Cognitive Decline"],"prefix":"10.1161","volume":"31","author":[{"given":"M. G.","family":"Dik","sequence":"first","affiliation":[{"name":"From the Institute for Research in Extramural Medicine (EMGO Institute) (M.G.D., D.J.H.D., L.M.B., C.J.) and Department of Psychiatry (D.J.H.D., C.J.), Vrije Universiteit, Amsterdam, Netherlands; Department of Clinical Chemistry, Academic Hospital Vrije Universiteit, Amsterdam, Netherlands (A.K.); and Center for Demographic Studies, Duke University, Durham, NC (E.H.C.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D. J. H.","family":"Deeg","sequence":"additional","affiliation":[{"name":"From the Institute for Research in Extramural Medicine (EMGO Institute) (M.G.D., D.J.H.D., L.M.B., C.J.) and Department of Psychiatry (D.J.H.D., C.J.), Vrije Universiteit, Amsterdam, Netherlands; Department of Clinical Chemistry, Academic Hospital Vrije Universiteit, Amsterdam, Netherlands (A.K.); and Center for Demographic Studies, Duke University, Durham, NC (E.H.C.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L. M.","family":"Bouter","sequence":"additional","affiliation":[{"name":"From the Institute for Research in Extramural Medicine (EMGO Institute) (M.G.D., D.J.H.D., L.M.B., C.J.) and Department of Psychiatry (D.J.H.D., C.J.), Vrije Universiteit, Amsterdam, Netherlands; Department of Clinical Chemistry, Academic Hospital Vrije Universiteit, Amsterdam, Netherlands (A.K.); and Center for Demographic Studies, Duke University, Durham, NC (E.H.C.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E. H.","family":"Corder","sequence":"additional","affiliation":[{"name":"From the Institute for Research in Extramural Medicine (EMGO Institute) (M.G.D., D.J.H.D., L.M.B., C.J.) and Department of Psychiatry (D.J.H.D., C.J.), Vrije Universiteit, Amsterdam, Netherlands; Department of Clinical Chemistry, Academic Hospital Vrije Universiteit, Amsterdam, Netherlands (A.K.); and Center for Demographic Studies, Duke University, Durham, NC (E.H.C.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Kok","sequence":"additional","affiliation":[{"name":"From the Institute for Research in Extramural Medicine (EMGO Institute) (M.G.D., D.J.H.D., L.M.B., C.J.) and Department of Psychiatry (D.J.H.D., C.J.), Vrije Universiteit, Amsterdam, Netherlands; Department of Clinical Chemistry, Academic Hospital Vrije Universiteit, Amsterdam, Netherlands (A.K.); and Center for Demographic Studies, Duke University, Durham, NC (E.H.C.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C.","family":"Jonker","sequence":"additional","affiliation":[{"name":"From the Institute for Research in Extramural Medicine (EMGO Institute) (M.G.D., D.J.H.D., L.M.B., C.J.) and Department of Psychiatry (D.J.H.D., C.J.), Vrije Universiteit, Amsterdam, Netherlands; Department of Clinical Chemistry, Academic Hospital Vrije Universiteit, Amsterdam, Netherlands (A.K.); and Center for Demographic Studies, Duke University, Durham, NC (E.H.C.)."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_2_1_2","doi-asserted-by":"publisher","DOI":"10.1161\/str.29.4.805"},{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(99)02355-7"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.44.10.1885"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1076\/jcen.20.4.503.1471"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1007\/s004150050064"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1073\/pnas.90.5.1977"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(95)92405-1"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1532-5415.1998.tb01532.x"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.54.7.1492"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1995.03520400044042"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1037\/0882-7974.14.2.295"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.282.1.40"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.53.7.1593"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.53.3.532"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1161\/str.27.12.2230"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.1161\/str.31.1.53"},{"key":"e_1_3_2_17_2","unstructured":"Deeg DJH Westendorp-de Seri\u00e8re M eds. 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