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Public Health.

Jenni Lehtisalo1,2, Alina Solomon2,3,4, Christelle Cantet5,6,7

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Summary
This summary is machine-generated.

Multidomain lifestyle interventions show greater cognitive benefits for individuals with the apolipoprotein E (ApoE) ε4 allele. These findings highlight ApoE4 carriers as a key target group for Alzheimer's Disease prevention strategies.

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Area of Science:

  • Neuroscience
  • Genetics
  • Public Health

Background:

  • The apolipoprotein E (ApoE) ε4 allele is the primary genetic risk factor for sporadic Alzheimer's Disease (AD).
  • ApoE genotype may influence the effectiveness of lifestyle interventions on cognitive health.
  • Previous research has not definitively shown if lifestyle interventions yield differential benefits for ApoE4 carriers versus non-carriers.

Purpose of the Study:

  • To conduct a meta-analysis investigating the interaction between ApoE genotype and multidomain lifestyle interventions on cognitive outcomes.
  • To determine if ApoE4 carriers experience greater cognitive benefits from lifestyle interventions compared to non-carriers.

Main Methods:

  • Meta-analysis combining data from three randomized clinical trials: FINGER (Finland), MAPT (France), and J-MINT (Japan).
  • Participants included at-risk individuals and those with mild cognitive impairment (MCI).
  • Intervention involved multidomain lifestyle factors (diet, exercise, cognitive training, risk monitoring); cognitive change was assessed using primary trial outcomes.

Main Results:

  • A statistically significant interaction (p=0.035) indicated greater cognitive benefits from the intervention among ApoE4 carriers compared to non-carriers.
  • Cognitive benefits were observed across diverse populations (Asian and European) and cognitive statuses (at-risk and MCI).
  • Effect sizes varied across trials, with J-MINT showing the largest benefit (0.36).

Conclusions:

  • This meta-analysis provides robust evidence that multidomain lifestyle interventions are particularly beneficial for ApoE4 carriers.
  • ApoE genotype significantly modifies the cognitive impact of lifestyle interventions.
  • ApoE4 carriers are an important target population for Alzheimer's Disease preventive strategies.