Time Course and Severity of Cognitive Changes as a Function of Aβ Positivity and <i>APOE</i> Genotype in Alzheimer Disease

These findings suggest that APOE4 carriers, particularly homozygotes, exhibit reduced cognitive resilience to Aβ accumulation, but that this effect is largely specific to episodic memory. These findings indicate that cognitive trajectories in AD differ by APOE genotype, highlighting the importance of examining clinical symptoms in the context of APOE status. Future research should investigate whether these differences are driven by distinct pathologic mechanisms in APOE4 carriers.