Modifying effects of race and ethnicity and APOE on the association of physical activity with risk of Alzheimer's disease and related dementias

Alzheimers Dement. 2023 Feb;19(2):507-517. doi: 10.1002/alz.12677. Epub 2022 Apr 27.

Abstract

Introduction: We investigated whether the protective association of physical activity with risk of Alzheimer's disease and related dementias (ADRD) has genetic or behavioral variations.

Methods: In the Multiethnic Cohort, we analyzed moderate or vigorous physical activity (MVPA) reported at ages 45 to 75 among 88,047 participants in relation to 13,039 incident diagnoses of late-onset ADRD identified in Medicare claims (1999 to 2014), by five racial and ethnic groups, hours sitting, and in a subset (16%), apolipoprotein E (APOE) genotype.

Results: MVPA was inversely associated with ADRD (hazard ratio for ≥14 vs <2.5 hours/week: 0.83, 95% confidence interval [CI]: 0.76 to 0.90 in men; 0.88, 5% CI: 0.81 to 0.95 in women). The association was inverse in all racial and ethnic groups except Black participants (P-heterogeneity = 0.52), but stronger in individuals with lower levels of sitting duration or those who do not carry the APOE e4 risk allele.

Discussion: The different effects of physical activity by sitting duration and APOE genotype warrant further research.

Keywords: Alzheimer's disease; dementia; physical activity; prospective studies; race and ethnicity; sitting.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Aged
  • Alzheimer Disease* / genetics
  • Apolipoproteins E / genetics
  • Ethnicity
  • Exercise
  • Female
  • Humans
  • Male
  • Medicare
  • Middle Aged
  • Risk Factors
  • United States / epidemiology

Substances

  • Apolipoproteins E