Cognitive dispersion and ApoEe4 genotype predict dementia diagnosis in 8-year follow-up of the oldest-old

Tamlyn Watermeyer*, Jantje Goerdten, Boo Johansson, Graciela Muniz-Terrera

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

5 Citations (Scopus)
5 Downloads (Pure)


Background Cognitive dispersion, or inconsistencies in performance across cognitive domains, has been posited as a cost-effective tool to predict conversion to dementia in older adults. However, there is a dearth of studies exploring cognitive dispersion in the oldest-old (>80 years) and its relationship to dementia incidence. Objective The main aim of this study was to examine whether higher cognitive dispersion at baseline was associated with dementia incidence within an eight-year follow-up of very old adults, while controlling for established risk factors and suggested protective factors for dementia. Methods Participants (n=468) were from the Origins of Variance in the Old‐Old: Octogenarian Twins study, based on the Swedish Twin Registry. Cox regression analyses were performed to assess the association between baseline cognitive dispersion scores and dementia incidence, while controlling for sociodemographic variables, ApoEe4 carrier status, co-morbidities, zygosity and lifestyle engagement scores. An additional model included a composite of average cognitive performance. Results Cognitive dispersion and ApoEe4 were significantly associated with dementia diagnosis. These variables remained statistically significant when global cognitive performance was entered into the model. Likelihood ratio tests revealed that cognitive dispersion and cognitive composite scores entered together in the same model, was superior to either predictor alone in the full model. Conclusions The study underscores the usefulness of cognitive dispersion metrics for dementia prediction in the oldest-old and highlights the influence of ApoEe4 on cognition in very late age. Our findings concur with others suggesting that health and lifestyle factors pose little impact upon cognition in very advanced age.
Original languageEnglish
Pages (from-to)868–874
JournalAge and Ageing
Issue number3
Early online date14 Nov 2020
Publication statusPublished - 1 May 2021


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