{"title":"Interactive Associations of Age, Apolipoprotein E ε4 Gene, Physical Activity, and Physical Functioning on Processing Speed","authors":"Ricardo Aurélio Carvalho Sampaio PhD , Yukiko Nishita PhD , Chikako Tange PhD , Shu Zhang PhD , Mitsuru Shinohara PhD , Mana Tateishi MSc , Kanae Furuya PhD , Sayaka Kubota PhD , Priscila Yukari Sewo Sampaio PhD , Naoyuki Sato MD, PhD , Hiroshi Shimokata MD, PhD , Hidenori Arai MD, PhD , Rei Otsuka PhD","doi":"10.1016/j.jamda.2025.105489","DOIUrl":null,"url":null,"abstract":"<div><h3>Objectives</h3><div>This study investigated the interactive associations of age, apolipoprotein E ε4 (APOE4) genetic status, physical activity energy expenditure (PAEE), and physical functioning on processing speed over a 10-year period.</div></div><div><h3>Design</h3><div>In this longitudinal study, participants underwent biennial assessments from 2002 to 2012 as part of the National Institute for Longevity Sciences-Longitudinal Study of Aging (NILS-LSA).</div></div><div><h3>Setting and Participants</h3><div>We used data from 2518 middle-aged and older community-dwelling adults in Japan.</div></div><div><h3>Methods</h3><div>Processing speed was assessed using the Digit Symbol Substitution Test, and additional data included APOE4 genotyping, objective PAEE measurement via accelerometry (in kcal/d), and physical functioning assessments (handgrip strength and walking speed, dichotomized according to specific cutoffs: <18 kg for women and <28 kg for men [weakness], and <1 m/s [slowness], respectively). Mixed-effects models were used to analyze the data, accounting for time-varying covariates, including living arrangement, hypertension, hyperlipidemia, diabetes, depressive symptoms, smoking, sleep duration, energy intake, and body mass index.</div></div><div><h3>Results</h3><div>Results revealed significant 3-way interactive associations among PAEE × age × APOE4 carrier (β = 0.000025, <em>P</em> = .021) and among slowness × age × APOE4 carrier (β = −0.014187, <em>P</em> = .013) on cognitive processing speed. Higher PAEE was associated with better processing speed, whereas slowness was associated with poorer processing speed, particularly in older APOE4 carriers. Although weakness showed significant interactions with age and APOE4 carrier, no 3-way interaction was observed.</div></div><div><h3>Conclusions and Implications</h3><div>Our findings underscore the complex interplay among physical activity, physical functioning, age, and genetic risk on processing speed. The protective associations of higher PAEE levels and better physical functioning, especially in older APOE4 carriers, suggest that maintaining an active lifestyle and mobility may be crucial for individuals with a genetic predisposition to cognitive decline.</div></div>","PeriodicalId":17180,"journal":{"name":"Journal of the American Medical Directors Association","volume":"26 11","pages":"Article 105489"},"PeriodicalIF":3.8000,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of the American Medical Directors Association","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1525861025000064","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/9/9 0:00:00","PubModel":"Epub","JCR":"Q2","JCRName":"GERIATRICS & GERONTOLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Objectives
This study investigated the interactive associations of age, apolipoprotein E ε4 (APOE4) genetic status, physical activity energy expenditure (PAEE), and physical functioning on processing speed over a 10-year period.
Design
In this longitudinal study, participants underwent biennial assessments from 2002 to 2012 as part of the National Institute for Longevity Sciences-Longitudinal Study of Aging (NILS-LSA).
Setting and Participants
We used data from 2518 middle-aged and older community-dwelling adults in Japan.
Methods
Processing speed was assessed using the Digit Symbol Substitution Test, and additional data included APOE4 genotyping, objective PAEE measurement via accelerometry (in kcal/d), and physical functioning assessments (handgrip strength and walking speed, dichotomized according to specific cutoffs: <18 kg for women and <28 kg for men [weakness], and <1 m/s [slowness], respectively). Mixed-effects models were used to analyze the data, accounting for time-varying covariates, including living arrangement, hypertension, hyperlipidemia, diabetes, depressive symptoms, smoking, sleep duration, energy intake, and body mass index.
Results
Results revealed significant 3-way interactive associations among PAEE × age × APOE4 carrier (β = 0.000025, P = .021) and among slowness × age × APOE4 carrier (β = −0.014187, P = .013) on cognitive processing speed. Higher PAEE was associated with better processing speed, whereas slowness was associated with poorer processing speed, particularly in older APOE4 carriers. Although weakness showed significant interactions with age and APOE4 carrier, no 3-way interaction was observed.
Conclusions and Implications
Our findings underscore the complex interplay among physical activity, physical functioning, age, and genetic risk on processing speed. The protective associations of higher PAEE levels and better physical functioning, especially in older APOE4 carriers, suggest that maintaining an active lifestyle and mobility may be crucial for individuals with a genetic predisposition to cognitive decline.
期刊介绍:
JAMDA, the official journal of AMDA - The Society for Post-Acute and Long-Term Care Medicine, is a leading peer-reviewed publication that offers practical information and research geared towards healthcare professionals in the post-acute and long-term care fields. It is also a valuable resource for policy-makers, organizational leaders, educators, and advocates.
The journal provides essential information for various healthcare professionals such as medical directors, attending physicians, nurses, consultant pharmacists, geriatric psychiatrists, nurse practitioners, physician assistants, physical and occupational therapists, social workers, and others involved in providing, overseeing, and promoting quality