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Psychol Med. 2014 Apr;44(6):1319-29. doi: 10.1017/S0033291713001918. Epub 2013 Jul 24.

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.

Author information

  • 1Institute of Social Medicine, Occupational Health and Public Health, University of Leipzig, Germany.
  • 2Institute for Biometrics, Hannover Medical School, Germany.
  • 3Centre for Psychosocial Medicine, Department of Primary Medical Care, University Medical Centre Hamburg-Eppendorf, Germany.
  • 4Department of Psychiatry, University of Bonn, Germany.
  • 5Department of Psychiatry, Klinikum rechts der Isar, Technical University of Munich, Germany.
  • 6Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany.
  • 7Medical Faculty, Institute of General Practice, Heinrich-Heine-University Düsseldorf, Germany.
  • 8Department of Medical Sociology and Health Economics, University Medical Centre Hamburg-Eppendorf, Germany.

Abstract

BACKGROUND:

As physical activity may modify the effect of the apolipoprotein E (APOE) ε4 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.

METHOD:

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 APOE ε4 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.

RESULTS:

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 APOE ε4 allele significantly increased and higher physical activity significantly decreased risk for dementia and AD. The co-presence of APOE ε4 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 APOE ε4 or low physical activity alone. Indices of interaction indicated no significant interaction between low physical activity and the APOE ε4 allele for general dementia risk, but a possible additive interaction for AD risk.

CONCLUSIONS:

Physical activity even in late life may be effective in reducing conversion to dementia and AD or in delaying the onset of clinical manifestations. APOE ε4 carriers may particularly benefit from increasing physical activity with regard to their risk for AD.

PMID:
23883793
[PubMed - in process]
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