From the Journals

APOE4: Elders with allele benefit from lifestyle changes



Healthy lifestyle interventions may benefit cognition in older at-risk individuals – even among those with susceptibility to dementia related to the apolipoprotein E–epsilon 4 (APOE4) allele, Alina Solomon, MD, PhD, reported in JAMA Neurology.

“Whether such benefits are more pronounced in APOE4 carriers, compared with noncarriers, should be further investigated,” wrote Dr. Solomon of the Institute of Clinical Medicine/Neurology at the University of Eastern Finland, Kuopio, and her associates.

The investigators analyzed data of 1,109 participants in the multicenter Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER), a randomized, controlled trial of at-risk individuals from the general population. Participants were aged 60-77 years, and 362 of them were carriers of the APOE4 allele.

Those randomized to the intervention group received targeted information about nutrition, instructions about physical exercise, and cognitive training – including group sessions led by a psychologist. The control group received “regular health advice” (JAMA Neurol. 2018 Jan 22. doi: 10.1001/jamaneurol.2017.4365).

After the interventions, participants underwent a battery of neuropsychological testing. Dr. Solomon and her associates found that the per-year difference between the intervention and control groups in the total score change was 0.037 (95% confidence interval, 0.001-0.073) among APOE4 carriers and 0.014 (95% CI, −0.011-0.039) among noncarriers.

Among other things, the findings stress the importance of early prevention strategies targeting simultaneously many risk factors that are modifiable, the investigators said.

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