RESUMO
BACKGROUND: Virtually all adult studies of APOE genotypes and cognition have included individuals over 60. In older adults, epsilon 4 carriers may manifest greater cognitive asymmetries than non-epsilon 4 carriers even in the absence of overall mean differences. General cognitive ability may also be affected by aging and APOE genotype, but most studies have inadequately addressed this potential confound. The goals of this study were to examine, in middle age, the relationship of APOE genotype with episodic memory and verbal-visuospatial episodic memory asymmetries, after accounting for prior general cognitive ability. METHOD: We compared epsilon 4+ and epsilon 4- individuals in 626 male twins in their 50s. We examined verbal and visuospatial episodic memory and verbal-visual asymmetry scores after adjusting for cognitive ability at age 20. Analyses corrected for correlations between twin pair members. RESULTS: Compared with epsilon 4- individuals, epsilon 4 carriers performed significantly more poorly on verbal, but not visuospatial memory, manifested significantly greater cognitive asymmetry, and also had significantly more concerns about memory. At age 20, epsilon 4 carriers had higher general cognitive ability than epsilon 4- individuals, and current memory differences were enhanced after adjusting for age 20 cognitive ability. CONCLUSIONS: Small, but significant, APOE-epsilon 4-related memory deficits appear in the sixth decade of life in individuals who show no signs of preclinical dementia. The results partially support studies of older adults that suggest that increased cognitive asymmetries reflect risk for dementia and are associated with the APOE-epsilon 4 genotype. The results also highlight the potential problems of not having accurate data on prior cognitive ability.
Assuntos
Envelhecimento/genética , Apolipoproteína E4/genética , Química Encefálica/genética , Transtornos Cognitivos/genética , Predisposição Genética para Doença/genética , Transtornos da Memória/genética , Envelhecimento/metabolismo , Apolipoproteína E4/metabolismo , Transtornos Cognitivos/diagnóstico , Transtornos Cognitivos/metabolismo , Análise Mutacional de DNA , Progressão da Doença , Testes Genéticos , Genótipo , Humanos , Masculino , Transtornos da Memória/diagnóstico , Transtornos da Memória/metabolismo , Pessoa de Meia-Idade , Testes Neuropsicológicos , Polimorfismo Genético/genética , Valor Preditivo dos Testes , Prognóstico , Isoformas de Proteínas/genética , Fatores de RiscoRESUMO
BACKGROUND: The fine needle aspiration finding of apocrine metaplasia in association with the usual cytologic findings of gynecomastia is distinctly unusual. Previous reports do not mention any historical clinical association. CASES: Two otherwise healthy adult males presented for fine needle aspiration (FNA) of new-onset breast masses. Both showed apocrine metaplasia associated with the typical clinical and cytologic features of gynecomastia on FNA. Additional questioning revealed that both patients reported recent anabolic steroid use as part of their body-building routines. CONCLUSION: The fine needle aspiration finding of apocrine metaplasia in association with the usual cytologic and clinical findings of gynecomastia in otherwise healthy adult males without a medication history may be an indicator of illicit anabolic steroid use. Anabolic steroid use often has serious consequences, so its possibility should prompt further evaluation by the patient's clinician.