Table 3.
Association Between Midlife Vigorous PA and Later Worse Cognitive Trajectory* Stratified by APOE-e4 Status†
| Global‡ (APOE-e4- n = 4691, APOE-e4+ n = 1445) |
Verbal memory‡ (APOE-e4-n = 4481, APOE-e4+ n = 1389) | TICS§ (APOE-e4- N = 4802, APOE-e4+ n = 1479) |
Category fluency (APOE-e4- n = 4621, APOE-e4+ n = 1435) | |||
|---|---|---|---|---|---|---|
| Trajectories* | Vigorous PA tertile | OR [95% CI] | OR [95% CI] | OR [95% CI] | OR [95% CI] | |
| p-interactions‖ | Medium-stable | p = .7 | p = .9 | p = .4 | p = .8 | |
| Decline | p = .07 | p = .8 | p = .09 | p = .5 | ||
| APOE-e4- | Medium-stable | 1 | 1 (ref) | 1 (ref) | 1 (ref) | 1 (ref) |
| 2 | 0.80 [0.69–0.93] | 0.88 [0.75–1.02] | 0.78 [0.66–0.92] | 0.82 [0.63–1.07] | ||
| 3 | 0.75 [0.64–0.87] | 0.79 [0.67–0.92] | 0.83 [0.70–0.98] | 0.81 [0.62–1.06] | ||
| p-trend | .002 | .005 | .1 | .3 | ||
| Decline | 1 | 1 (ref) | 1 (ref) | 1 (ref) | 1 (ref) | |
| 2 | 1.11 [0.81–1.52] | 1.38 [0.96–1.96] | 1.34 [0.84–2.12] | 0.76 [0.58–1.00] | ||
| 3 | 0.82 [0.59–1.16] | 0.87 [0.58–1.29] | 0.98 [0.59–1.61] | 0.74 [0.56–0.98] | ||
| p-trend | .1 | .1 | .6 | .1 | ||
| APOE-e4+ | Medium-stable | 1 | 1 (ref) | 1 (ref) | 1 (ref) | 1 (ref) |
| 2 | 0.78 [0.58–1.05] | 0.89 [0.66–1.21] | 0.91 [0.68–1.21] | 0.76 [0.44–1.32] | ||
| 3 | 0.58 [0.43–0.78] | 0.72 [0.53–0.97] | 0.74 [0.56–0.99] | 0.80 [0.46–1.39] | ||
| p-trend | .0006 | .03 | .04 | .6 | ||
| Decline | 1 | 1 (ref) | 1 (ref) | 1 (ref) | 1 (ref) | |
| 2 | 0.71 [0.46–1.11] | 0.69 [0.43–1.09] | 0.75 [0.42–1.33] | 0.71 [0.41–1.24] | ||
| 3 | 0.60 [0.39–0.92] | 0.65 [0.42–1.01] | 0.66 [0.38–1.15] | 0.63 [0.36–1.10] | ||
| p-trend | .04 | .1 | .2 | .2 |
Notes: APOE = apolipoprotein E; OR = odds ratio; PA = physical activity; TICS = Telephone Interview of Cognitive Status.
*The high-stable cognitive trajectory is considered as the reference.
†Adjusted for age at first cognitive assessment (continuous, in years), education (Associate’s degree or Nursing degree, Bachelor’s degree, Master’s or Doctorate degree), walking (continuous, in MET-hours/wk), smoking status (never smoker, past smoker, current smoker), alcohol consumption (0, 1–14, >15 g /d), body mass index (≤21, [22–24], [25–29], ≥30 kg/m2), the Alternate Healthy Eating Index score (<50, ≥50), age at menopause (≤49, [50–52], ≥53 years), postmenopausal hormone use (never, past, current use), vitamin E supplement use (nonuse, current use, missing), multivitamin supplement use (nonuse, current use), current aspirin use (nonuse, 1–2 times/wk, 3–7 times/wk), ibuprofen use (nonuse, current use), SF-36 Mental Health Index (≤52, >52), diabetes (yes, no), high blood pressure (yes, no), hypercholesterolemia (yes, no), myocardial infarction history (yes, no), and SF-36 physical function score (in tertiles).
‡Global score is the average of the z-scores of TICS, immediate and delayed recalls of the East Boston Memory Test, delayed recall of TICS 10-word list, test of category fluency, and digit backwards test; verbal memory score is the average of the z-scores of the immediate and delayed recalls of the East Boston Memory Test and the immediate and delayed recalls of the TICS 10-word list.
§Telephone Interview of Cognitive Status.
‖Interaction between vigorous physical activity and APOE-e4 status was formally tested using a binary logistic regression model. The dependent variable was alternately the “medium-stable vs high-stable” cognitive trajectory or the “decline vs high-stable” cognitive trajectory.