Apolipoprotein E, Executive Function, and Falls across Cognitive Status: A Cross-Sectional Study

Falls are a critical public health issue, with executive function (EF) impairment being a contributing factor. However, whether apolipoprotein E4 (ApoE4) influences the relationship between EF and falls is unclear. This study investigated the potential moderating effect of ApoE4 on the EF and falls relationship in older adults with unimpaired cognition, mild cognitive impairment (MCI), and Alzheimer's disease (AD) dementia.

We analyzed cross-sectional data from 486 participants in the Brain and Body Donation Program of the Arizona Study of Aging and Neurodegenerative Disorders database. EF was assessed through a composite latent variable using the Trail Making Test, Stroop Interference, Digit Span, Clock Drawing test, and verbal fluency tests. ApoE genotypes were categorized as carriers and noncarriers of ApoE4. Logistic regression was used with fall history and future falls as outcomes.

ApoE4 did not moderate the EF and falls relationship (p ≥ 0.05). A significant interaction effect revealed that EF is associated with fall history for individuals with unimpaired cognition and MCI but not with AD dementia (OR = 1.658, p = 0.032). Significantly associated covariates with fall history included elements from the Unified Parkinson's Disease Rating Scale, medical conditions, and depression (p < 0.05), while medical conditions and fall history were significantly associated with future falls (p < 0.05).

ApoE4 did not significantly moderate the relationship between EF and falls. However, EF's impact on falls varied by cognitive status.