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Timing of Physical Activity, Apolipoprotein E ?4 Genotype, and Risk of Incident Mild Cognitive Impairment.

ABSTRACT: OBJECTIVESTo investigate the timing (mid- vs late life) of physical activity, apolipoprotein (APO)E ?4, and risk of incident mild cognitive impairment (MCI).DESIGNProspective cohort study.SETTINGMayo Clinic Study of Aging (Olmsted County, MN).PARTICIPANTSCognitively normal elderly adults (N = 1,830, median age 78, 50.2% female).MEASUREMENTSLight, moderate, and vigorous physical activities in mid- and late life were assessed using a validated questionnaire. An expert consensus panel measured MCI based on published criteria. Cox proportional hazards models were used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) with age as a time scale after adjusting for sex, education, medical comorbidity, and depression.RESULTSLight (HR = 0.58, 95% CI = 0.43-0.79) and vigorous (HR = 0.78, 95% CI = 0.63-0.97) physical activity in midlife were associated with lower risk of incident MCI. The association between moderate activity and incident MCI was not significant (HR = 0.85, 95% CI = 0.67-1.09). In late life, light (HR = 0.75, 95% CI = 0.58-0.97) and moderate (HR = 0.81, 95% CI = 0.66-0.99) but not vigorous physical activity were associated with lower risk of incident MCI. A synergistic interaction was also observed between mid- and late-life activity in reducing risk of incident MCI. Furthermore, APOE ?4 carriers who did not exercise had a higher risk of incident MCI than noncarriers who reported physical activity.CONCLUSIONPhysical activity reduced the risk of incident MCI. Exercising in mid- and late life had an additive synergistic interaction in reducing the risk of MCI.

SUBMITTER: Krell-Roesch J

PROVIDER: S-EPMC5173416 | biostudies-literature | 2016 Dec

REPOSITORIES: biostudies-literature

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Timing of Physical Activity, Apolipoprotein E ε4 Genotype, and Risk of Incident Mild Cognitive Impairment.

Krell-Roesch Janina J Pink Anna A Roberts Rosebud O RO Stokin Gorazd B GB Mielke Michelle M MM Spangehl Kathleen A KA Bartley Mairead M MM Knopman David S DS Christianson Teresa J H TJ Petersen Ronald C RC Geda Yonas E YE

Journal of the American Geriatrics Society 20161101 12

<h4>Objectives</h4>To investigate the timing (mid- vs late life) of physical activity, apolipoprotein (APO)E ε4, and risk of incident mild cognitive impairment (MCI).<h4>Design</h4>Prospective cohort study.<h4>Setting</h4>Mayo Clinic Study of Aging (Olmsted County, MN).<h4>Participants</h4>Cognitively normal elderly adults (N = 1,830, median age 78, 50.2% female).<h4>Measurements</h4>Light, moderate, and vigorous physical activities in mid- and late life were assessed using a validated questionn ...[more]

PMID: 27801933

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Project description:BACKGROUND:Apolipoprotein E (APOE) ?4 allele is a major genetic risk factor for Alzheimer disease and mild cognitive impairment (MCI). Computer-based training programs can improve cognitive performance in elderly populations. However, the effects of computer-based interventions on MCI APOE ?4 carriers have never been studied before. OBJECTIVE:The effects of different web-based interventions and the APOE isoform-specific differences in training outcomes are investigated. METHODS:Using a quasi-experimental study design, 202 participants with MCI aged 60 years and older took part in three different intervention programs (physical and cognitive [Long-Lasting Memories, or LLM], cognitive [Active Control, or AC], or physical intervention [Physical Training Control, or PTC]) via an innovative information and communication technologies exergaming platform. Participants in each interventional group were subdivided into APOE ?4 carriers and non-APOE ?4 carriers. All participants underwent an extensive neuropsychological evaluation before and after the training, blood tests, and brain imaging. RESULTS:All interventions resulted in multiple statistically significant cognitive benefits after the intervention. Verbal learning (California Verbal Learning Test: immediate recall test score-LLM: P=.04; AC: P<.001), working memory (digit span forward and backward test scores-AC: P=.03; PTC: P=.02 and P=.006, respectively), and long-term memory (California Verbal Learning Test: delayed recall test score-LLM: P=.02; AC: P=.002; and PTC: P=.02) were improved. There was no statistically significant difference among the intervention effects. APOE ?4 presence moderates intervention effects as the LLM intervention improved only their task-switching processing speed (Trail Making Test, Part B: P=.03) and the PTC intervention improved only the working memory (digit span backward: P=.03). No significant performance alteration was noted for the APOE ?4+ cognitive AC training group. CONCLUSIONS:None of the applied interventions could be identified as the optimal one; it is suggested, however, that combined cognitive and physical training and physical training via exergaming may be more effective for the high-risk MCI ?POE ?4+ subgroup.

Project description:ObjectiveTo estimate the incidence of psychotic symptoms in Alzheimer's disease.MethodsThe study consists of 776 elderly subjects presenting to the Alzheimer Disease Research Center at the University of Pittsburgh (Pittsburgh, Pennsylvania) between May 9, 2000, and August 19, 2014. All participants were diagnosed with mild cognitive impairment (National Institute on Aging-Alzheimer's Association workgroup criteria) or possible or probable Alzheimer's disease (National Institute of Neurologic and Communicative Disorders and Stroke and the Alzheimer's Disease and Related Disorders Association criteria) and were without psychosis at entry. Psychotic symptoms were evaluated using the Consortium to Establish a Registry for Alzheimer's Disease Behavioral Rating Scale every 6 months. One-, 3- and 5-year cumulative incidences of psychosis were calculated.ResultsThe 1-year psychosis incidence was 10% (95% CI, 8%-12%), and this annual rate remained remarkably consistent at 3 and 5 years. Psychosis incidence was related to cognitive status at all time points. However, the incidence rate reached a plateau during the disease course. Cumulative psychosis incidence at 5 years was 61% (95% CI, 52%-69%) in individuals with moderate to severe Alzheimer's disease, not statistically significantly different from the cumulative incidence at 3 years in this group, which was 48% (95% CI, 40%-55%) or from the 5-year incidence in individuals who entered the study with mild Alzheimer's disease, which was 48% (95% CI, 41%-56%).ConclusionsPsychosis in Alzheimer's disease has been associated with a number of adverse clinical outcomes. We provide estimates of the risk of psychosis onset within clinically defined subgroups of individuals, a tool clinicians can use in treatment planning. Anticipating which subjects are at high risk for psychosis and the poor outcomes associated with it can help with family education and support decisions to implement nonpharmacologic strategies that may reduce or prevent symptoms.

Dataset Information

Timing of Physical Activity, Apolipoprotein E ?4 Genotype, and Risk of Incident Mild Cognitive Impairment.

Publications

Timing of Physical Activity, Apolipoprotein E ε4 Genotype, and Risk of Incident Mild Cognitive Impairment.

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