Dementia in patients with type 2 diabetes (T2D) is associated with apolipoprotein E (APOE) genetic variation, with E2 and E4 carriers performing worse than E3 carriers in memory and global cognition.

The study takes particular significance since patients with T2D are at increased risk for dementia. The study was conducted in 754 European Americans from the Diabetes Heart Study (DHS) MIND and 517 African Americans from the African American (AA) DHS MIND. Identifying patients with T2D genetically at risk for dementia may help devise strategies for screening, prevention, early intervention, and therapeutic targets.

The patients underwent cognitive battery and brain MRI. In European Americans and African Americans, the APOE E4 risk haplotype group was associated with poorer performance on the modified Mini-Mental Status Examination (P < 0.017), a measure of global cognition. In contrast to the literature, the APOE E2 haplotype group, which was overrepresented in these participants with T2D, was associated with poorer Rey Auditory Verbal Learning Test performance (P < 0.032). Nominal associations between APOE haplotype groups and MRI-determined cerebral structure were observed.

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