Apolipoprotein E epsilon 4 genotype and a physically active lifestyle in late life: analysis of gene–environment interaction for the risk of dementia and Alzheimer's disease dementia. Issue 6 (April 2014)

• Record Type: Journal Article
• Authors: Luck, T.; Riedel-Heller, S. G.; Luppa, M.; Wiese, B.; Köhler, M.; Jessen, F.; Bickel, H.; Weyerer, S.; Pentzek, M.; König, H.-H.; Prokein, J.; Ernst, A.; Wagner, M.; Mösch, E.; Werle, J.; Fuchs, A.; Brettschneider, C.; Scherer, M.; Maier, W.
• Is Part Of: Psychological medicine. Volume 44:Issue 6(2014)
• Page Start: 1319
• Page End: 1329
• Publication Date: 2014-04
• Subjects: Psychiatry -- Periodicals; Medicine and psychology -- Periodicals; Clinical psychology -- Periodicals; 616.89
• DOI: 10.1017/S0033291713001918
• Languages: English
• ISSNs: 0033-2917

Abstract

<abstract abstract-type="normal"> <title> <x content-type="archive" xml:space="preserve">Abstract</x> </title> <sec id="sec_a1"> <title>Background</title> <p>As physical activity may modify the effect of the apolipoprotein E (<italic>APOE</italic>) <italic>ε</italic>4 allele on the risk of dementia and Alzheimer's disease (AD) dementia, we tested for such a gene–environment interaction in a sample of general practice patients aged ⩾75 years.</p> </sec> <sec id="sec_a2" sec-type="methods"> <title>Method</title> <p>Data were derived from follow-up waves I–IV of the longitudinal German study on Ageing, Cognition and Dementia in Primary Care Patients (AgeCoDe). The Kaplan–Meier survival method was used to estimate dementia- and AD-free survival times. Multivariable Cox regression was used to assess individual associations of <italic>APOE ε</italic>4 and physical activity with risk for dementia and AD, controlling for covariates. We tested for gene–environment interaction by calculating three indices of additive interaction.</p> </sec> <sec id="sec_a3" sec-type="results"> <title>Results</title> <p>Among the randomly selected sample of 6619 patients, 3327 (50.3%) individuals participated in the study at baseline and 2810 (42.5%) at follow-up I. Of the 2492 patients without dementia included at follow-up I, 278 developed dementia (184 AD) over the subsequent follow-up interval of 4.5 years. The presence of the <italic>APOE ε</italic>4 allele significantly increased and higher physical activity significantly decreased risk for dementia and AD. The co-presence of <italic>APOE ε</italic>4 with low physical activity was associated with higher risk for dementia and AD and shorter dementia- and AD-free survival time than the presence of <italic>APOE ε</italic>4 or low physical activity alone. Indices of interaction indicated no significant interaction between low physical activity and the <italic>APOE ε</italic>4 allele for general dementia risk, but a possible additive interaction for AD risk.</p> </sec> <sec id="sec_a4" sec-type="conclusion"> <title>Conclusions</title> <p>Physical activity even in late life may be effective in reducing conversion to dementia and AD or in delaying the onset of clinical manifestations. <italic>APOE ε</italic>4 carriers may particularly benefit from increasing physical activity with regard to their risk for AD.</p> </sec> </abstract>