Evidence map›Paper›PMID 41720779›Full record

ArticleNature communications2026

Genetic modifiers of APOE-ε4-associated cognitive decline.

Alex G Contreras, Skylar Walters, Jaclyn M Eissman, Derek B Archer, Alexandra N Regelson, Alaina Durant, Michelle Clifton, Subhabrata Mukherjee, Michael L Lee, Seo-Eun Choi and 37 more

Abstract read
In one paragraph

Article in Nature communications, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Review
  2. Article
  3. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

47 authors.

Alex G ContrerasVanderbilt Memory & Alzheimer's Center, Vanderbilt University Medical Center, Nashville, TN, USA.
Skylar WaltersVanderbilt Memory & Alzheimer's Center, Vanderbilt University Medical Center, Nashville, TN, USA.
Jaclyn M EissmanVanderbilt Memory & Alzheimer's Center, Vanderbilt University Medical Center, Nashville, TN, USA.
Derek B ArcherVanderbilt Memory & Alzheimer's Center, Vanderbilt University Medical Center, Nashville, TN, USA.ORCID http://orcid.org/0000-0001-8638-0785
Alexandra N RegelsonVanderbilt Memory & Alzheimer's Center, Vanderbilt University Medical Center, Nashville, TN, USA.
Alaina DurantVanderbilt Memory & Alzheimer's Center, Vanderbilt University Medical Center, Nashville, TN, USA.
Michelle CliftonVanderbilt Memory & Alzheimer's Center, Vanderbilt University Medical Center, Nashville, TN, USA.
Subhabrata MukherjeeDepartment of Medicine, University of Washington, Seattle, WA, USA.ORCID http://orcid.org/0000-0003-2522-2884
Michael L LeeDepartment of Medicine, University of Washington, Seattle, WA, USA.
Seo-Eun ChoiDepartment of Medicine, University of Washington, Seattle, WA, USA.
Phoebe ScollardDepartment of Medicine, University of Washington, Seattle, WA, USA.ORCID http://orcid.org/0000-0002-4094-938X
Emily H TrittschuhDepartment of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, WA, USA.
Jesse MezDepartment of Neurology, Boston University Chobanian & Avedisian School of Medicine, Boston, MA, USA.
William S BushDepartment of Population and Quantitative Health Sciences, Cleveland Institute for Computational Biology, School of Medicine, Case Western Reserve University, Cleveland, OH, USA.ORCID http://orcid.org/0000-0002-9729-6519
Brian W KunkleJohn P. Hussman Institute for Human Genomics, University of Miami Miller School of Medicine, Miami, FL, USA.ORCID http://orcid.org/0000-0002-9515-5157
Carlos CruchagaDepartment of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA.ORCID http://orcid.org/0000-0002-0276-2899
Adam C NajDepartment of Biostatistics, Epidemiology, and Informatics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA.ORCID http://orcid.org/0000-0002-9621-2942
Katherine A GiffordVanderbilt Memory & Alzheimer's Center, Vanderbilt University Medical Center, Nashville, TN, USA.
Murat BilgelLaboratory of Behavioral Neuroscience National Institute on Aging National Institutes of Health, Baltimore, MD, USA.ORCID http://orcid.org/0000-0001-5042-7422
Amanda B KuzmaDepartment of Pathology and Laboratory Medicine, Penn Neurodegeneration Genomics Center, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA.ORCID http://orcid.org/0000-0002-6064-5420
Alzheimer’s Disease Neuroimaging Initiative (ADNI)
Alzheimer’s Disease Genetics Consortium (ADGC)
Alzheimer’s Disease Sequencing Project (ADSP)
Michael L CuccaroJohn P. Hussman Institute for Human Genomics, University of Miami Miller School of Medicine, Miami, FL, USA.
Margaret A Pericak-VanceJohn P. Hussman Institute for Human Genomics, University of Miami Miller School of Medicine, Miami, FL, USA.
Lindsay A FarrerDepartment of Neurology, Boston University Chobanian & Avedisian School of Medicine, Boston, MA, USA.ORCID http://orcid.org/0000-0001-5533-4225
Li-San WangDepartment of Pathology and Laboratory Medicine, Penn Neurodegeneration Genomics Center, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA.
Gerard D SchellenbergDepartment of Pathology and Laboratory Medicine, Penn Neurodegeneration Genomics Center, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA.
Jonathan L HainesDepartment of Population and Quantitative Health Sciences, Cleveland Institute for Computational Biology, School of Medicine, Case Western Reserve University, Cleveland, OH, USA.
Angela L JeffersonVanderbilt Memory & Alzheimer's Center, Vanderbilt University Medical Center, Nashville, TN, USA.
Walter A KukullDepartment of Epidemiology, School of Public Health, University of Washington, Seattle, WA, USA.ORCID http://orcid.org/0000-0001-8761-9014
C Dirk KeeneDepartment of Laboratory Medicine and Pathology, University of Washington, Seattle, WA, USA.ORCID http://orcid.org/0000-0002-5291-1469
Andrew J SaykinDepartment of Radiology and Imaging Services, Indiana University School of Medicine, Indianapolis, IN, USA.
Paul M ThompsonImaging Genetics Center, Stevens Neuroimaging & Informatics Institute, Keck School of Medicine, University of Southern California, Marina del Rey, CA, USA.
Eden R MartinJohn P. Hussman Institute for Human Genomics, University of Miami Miller School of Medicine, Miami, FL, USA.
Marilyn S AlbertDepartment of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Sterling C JohnsonAlzheimer's Disease Research Center, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.ORCID http://orcid.org/0000-0002-8501-545X
Corinne D EngelmanAlzheimer's Disease Research Center, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.
Luigi FerrucciJohns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA.ORCID http://orcid.org/0000-0002-6273-1613
David A BennettRush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, USA.
Lisa L BarnesRush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, USA.
Julie A SchneiderRush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, USA.ORCID http://orcid.org/0000-0002-9482-1752
Reisa A SperlingDepartment of Neurology, Massachusetts General Hospital/Harvard Medical School, Boston, MA, USA.ORCID http://orcid.org/0000-0003-1535-6133
Susan M ResnickLaboratory of Behavioral Neuroscience National Institute on Aging National Institutes of Health, Baltimore, MD, USA.ORCID http://orcid.org/0000-0003-1115-7145
Paul K CraneDepartment of Medicine, University of Washington, Seattle, WA, USA.
Logan DumitrescuVanderbilt Memory & Alzheimer's Center, Vanderbilt University Medical Center, Nashville, TN, USA.ORCID http://orcid.org/0000-0002-9782-9944
Timothy J HohmanVanderbilt Memory & Alzheimer's Center, Vanderbilt University Medical Center, Nashville, TN, USA. timothy.j.hohman@vumc.org.ORCID http://orcid.org/0000-0002-3377-7014

