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Effect of the Apoli...
Effect of the Apolipoprotein E Genotype on Cognitive Change During a Multidomain Lifestyle Intervention A Subgroup Analysis of a Randomized Clinical Trial
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- Solomon, Alina (author)
- Karolinska Institutet,Stockholms universitet,Centrum för forskning om äldre och åldrande (ARC), (tills m KI),University of Eastern Finland, Finland; Karolinska Institutet, Sweden,Univ Eastern Finland, Inst Clin Med Neurol, Kuopio, Finland, Stockholm Univ, Karolinska Inst
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- Turunen, Heidi (author)
- Eastern Finland, Inst Clin Med Neurol, Kuopio, Finland
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- Ngandu, Tiia (author)
- Karolinska Institutet
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- Peltonen, Markku (author)
- Natl Inst Hlth & Welf, Chron Dis Prevent Unit, Helsinki, Finland
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- Levalahti, Esko (author)
- Natl Inst Hlth & Welf, Chron Dis Prevent Unit, Helsinki, Finland
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- Helisalmi, Seppo (author)
- Eastern Finland, Inst Clin Med Neurol, Kuopio, Finland
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- Antikainen, Riitta (author)
- Univ Oulu Finland
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- Backman, Lars (author)
- Karolinska Institutet,Stockholms universitet,Centrum för forskning om äldre och åldrande (ARC), (tills m KI),Stockholm Univ, Karolinska Inst
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- Hanninen, Tuomo (author)
- Kuopio Univ Hosp Finland
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- Jula, Antti (author)
- Natl Inst Hlth & Welf, Chron Dis Prevent Unit, Helsinki, Finland
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- Laatikainen, Tiina (author)
- Natl Inst Hlth & Welf, Chron Dis Prevent Unit, Helsinki, Finland
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- Lehtisalo, Jenni (author)
- Natl Inst Hlth & Welf, Chron Dis Prevent Unit, Helsinki, Finland
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- Lindstrom, Jaana (author)
- Natl Inst Hlth & Welf, Chron Dis Prevent Unit, Helsinki, Finland
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- Paajanen, Teemu (author)
- Finnish Inst Occupat Hlth, Helsinki, Finland
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- Pajala, Satu (author)
- Natl Inst Hlth & Welf, Welf & Hlth Promot Unit, Helsinki, Finland
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- Stigsdotter Neely, Anna, 1961- (author)
- Karlstads universitet,Institutionen för sociala och psykologiska studier (from 2013),Umeå universitet,Institutionen för psykologi,Department of Social and Psychological Studies, Karlstad University, Karlstad, Sweden
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- Strandberg, Timo (author)
- Univ Oulu Finland
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- Tuomilehto, Jaakko (author)
- Natl Inst Hlth & Welf, Chron Dis Prevent Unit, Helsinki, Finland
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- Soininen, Hilkka (author)
- Eastern Finland, Inst Clin Med Neurol, Kuopio, Finland
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- Kivipelto, Miia (author)
- Karolinska Institutet
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(creator_code:org_t)
- American Medical Association (AMA), 2018
- 2018
- English.
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In: JAMA Neurology. - : American Medical Association (AMA). - 2168-6149 .- 2168-6157. ; 75:4, s. 462-470
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https://urn.kb.se/re...
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https://doi.org/10.1...
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https://urn.kb.se/re...
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https://urn.kb.se/re...
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http://kipublication...
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Abstract
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- IMPORTANCE The role of the apolipoprotein E (APOE) epsilon 4 allele as an effect modifier in lifestyle interventions to prevent cognitive impairment is still unclear. OBJECTIVE To examine whether the APOE epsilon 4 allele modifies the previously reported significant cognitive benefits of a multidomain lifestyle intervention (prespecified subgroup analysis). DESIGN, SETTING, AND PARTICIPANTS The Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER) was a randomized clinical trial in 6 centers across Finland (screening and randomization performed from September 7, 2009, through November 24, 2011; intervention duration, 2 years). Data analysis was performed from August 1, 2015, to March 31, 2016. The study population was at-risk older individuals from the general population. Inclusion criteria were age of 60 to 77 years; Cardiovascular Risk Factors, Aging, and Dementia risk score of at least 6 points; and cognition at a mean level or slightly lower than expected for age. Individuals with dementia or substantial cognitive impairment and conditions that prevented cooperation or safe engagement in the intervention were excluded. APOE genotype data were available for 1175 of the 1260 participants. INTERVENTIONS Participants were randomly assigned in a 1: 1 ratio to a multidomain intervention group (diet, exercise, cognitive training, and vascular risk management) or a control group (general health advice). Group allocation was not actively disclosed to participants, and outcome assessors were masked to group allocation. MAIN OUTCOMES AND MEASURES Primary outcome was change in cognition measured through a comprehensive neuropsychological test battery. Analysis was based on modified intention to treat (participants with at least 1 postbaseline assessment). RESULTS A total of 1109 participants (mean [SD] age, 69.3 [4.7] years; 514 [46.3%] female) were included in the analysis: 362 APOE epsilon 4 allele carriers (173 intervention and 189 control) and 747 noncarriers (380 intervention and 367 control). The APOE epsilon 4 carriers and noncarriers were not significantly different at baseline (except for serum cholesterol level). The difference between the intervention and control groups in annual neuropsychological test battery total score change was 0.037 (95% CI, 0.001 to 0.073) among carriers and 0.014 (95% CI, -0.011 to 0.039) among noncarriers. Intervention effect was not significantly different between carriers and noncarriers (0.023; 95% CI, -0.021 to 0.067). CONCLUSIONS AND RELEVANCE Healthy lifestyle changesmay be beneficial for cognition in older at-risk individuals even in the presence of APOE-related genetic susceptibility to dementia. Whether such benefits are more pronounced in APOE epsilon 4 carriers compared with noncarriers should be further investigated. The findings also emphasize the importance of early prevention strategies that target multiple modifiable risk factors simultaneously.
Subject headings
- SAMHÄLLSVETENSKAP -- Psykologi (hsv//swe)
- SOCIAL SCIENCES -- Psychology (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Neurologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Neurology (hsv//eng)
Keyword
- Psychology with an emphasis on medical psychology
- Psykologi inr. medicinsk psykologi
Publication and Content Type
- ref (subject category)
- art (subject category)
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- By the author/editor
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Solomon, Alina
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Turunen, Heidi
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Ngandu, Tiia
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Peltonen, Markku
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Levalahti, Esko
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Helisalmi, Seppo
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Antikainen, Riit ...
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Backman, Lars
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Hanninen, Tuomo
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Jula, Antti
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Laatikainen, Tii ...
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Lehtisalo, Jenni
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Lindstrom, Jaana
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Paajanen, Teemu
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Pajala, Satu
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Stigsdotter Neel ...
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Strandberg, Timo
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Tuomilehto, Jaak ...
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Soininen, Hilkka
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Kivipelto, Miia
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- About the subject
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- SOCIAL SCIENCES
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SOCIAL SCIENCES
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and Psychology
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Neurology
- Articles in the publication
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JAMA Neurology
- By the university
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Karlstad University
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Stockholm University
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Umeå University
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Karolinska Institutet