We found no association between ACE genotype and cognitive function with the cross-sectional and the longitu- dinal approach. The previous studies have focused on the re- lation between ACE genotype and dementia and have come to quite different conclusions. The risk of dementia (all types) or AD have thus been reported to be increased with the I allele (7), and the D allele, but confined to the age group 66 to 71 years (8), or to the male sex (33), and to have no association with ACE genotype (34, 35). We studied as- sociations between ACE genotype and cognitive function on a continuous scale. Only one other cross-sectional study has examined the association between ACE genotype and MMSE score and failed as in the present study to show any relation between genotype and cognition (36).

twins were alive at baseline, which could introduce selec- tion bias. However, physical abilities in old twin pairs where both twins were alive have previously been shown only marginally better than in twins with a deceased co- twin (14). The instrument to determine physical perfor- mance in this study was self-report and measurements of upper and lower extremity function. This gives information from several functions each important for physical perfor- mance, none of which showed an association with ACE genotype. The assessment of physical abilities through self- report was done with a questionnaire that has been vali- dated in a Danish population on several occasions. Further, the reliability of self-reported physical functioning in the elderly is reported to be high (23). Both physical perfor- mance measures (grip strength and repeated chair stands) have been used in other studies among the elderly and have been shown to discriminate different levels of physical functioning (29, 30). All the previous association studies comparing physical performance with ACE genotype have studied young healthy individuals. Two different types of studies have been used: intervention and association stud- ies. Among male military recruits the intervention studies have found improved muscular function (3, 4) and whole

One study found a significantly larger proportion of DD’s among octogenarians (9), whereas in a study of 9203 persons from the Copenhagen City heart study (28) and in two stud- ies of centenarians (10, 11) the DD proportion was similar in the age groups compared. We studied mortality longitudi- nally and found an increased mortality among II’s in old age. To our knowledge, only one longitudinal study has investi- gated survival in relation to ACE genotype in 61 patients with renovascular disease where the DD patients had a poorer survival than the ID patients (37). The small differ- ence in the survival curves in the present study indicates that the ACE genotype does not have a major impact on survival and that the poorer II survival may reflect random variation. In conclusion, we found no substantial effects of ACE

In conclusion, we found no substantial effects of ACE genotype on physical and cognitive performance in neither the cross-sectional nor the follow-up study. Persons with

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