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Alzheimer's Association International Conference 2026

July 12-15, 2026 | London, United Kingdom, and Online

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6187

Brain Metabolic Protection Conferred By The APOE3Ch Mutation In Normal Aging

Part of Topic

Introduction: 

The APOE3 Christchurch (APOE3Ch) is a rare genetic variant associated with marked protection against autosomal dominant Alzheimer’s disease (ADAD) due to the PSEN1E280A variant (1,2)

•Delayed onset of clinical symptoms in APOE3Ch carriers
•Despite high amyloid-β burden, tau pathology and glucose metabolism remained preserved
•Glucose metabolism, measured with FDG-PET, is markedly reduced in ADAD (3) and is sensitive to age-related changes in healthy aging, being highly correlated with cognitive performance
 
Objectives:

To investigate age-related alterations in cerebral glucose metabolism and cognitive function in:

1)APOE3Ch-PSEN1E280A carriers compared to typical PSEN1E280A carriers across the ADAD continuum
2)cognitively unimpaired APOE3Ch carriers compared to non-carriers across the healthy adult lifespan
 
 
Results:

APOE3Ch-PSEN1E280A carriers had a 58% smaller age-related reduction in precuneus metabolism, along with a 50% smaller reduction in episodic memory, compared to typical PSEN1E280A carriers

Across the adult lifespan, APOE3Ch carriers had preserved glucose metabolism in the ACC compared to non-carriers (slope: 0.001 vs -0.009), which correlated with greater global cognition and episodic memory and fewer memory complaints and depressive symptoms.

 
Conclusions: 
 
•Metabolic resilience patterns conferred by the APOE3Ch variant are notably different across groups, suggesting dissociation between processes of resilience to AD-specific pathology and healthy aging
•Structural and functional role of the anterior cingulate cortex (ACC) in this population may shed light on cognitive reserve and aging-resilience mechanisms
•Understanding the pathways through which APOE3Ch confers protection could inform novel therapeutic avenues to enhance resilience against AD and neurodegeneration and promote healthy brain aging (4)

The APOE3Ch variant may be protective against brain metabolic changes both in ADAD and across the disease-free adult lifespan, with corresponding benefits in cognitive function.

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