Effect of physical exercise on cognitive function in older adults’ carriers versus noncarriers of apolipoprotein E4: systematic review and meta-analysis

Abstract

The presence of apolipoprotein (Apo) E4 is a genetic risk factor in cognitive impairment. Physical exercise contributes to slowing cognitive impairment in older adults, but little is known about the influence of exercise on ApoE4 carriers and noncarriers. The objective of systematic review is to study the role of physical exercise in older adults' ApoE4 carriers and noncarriers. A systematic literature search was carried out in five international databases: PubMed, Web of Science, PeDro, Scopus, and SPORTDiscus. A total of nine randomized controlled trials were included with a sample size of 2,025 subjects (901 ApoE4 carriers). The exercise reported a significant improvement on cognitive performance in older adults' ApoE4 noncarriers (standardized mean difference [SMD]= 0.653; 95% confidence interval [CI], 0.29-1.00; chi 2 = 35.36; degrees of freedom [df ]= 7; P< 0.0001; l 2 = 80%). It was also reported that a total program duration greater than 50 sessions generated different and significant effects on cognitive performance in older adults' ApoE4 noncarriers (SMD= 0.878; 95% CI, 0.14-1.61; chi 2 = 31.82; df= 3; P< 0.0001; l 2 = 91%). The results reported that high intensity generated a differential effect on cognitive performance in older adults' ApoE4 carriers versus noncarriers (SMD= 0.963; 95% CI, 0.25-1.67; chi 2 = 18.11; df= 3; P< 0.0004; l 2 = 83%). The effect of physical exercise on cognitive performance in older adults is conditioned by the presence or not of ApoE4.

ApoE in Alzheimer’s disease: pathophysiology and therapeutic strategies

“…Physical activity has been shown to reduce Aβ accumulation, improve cholesterol levels, reduce neuroinflammation, and enhance cognitive function [ 246 ]. Despite some contradictory evidence in the field, it is becoming increasingly apparent that the beneficial effects of exercise and diet are likely dependent on APOE genotype [ 247 ]. Following the assessment of physical activity and cognitive function in 806 participants over 6 years, a recent study showed that an active lifestyle has a favorable correlation with cognitive performance in APOE4 non-carriers [ 248 ].…”

Physical exercise as a potential strategy to mitigate the effects of Covid-19 in sleep quality: a systematic review

“…A national policy to support physical exercise at home seems essential in this context, especially for older adults [50]. Policies that address the improvement of unhealthy behaviors, as well as sleep quality and MH, are important during quarantine, with physical exercise as an effective and affordable non-pharmacological therapy option, of low cost and without side effects, to achieve this objective in an economical and sustainable way [51,52].…”

Individual and environmental factors associated with cognitive function in older people: a longitudinal multilevel analysis

“…Genetic factors may also interact with behavioral factors and affect cognitive function. The effect of physical exercise on cognitive performance in older adults is also conditioned or moderated by the presence of apolipoprotein E (ApoE4) [ 12 , 13 ], a genetic risk factor in cognitive impairment. Dietary habits such as protein or fiber intake showed a similar pattern [ 14 ].…”