Patients with Alzheimer's disease who carry the APOE ε4 allele benefit more from physical exercise

Camilla Steen Jensen; Anja Hviid Simonsen; Volkert Siersma; Nina Beyer; Kristian Steen Frederiksen; Hanne Gottrup; Kristine Hoffman; Peter Høgh; Ruth Frikke-Schmidt; Nanna Aue Sobol; Gunhild Waldemar; Lene Wermuth; Steen Gregers Hasselbalch

doi:10.1016/j.trci.2019.02.007

Patients with Alzheimer's disease who carry the APOE ε4 allele benefit more from physical exercise

Alzheimers Dement (N Y). 2019 Apr 8:5:99-106. doi: 10.1016/j.trci.2019.02.007. eCollection 2019.

Authors

Camilla Steen Jensen¹, Anja Hviid Simonsen¹, Volkert Siersma², Nina Beyer³, Kristian Steen Frederiksen¹, Hanne Gottrup⁴, Kristine Hoffman¹, Peter Høgh^{5

6}, Ruth Frikke-Schmidt^{6

7}, Nanna Aue Sobol³, Gunhild Waldemar^{1

6}, Lene Wermuth⁸, Steen Gregers Hasselbalch^{1

6}

Affiliations

¹ Department of Neurology, Danish Dementia Research Centre, Rigshospitalet Copenhagen University Hospital, Denmark.
² Department of Public Health, Research Unit for General Practice and Section of General Practice, University of Copenhagen, Denmark.
³ Department of Physical and Occupational Therapy, Institute of Sports Medicine, Bispebjerg and Frederiksberg Hospital, University of Copenhagen, Denmark.
⁴ Dementia Clinic, Department of Neurology, Aarhus University Hospital, Aarhus, Denmark.
⁵ Regional Dementia Research Centre, Department of Neurology, Zealand University Hospital, Roskilde, Denmark.
⁶ Department of Clinical Medicine, Faculty of Health and Medical Science, University of Copenhagen, Copenhagen, Denmark.
⁷ Department of Clinical Biochemistry, Rigshospitalet Copenhagen University Hospital, Denmark.
⁸ Dementia Clinic, Department of Neurology, Odense University Hospital, Denmark.

Abstract

Introduction: Our group has completed an exercise study of 200 patients with mild Alzheimer's disease. We found improvements in cognitive, neuropsychiatric, and physical measures in the participants who adhered to the protocol. Epidemiological studies in healthy elderly suggest that exercise preserves cognitive and physical abilities to a higher extent in AP OE ε4 carriers.

Methods: In this post hoc subgroup analysis study, we investigated whether the beneficial effect of an exercise intervention in patients with mild AD was dependent on the patients' APOE genotype.

Results: We found that patients who were APOE ε4 carriers benefitted more from the exercise intervention by preservation of cognitive performance and improvement in physical measures.

Discussion: This exploratory study establishes a possible connection between the beneficial effects of exercise in AD and the patients' APOE genotype. These findings, if validated, could greatly impact the clinical management of patients with AD and those at risk for developing AD.

Keywords: APOE; Alzheimer's disease; Exercise; Genetic; Intervention.