Wholesome lifestyle mixed with higher cognition for older adults – no matter genetic danger


A new analysis of adults aged 80 and over shows that a healthier lifestyle is associated with a lower risk of cognitive impairment and that this relationship does not depend on whether a person carries a certain form of the APOE gene. Xurui Jin from Duke Kunshan University in Jiangsu, China, and colleagues present these results in the open access journal PLOS Medicine.

The APOE gene comes in a variety of forms, and people with a form known as APOE ε4 are at increased risk of cognitive impairment and Alzheimer’s disease. Previous research has also linked cognitive function to lifestyle factors such as smoking, exercise, and diet. However, it was unclear whether APOE ε4 affects the benefits of healthy lifestyle, especially in adults over 80 years of age.

To clarify the association between APOE ε4 and lifestyle, Jin and colleagues examined data from 6,160 adults, ages 80 or older, who participated in a larger, ongoing study called the Chinese Longitudinal Healthy Longevity Survey. The researchers analyzed the data statistically to investigate relationships between APOE ε4, lifestyle and cognition. They also took into account sociodemographic and other factors that could affect cognition.

The analysis confirmed that participants with a healthy lifestyle or a moderately healthy lifestyle had significantly fewer cognitive impairments than those with an unhealthy lifestyle, at 55 percent and 28 percent, respectively. In addition, participants with APOE cognitive4 were 17 percent more likely to have cognitive impairment than participants with other forms of APOE.

A previous study suggested that people with low and medium genetic risk are associated with lower risk of dementia when compared to unfavorable profiles. But these protective associations were not found in individuals at high genetic risk. However, the investigation showed that the association between lifestyle and cognitive impairment based on the APOE ε4 status, which represents the genetic risk of dementia, did not vary significantly. This suggests that maintaining a healthier lifestyle could be important for maintaining cognitive function in adults over 80 years of age regardless of genetic risk.

This cross-sectional study emphasized the importance of a healthy lifestyle for cognitive health. While more research is needed to validate these results across different populations, this study could help support efforts to improve cognitive function in the oldest adults.

In the next step, the team will investigate this relationship using the polygenetic risk score (AD-PRS) for AD and examine the interactive relationship between AD-PRS and lifestyle for cognition using the longitudinal data.


Research article

Peer-reviewed; Observation; People

Please use this URL in your reporting to get access to the freely available article: http://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1003597

Funding: The CLHLS surveys and genetic sub-study datasets (principal investigator: YZ) used for this research were supported by the National Key R&D Program of China and the National Natural Sciences Foundation of China through the grant: No. 2018YFC2000400, 71490732 and 81903392. The Funders played no role in study design, data collection and analysis, the decision to publish, or the preparation of the manuscript.

Competing Interests: I have read the journal’s guidelines and the authors of this manuscript have the following competing interests: XJ and ZN were employees of MindRank AI ltd. The other authors have no conflicts of interest.

Quote: Jin X, He W, Zhang Y, Gong E, Niu Z, Ji J, et al. (2021) Association of the APOE ε4 Genotype and Lifestyle with Cognitive Function in Chinese Adults 80 Years of Age and Older: A Cross-Sectional Study. PLoS Med 18 (6): e1003597. https://doi.org/10.1371/journal.pmed.1003597

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