Genetic risk for Alzheimer disease predicts hippocampal volume through the human lifespan

Objective To test the hypothesis that genetic risk for Alzheimer disease (AD) may represent a stable influence on the brain from early in life, rather than being primarily age dependent, we investigated in a lifespan sample of 1,181 persons with a total of 2,690 brain scans, whether higher polygenic risk score (PGS) for AD and presence of APOE e4 was associated with lower hippocampal volumes to begin with, as an offset effect, or possibly faster decline in older age. Methods Using general additive mixed models, we assessed the relations of PGS for AD, including variants in APOE with hippocampal volume and its change in a cognitively healthy longitudinal lifespan sample (age range: 4–95 years, mean visit age 39.7 years, SD 26.9 years), followed for up to 11 years. Results AD-PGS and APOE e4 in isolation showed a significant negative effect on hippocampal volume. The effect of a 1 sample SD increase in AD-PGS on hippocampal volume was estimated to –36.4 mm³ (confidence interval [CI]: –71.8, –1.04) and the effect of carrying e4 allele(s) –107.0 mm³ (CI: –182.0, –31.5). Offset effects of AD-PGS and APOE e4 were present in hippocampal development, and interactions between age and genetic risk on volume change were not consistently observed. Conclusions Endophenotypic manifestation of polygenic risk for AD may be seen across the lifespan in cognitively healthy persons, not being confined to clinical populations or older age. This emphasizes that a broader population and age range may be relevant targets for attempts to prevent AD.