Anxiety Affects Cognition Differently in Healthy Apolipoprotein E ε4 Homozygotes and Non-Carriers

The authors investigated the effect of carrying the apolipoprotein epsilon4 allele on performance of cognitive tasks of executive functioning when anxiety was present. They studied 185 cognitively normal individuals matched for age, gender, education, cognitive test scores, psychotropic medications, and state- or trait-anxiety; some were homozygote carriers, some heterozygote, and some, non-carriers. A higher anxiety level was associated with poorer performance on the Trails B test in the e4 homozygote participants, which may be indicative of greater risk for subsequent cognitive decline.

It is not known whether apolipoprotein E ε4—an Alzheimer disease susceptibility gene—influences the effects of state-anxiety on executive functioning in healthy individuals. In a prospective cohort study of 185 cognitively normal individuals, there were ε4 homozygotes, heterozygotes, and non-carriers, who did not differ in age, sex, years of education, cognitive test scores, psychotropic medications, and state- or trait-anxiety. However, higher anxiety was associated with significantly worse Trails B performance in the ε4 homozygotes, as compared with ε4 non-carriers. The association of executive-functioning difficulties and anxiety appears more likely to occur in persons who are most at risk for subsequent cognitive decline.