Association of APOE ɛ4 haplotype and biological sex with Alzheimer’s disease prevalence and cognitive decline. (A) Point prevalence of symptomatic Alzheimer’s disease by sex and APOE ɛ4 haplotype across 5-year age intervals. Group differences were assessed with Pearson's chi-squared analysis (for details, see Supplementary Table 4). (B) Survival analysis showing the probability to develop symptomatic Alzheimer’s disease by sex and APOE haplotype across age. The P-value refers to log-rank test analysis. (C) Scatterplots illustrating the distribution of age at diagnosis of Alzheimer’s disease and showing the individual data points, the means and the nonparametric bootstrapped 95% confidence intervals. The P-values refer to t-tests (for details, see Supplementary Table 4). (D–I) Age-related changes in neuropsychological performance at the CAMCOG-DS (D, G), immediate (E, H) and delayed recall (F, I) at the mCRT, with bands representing the 95% confidence intervals in male and female separately. A significant difference between LOESS curves was defined as the age at which the curves diverged visually and the 95% confidence intervals did not overlap (P < 0.05). CAMCOG-DS, Cambridge Cognitive Examination for Older Adults with Down Syndrome; mCRT, modified cued recall test; F, female; M, male; ɛ4, APOE ɛ4 carriers.