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61/100

✓ Peer-reviewed alzhub usefulness score 61 out of 100. Disparities

Topic: Risk, prevention and care in population studies

Objective Using APOE ε4 as an indicator of high risk, we investigated factors associated with cognitive resilience among black and white older adults who are APOE ε4 carriers. Results Among white APOE ε4 carriers, the strongest predictors of cognitive resilience were, in relative order of importance, no recent negative life events, a higher literacy level, advanced age, a higher educational level, and more time spent reading. In follow-up logistic regression models, higher literacy level (adjusted odds ratio [OR], 9.50 [95% CI, 2.67-60.89]), a higher educational level (adjusted OR for college graduate vs less than high school, 3.81 [95% CI, 1.13-17.56]), and age (adjusted OR for 73-76 vs 69-72 years, 2.01 [95% CI, 1.13-3.63]) had significant independent effects in predicting cognitive resilience among white APOE ε4 carriers. Among black APOE ε4 carriers, a higher literacy level (adjusted OR, 2.27 [95% CI, 1.29-4.06]) and a higher educational level (adjusted OR for high school graduate/some college vs less than high school, 2.86 [95% CI, 1.54-5.49]; adjusted OR for college graduate vs less than high school, 2.52 [95% CI, 1.14-5.62]) had significant independent effects in predicting cognitive resilience. Conclusions and relevance Although APOE ε4 carriers are at high risk for cognitive decline, our findings suggest possible intervention targets, including the enhancement of cognitive reserve and improvement of other psychosocial and health factors, to promote cognitive resilience among black and white APOE ε4 carriers.

Key findings

Objective Using APOE ε4 as an indicator of high risk, we investigated factors associated with cognitive resilience among black and white older adults who are APOE ε4 carriers.
Results Among white APOE ε4 carriers, the strongest predictors of cognitive resilience were, in relative order of importance, no recent negative life events, a higher literacy level, advanced age, a higher educational level, and more time spent reading.
In follow-up logistic regression models, higher literacy level (adjusted odds ratio [OR], 9.50 [95% CI, 2.67-60.89]), a higher educational level (adjusted OR for college graduate vs less than high school, 3.81 [95% CI, 1.13-17.56]), and age (adjusted OR for 73-76 vs 69-72 years, 2.01 [95% CI, 1.13-3.63]) had significant independent effects in predicting cognitive resilience among white APOE ε4 carriers.
Among black APOE ε4 carriers, a higher literacy level (adjusted OR, 2.27 [95% CI, 1.29-4.06]) and a higher educational level (adjusted OR for high school graduate/some college vs less than high school, 2.86 [95% CI, 1.54-5.49]; adjusted OR for college graduate vs less than high school, 2.52 [95% CI, 1.14-5.62]) had significant independent effects in predicting cognitive resilience.
Conclusions and relevance Although APOE ε4 carriers are at high risk for cognitive decline, our findings suggest possible intervention targets, including the enhancement of cognitive reserve and improvement of other psychosocial and health factors, to promote cognitive resilience among black and white APOE ε4 carriers.

Why it matters

Among APOE ε4 carriers, higher literacy and higher educational level predicted cognitive resilience in both black and white older adults. These findings suggest possible intervention targets such as enhancing cognitive activity, but they do not show that any intervention prevents or treats Alzheimer's disease.

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Study details

Study designprospective cohort
Participants2,487
Evidence strengthModerate

How this study scored 61/100

Published in a leading specialty journal, and it is a prospective cohort study, followed forward from enrollment. Scored zero for effect reported and randomised / blinded because the record does not state it.

Component	Points	Why
Journal tier	9 / 10	Tier 2 — leading specialty journal (JAMA neurology)
Journal's citation record	2 / 4	JAMA Neurology: journal h-index 235 (OpenAlex, 2026-10-29)
Study design	7 / 12	A prospective cohort study, followed forward from enrollment
Strength of evidence	3 / 5	Rated “moderate” in our summary
Peer-review validation	10 / 10	Peer-reviewed. Published as an article in a named peer-reviewed journal.
How recent	1 / 5	2015 — within 20 year(s) of the newest study here
Sample size	3 / 4	2,487 participants
Effect reported	0 / 3	No effect size reported — scores zero (not stated in the record — scored 0)
Studied in people	3 / 3	Studied in people (participant count stated)
Randomised / blinded	0 / 2	No randomisation or blinding stated — scores zero (not stated in the record — scored 0)
Times cited	4 / 7	Cited 90 times (OpenAlex, 2026-10-10)
Citations per year	2 / 5	6.9 citations a year over 13 year(s) since 2015
Impact for its field and year	3 / 6	Cited 5.3× the average for papers of its field and year (OpenAlex FWCI)
Cited by studies here	1 / 6	Cited by 2 other studies in this library
Still being cited	2 / 4	Cited 23 times in 2024–2026 (2026 still in progress; OpenAlex)
Senior author's track record	4 / 4	Last-listed author Kristine S. Yaffe: h-index 155 (OpenAlex, whole career)
Institution's track record	3 / 3	National Institutes of Health: institution h-index 2,723 (OpenAlex)
Multi-centre collaboration	2 / 3	OpenAlex lists 8 institution(s) in 1 country
Indexed in PubMed	2 / 2	Indexed in PubMed (PMID 25599330)
Free to read	0 / 2	Behind a paywall — scores zero
Total	61 / 100	—

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Read the original

Full text: free to read — OpenAlex lists this copy as free to read: the link above (checked 6 Feb 1020).

Cite this study APA, Vancouver, BibTeX · download .bib or .ris

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APA 7th

Kaup, A. R., Nettiksimmons, J., Harris, T. B., Sink, K. M., Satterfield, S., Metti, A. L., et al. (2015). Cognitive resilience to apolipoprotein E ε4: contributing factors in black and white older adults. JAMA neurology. https://doi.org/10.1001/jamaneurol.2014.3978

Vancouver

Kaup AR, Nettiksimmons J, Harris TB, Sink KM, Satterfield S, Metti AL, et al. Cognitive resilience to apolipoprotein E ε4: contributing factors in black and white older adults. JAMA neurology. 2015. doi:10.1001/jamaneurol.2014.3978. PMID: 25599330.

BibTeX

@article{kaup2015-25599330,
  author  = {Kaup, A. R. and Nettiksimmons, J. and Harris, T. B. and Sink, K. M. and Satterfield, S. and Metti, A. L. and Ayonayon, H. N. and Yaffe, K. and others},
  title   = {{Cognitive resilience to apolipoprotein E ε4: contributing factors in black and white older adults}},
  journal = {JAMA neurology},
  year    = {2015},
  doi     = {10.1001/jamaneurol.2014.3978},
  pmid    = {25599330},
  url     = {https://doi.org/10.1001/jamaneurol.2014.3978}
}

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