A Multi‐domain Lifestyle Intervention does not Improve Health and Cognitive Outcomes Among APOE e4 Carriers after 4‐months

Abstract

AbstractBackgroundAlzheimer’s Disease (AD) currently affects 24 million individuals worldwide, this rate is expected to triple by 2050. The greatest genetic risk for AD is apolipoprotein E (ApoE; e4 allele carriers), e4 carriers typically exhibit abnormal regulation of lipoprotein metabolism. It is important to understand whether multi‐domain lifestyle interventions can mitigate cognitive decline and improve overall health in ApoEe4 carriers. Thus far, the data are mixed due to sample sizes and methodological limitations. Therefore, the purpose of this present investigation is to determine if a digital multi‐domain intervention (MDI) can improve health and cognitive outcomes in cognitively at‐risk e4 carriers over 4 months.MethodAdults 45‐75 years old participated in this present investigation, each participant was randomly assigned to a health coaching intervention group (HC; n=61 non‐carriers; n=24 e4 carriers) or health education control group (HE; n=62 non‐carriers; n=20 e4 carriers). Participants completed weight, height, venous blood draw, a digital memory and associative learning test during baseline and 4‐month follow‐up visits. A 2 (time) x 2 (group) x 2 (APOE) factorial‐ANOVA was utilized to examine differences in the dependent variables (body mass index (BMI), cholesterol, triglycerides, memory, learning). Age, sex, and education were accounted for.ResultTriglycerides significantly increased among HC e4carriers compared to HC non‐carriers (p=.009). BMI significantly increased among carriers regardless of intervention group compared to non‐carriers (p< .001). Cholesterol values showed a decreasing trend among HC non‐carriers, HE carriers, and non‐carriers compared to no change among HC carriers (p=.118). At both time points, e4 carriers in HE and HC exhibited significantly lower scores on memory tasks compared to non‐carriers (p=.020). HC non‐carriers saw a significant increase in associative learning scores, HC e4carriers and HE group (e4 carriers and non‐carriers) showed decreases in an associative learning task (p=.016).ConclusionHC e4 carriers are unresponsive to a MDI lifestyle intervention compared to non‐carriers after 4‐months. These findings could be due to ApoE essential role in circulation lipoprotein metabolism and key role in regulation of cholesterol impacting synaptic function maintenance; e4 allele carriers usually demonstrate higher dysfunction. Follow‐up analyses are required to substantiate current preliminary findings.