Disentangling sex-dependent effects of APOE on diverse trajectories of cognitive decline in Alzheimer's disease

Haixu Ma, Zhuoyu Shi, Minjeong Kim, Bin Liu, Patrick J. Smith, Yufeng Liu, Guorong Wu

Abstract: Highlights•The statistical model on change point detection offers a new window to stratify the diverse trajectories of cognitive decline in the temporal domain.•The relationship between tau biomarkers and MMSE manifests multiple change points occurring at the ages of 72, 78, and 83.•T biomarker exhibits higher sensitivity in tracking cognitive decline than A and [N] biomarkers. AT[N] biomarkers are more sensitive to the decline of executive function compared to memory performance.•Biological sex moderates the rate of cognitive decline associated with APOE4 genotype.•Higher levels of education, a marker of cognitive reserve, may moderate the effects of APOE4 and play an important role on cognitive decline.