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APOE genotype and multimorbidity in the FINGER multidomain lifestyle trial
Author(s) -
Turunen Heidi,
Marengoni Alessandra,
Antikainen Riitta,
Helisalmi Seppo,
Laatikainen Tiina,
Soininen Hilkka,
Strandberg Timo,
Kivipelto Miia,
Solomon Alina,
Ngandu Tiia
Publication year - 2020
Publication title -
alzheimer's and dementia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 6.713
H-Index - 118
eISSN - 1552-5279
pISSN - 1552-5260
DOI - 10.1002/alz.043512
Subject(s) - medicine , polypharmacy , randomized controlled trial , population , quality of life (healthcare) , gerontology , logistic regression , dementia , physical therapy , environmental health , disease , nursing
Background A growing burden on healthcare systems is the increasing amount of chronic diseases in single person (multimorbidity), especially in the elderly population. Multimorbidity leads to many problems, such as higher use and cost of healthcare, polypharmacy and poorer quality of life. The present study reports exploratory analyses of APOE genotype and multimorbidity in the Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER, ClinicalTrials.gov NCT01041989). Method FINGER was a 2‐year randomized controlled trial with 1260 participants at risk for dementia from the general Finnish population, aged 60‐77 years. Beneficial effects of the multidomain intervention (diet, exercise, cognitive training and monitoring of vascular risk factors) versus control (regular health advice) have been previously reported on the primary cognitive outcome and several secondary outcomes. APOE and multimorbidity data at baseline and the 2‐year follow‐up were available for 532 participants in the intervention group and 527 in the control group. Multimorbidity was assessed through a standardized questionnaire, and an interview by the study physicians. The questionnaire entailed 17 diseases. Associations between APOE genotype (carrier vs non‐carrier of the ε4 allele) and multimorbidity after 2 years were assessed using logistic regression analyses, adjusted for randomization group, age, sex, education, smoking, alcohol consumption and baseline multimorbidity. Result At baseline APOE was not related to multimorbidity. However, in longitudinal analyses carriers of the APOE4 allele were more likely to develop 3 or more new chronic diseases during follow‐up, with OR (95%CI) 2.2 (1.04‐4.87), p=0.04. No significant associations were found between APOE and multimorbidity defined as one or more new chronic diseases (p=0.21) or 2 or more new chronic diseases (p=0.59). Conclusion Preliminary findings from the FINGER trial suggest that in this at‐risk general older population the APOE4 allele was related to multimorbidity defined as 3 or more new chronic diseases. To our knowledge this is the first study to link APOE to multimorbidity in the context of a lifestyle intervention to prevent cognitive decline. This is in line with previous findings linking APOE4 to cardiovascular and metabolic conditions.