Funding

NATIONAL ALZHEIMERS COORDINATING CENTER (NACC)U01AG016976 · NIA · UNIVERSITY OF WASHINGTON · PI KUKULL, WALTER ANTHONY · 1999 to 2020
$72.8M
Research Education ComponentP30AG066507 · NIA · JOHNS HOPKINS UNIVERSITY · PI Corinne Pettigrew · 2020 to 2026
$29.3M
University of Washington Alzheimer's Disease Research CenterP30AG066509 · NIA · UNIVERSITY OF WASHINGTON · PI Amanda D. Boyd · 2020 to 2026
$29.0M
Research Education ComponentP30AG066512 · NIA · NEW YORK UNIVERSITY SCHOOL OF MEDICINE · PI Mary Sherman Mittelman · 2020 to 2026
$28.4M
Wake Forest University School of Medicine Alzheimer's Disease Research CenterP30AG072947 · NIA · WAKE FOREST UNIVERSITY HEALTH SCIENCES · PI SUZANNE CRAFT · 2021 to 2026
$24.3M
Research Education ComponentP30AG072976 · NIA · INDIANA UNIVERSITY INDIANAPOLIS · PI ANDREW J SAYKIN · 2021 to 2026
$24.1M
Genetic Epidemiology and Multi-Omics Analyses in Familial and Sporadic Alzheimer's Disease Among Secular Caribbean Hispanics and Religious OrderR01AG067501 · NIA · COLUMBIA UNIVERSITY HEALTH SCIENCES · PI MAYEUX, RICHARD P, MILLER, GARY W · 2020 to 2024
$11.7M
Sex-Specific Genetic Drivers of Alzheimer's Disease EndophenotypesR01AG073439 · NIA · VANDERBILT UNIVERSITY MEDICAL CENTER · PI Logan C Dumitrescu · 2021 to 2026
$4.8M
Genomic and Metabolomic Data Integration in a Longitudinal Cohort at Risk for Alzheimer's DiseaseRF1AG054047 · NIA · UNIVERSITY OF WISCONSIN-MADISON · PI ENGELMAN, CORINNE D. · 2022 to 2025
$3.8M
Genomic and Metabolomic Data Integration in a Longitudinal Cohort at Risk for Alzheimer's DiseaseR01AG054047 · NIA · UNIVERSITY OF WISCONSIN-MADISON · PI ENGELMAN, CORINNE D. · 2016 to 2020
$3.6M
NIA NIH HHS P30 AG066507NIA NIH HHS P30 AG066509NIA NIH HHS P30 AG066512NIA NIH HHS P30 AG072947NIA NIH HHS P30 AG072976NIA NIH HHS R01 AG054047NIA NIH HHS R01 AG067501NIA NIH HHS R01 AG073439NIA NIH HHS RF1 AG054047NIA NIH HHS U01 AG016976U.S. Department of Health & Human Services | NIH | National Institute on Aging (U.S. National Institute on Aging) AG074855
6 · The paper itself

Abstract

The APOE-ε4 allele is the strongest genetic risk factor for late-onset Alzheimer's disease. However, APOE-ε4 is not deterministic, highlighting the need to identify additional genetic and environmental factors. APOE-ε4 has been linked to accelerated cognitive decline, so we sought to investigate genetic factors that modify APOE-ε4-associated cognitive decline. We conduct cross-ancestry APOE-ε4-stratified and interaction GWAS using harmonized cognitive data from 32,778 participants, including 29,354 non-Hispanic White and 3,424 non-Hispanic Black individuals. Our primary outcome is late-life cognition, measured using harmonized composite scores for memory, executive function, and language, modeled as continuous traits reflecting both normative cognitive aging and disease-related decline. We identify two genome-wide significant loci in APOE-ε4 carriers, reaching genome-wide significance for executive function. These loci also demonstrate nominal associations across the other domains, suggesting broad effects on cognition. In non-carriers, we identify a genome-wide significant association at ITGB8 restricted to executive function, and another locus associated with language. We further link these loci to SEMA6D, GRIN3A, and ITGB8 through expression and methylation databases. Post-GWAS analyses implicate additional genes including SLCO1A2, and DNAH11. Genetic correlation analyses reveal differences by APOE-ε4 status for immune-related traits, suggesting immune-related predispositions may exacerbate cognitive risk in APOE-ε4 carriers.

Indexed as

Apolipoprotein E4Cognitive DysfunctionAgedAged, 80 and overAllelesAlzheimer DiseaseExecutive FunctionFemaleGenetic Predisposition to DiseaseGenome-Wide Association StudyHumansMalePolymorphism, Single NucleotideApolipoprotein E4

Identifiers

PMID41720779
PMCPMC13036010

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.