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Association of APOE ε4 genotype and lifestyle with cognitive function among Chinese adults aged 80 years and older: A cross-sectional study.

Publication ,  Journal Article
Jin, X; He, W; Zhang, Y; Gong, E; Niu, Z; Ji, J; Li, Y; Zeng, Y; Yan, LL
Published in: PLoS medicine
June 2021

Apolipoprotein E (APOE) ε4 is the single most important genetic risk factor for cognitive impairment and Alzheimer disease (AD), while lifestyle factors such as smoking, drinking, diet, and physical activity also have impact on cognition. The goal of the study is to investigate whether the association between lifestyle and cognition varies by APOE genotype among the oldest old.We used the cross-sectional data including 6,160 oldest old (aged 80 years old or older) from the genetic substudy of the Chinese Longitudinal Healthy Longevity Survey (CLHLS) which is a national wide cohort study that began in 1998 with follow-up surveys every 2-3 years. Cognitive impairment was defined as a Mini-Mental State Examination (MMSE) score less than 18. Healthy lifestyle profile was classified into 3 groups by a composite measure including smoking, alcohol consumption, dietary pattern, physical activity, and body weight. APOE genotype was categorized as APOE ε4 carriers versus noncarriers. We examined the associations of cognitive impairment with lifestyle profile and APOE genotype using multivariable logistic regressions, controlling for age, sex, education, marital status, residence, disability, and numbers of chronic conditions. The mean age of our study sample was 90.1 (standard deviation [SD], 7.2) years (range 80-113); 57.6% were women, and 17.5% were APOE ε4 carriers. The mean MMSE score was 21.4 (SD: 9.2), and 25.0% had cognitive impairment. Compared with those with an unhealthy lifestyle, participants with intermediate and healthy lifestyle profiles were associated with 28% (95% confidence interval [CI]: 16%-38%, P < 0.001) and 55% (95% CI: 44%-64%, P < 0.001) lower adjusted odds of cognitive impairment. Carrying the APOE ε4 allele was associated with 17% higher odds (95% CI: 1%-31%, P = 0.042) of being cognitively impaired in the adjusted model. The association between lifestyle profiles and cognitive function did not vary significantly by APOE ε4 genotype (noncarriers: 0.47 [0.37-0.60] healthy versus unhealthy; carriers: 0.33 [0.18-0.58], P for interaction = 0.30). The main limitation was the lifestyle measurements were self-reported and were nonspecific. Generalizability of the findings is another limitation because the study sample was from the oldest old in China, with unique characteristics such as low body weight compared to populations in high-income countries.In this study, we observed that healthier lifestyle was associated with better cognitive function among the oldest old regardless of APOE genotype. Our findings may inform the cognitive outlook for those oldest old with high genetic risk of cognitive impairment.

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Published In

PLoS medicine

DOI

EISSN

1549-1676

ISSN

1549-1277

Publication Date

June 2021

Volume

18

Issue

6

Start / End Page

e1003597

Related Subject Headings

  • Smoking
  • Risk Reduction Behavior
  • Risk Factors
  • Risk Assessment
  • Protective Factors
  • Male
  • Life Style
  • Humans
  • Healthy Lifestyle
  • Health Surveys
 

Citation

APA
Chicago
ICMJE
MLA
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Jin, X., He, W., Zhang, Y., Gong, E., Niu, Z., Ji, J., … Yan, L. L. (2021). Association of APOE ε4 genotype and lifestyle with cognitive function among Chinese adults aged 80 years and older: A cross-sectional study. PLoS Medicine, 18(6), e1003597. https://doi.org/10.1371/journal.pmed.1003597
Jin, Xurui, Wanying He, Yan Zhang, Enying Gong, Zhangming Niu, John Ji, Yaxi Li, Yi Zeng, and Lijing L. Yan. “Association of APOE ε4 genotype and lifestyle with cognitive function among Chinese adults aged 80 years and older: A cross-sectional study.PLoS Medicine 18, no. 6 (June 2021): e1003597. https://doi.org/10.1371/journal.pmed.1003597.
Jin, Xurui, et al. “Association of APOE ε4 genotype and lifestyle with cognitive function among Chinese adults aged 80 years and older: A cross-sectional study.PLoS Medicine, vol. 18, no. 6, June 2021, p. e1003597. Epmc, doi:10.1371/journal.pmed.1003597.
Jin X, He W, Zhang Y, Gong E, Niu Z, Ji J, Li Y, Zeng Y, Yan LL. Association of APOE ε4 genotype and lifestyle with cognitive function among Chinese adults aged 80 years and older: A cross-sectional study. PLoS medicine. 2021 Jun;18(6):e1003597.

Published In

PLoS medicine

DOI

EISSN

1549-1676

ISSN

1549-1277

Publication Date

June 2021

Volume

18

Issue

6

Start / End Page

e1003597

Related Subject Headings

  • Smoking
  • Risk Reduction Behavior
  • Risk Factors
  • Risk Assessment
  • Protective Factors
  • Male
  • Life Style
  • Humans
  • Healthy Lifestyle
  • Health Surveys