Age at onset of cognitive impairment as a function of TOMM40'523 genotype. The Bryan Alzheimer's Disease Research Center (ADRC) Memory, Health, and Aging cohort (n = 508, 106 conversion events) was followed prospectively at the Bryan ADRC at Duke University. Cognitive status was determined using standard neuropsychological tests. The age at which cognitive impairment occurred was retrospectively stratified by TOMM40'523 genotype, and Kaplan–Meier curves were constructed. TOMM40'523 genotype was determined using a sequencing‐based genotyping method (Polymorphic DNA Technologies). TOMM40'523 genotypes and the corresponding APOE genotypes are indicated in the figure. The red line corresponds to APOE ɛ4/4; the two green lines correspond to APOE ɛ3/4, and the three blue lines correspond to APOE ɛ3/3. Note that within this cohort there were 78 individuals who carried an APOE ɛ2 allele, but only five developed cognitive impairment during the study (VL/L (APOE ɛ2/4), n = 1; S/L (APOE ɛ2/4), n = 2; VL/VL (APOE ɛ3/3), n = 2). The numbers of subjects per TOMM40'523 genotype (number converted to case status) were: L/L, n = 23 (11); VL/L, n = 54 (24); S/L, n = 72 (23); S/S, n = 100 (20); S/ VL, n = 138 (22); VL/VL, n = 51 (6). Reprinted from ref. 4.