학술논문

Genetic variants and functional pathways associated with resilience to Alzheimer’s disease
Document Type
article
Source
Brain. 143(8)
Subject
Biological Psychology
Health Sciences
Psychology
Alzheimer's Disease including Alzheimer's Disease Related Dementias (AD/ADRD)
Neurosciences
Clinical Trials and Supportive Activities
Genetics
Dementia
Aging
Acquired Cognitive Impairment
Behavioral and Social Science
Brain Disorders
Clinical Research
Neurodegenerative
Human Genome
Alzheimer's Disease
Prevention
2.1 Biological and endogenous factors
Aetiology
Neurological
Good Health and Well Being
Aged
80 and over
Alzheimer Disease
Brain
Chromosomes
Human
Pair 18
Cognitive Dysfunction
Cognitive Reserve
Female
Genome-Wide Association Study
Genotype
Humans
Male
Polymorphism
Single Nucleotide
Alzheimer's disease
amyloid
resilience
GWAS
reserve
Alzheimer’s Disease Neuroimaging Initiative
Alzheimer’s Disease Genetics Consortium (ADGC)
A4 Study Team
Alzheimer’s disease
Medical and Health Sciences
Psychology and Cognitive Sciences
Neurology & Neurosurgery
Biomedical and clinical sciences
Health sciences
Language
Abstract
Approximately 30% of older adults exhibit the neuropathological features of Alzheimer's disease without signs of cognitive impairment. Yet, little is known about the genetic factors that allow these potentially resilient individuals to remain cognitively unimpaired in the face of substantial neuropathology. We performed a large, genome-wide association study (GWAS) of two previously validated metrics of cognitive resilience quantified using a latent variable modelling approach and representing better-than-predicted cognitive performance for a given level of neuropathology. Data were harmonized across 5108 participants from a clinical trial of Alzheimer's disease and three longitudinal cohort studies of cognitive ageing. All analyses were run across all participants and repeated restricting the sample to individuals with unimpaired cognition to identify variants at the earliest stages of disease. As expected, all resilience metrics were genetically correlated with cognitive performance and education attainment traits (P-values < 2.5 × 10-20), and we observed novel correlations with neuropsychiatric conditions (P-values < 7.9 × 10-4). Notably, neither resilience metric was genetically correlated with clinical Alzheimer's disease (P-values > 0.42) nor associated with APOE (P-values > 0.13). In single variant analyses, we observed a genome-wide significant locus among participants with unimpaired cognition on chromosome 18 upstream of ATP8B1 (index single nucleotide polymorphism rs2571244, minor allele frequency = 0.08, P = 2.3 × 10-8). The top variant at this locus (rs2571244) was significantly associated with methylation in prefrontal cortex tissue at multiple CpG sites, including one just upstream of ATPB81 (cg19596477; P = 2 × 10-13). Overall, this comprehensive genetic analysis of resilience implicates a putative role of vascular risk, metabolism, and mental health in protection from the cognitive consequences of neuropathology, while also providing evidence for a novel resilience gene along the bile acid metabolism pathway. Furthermore, the genetic architecture of resilience appears to be distinct from that of clinical Alzheimer's disease, suggesting that a shift in focus to molecular contributors to resilience may identify novel pathways for therapeutic targets.