Combined effects of physical activity, cognitive activity, and dietary patterns on cognitive impairment in older adults with consideration of APOE genotype: a cohort study

作者：Wen-Fang Zhong, Xiao-Meng Wang, Huan Chen, Wei-Qi Song, Jian Gao, Pei‐Liang Chen, Qiaoqiao Shen, Fang‐Fei You, Chuan Li, Yuebin Lv, Zhihao Li, Xiaoming Shi, Chen Mao · 发表于：Alzheimer s Research & Therapy · 年份：2025 · DOI：10.1186/s13195-025-01806-7 · 被引用次数：3 · 研究领域：Dementia and Cognitive Impairment Research、Nutritional Studies and Diet、Nutrition and Health in Aging

BACKGROUND: This study aims to evaluate the combination effects of physical activity (PA), cognitive activity (CA), and dietary patterns impacts cognitive impairment among older adults, and whether these associations differ by apolipoprotein E (APOE) genotype. METHODS: A total of 18,909 adults aged 65 years or older at baseline were enrolled from 1998 to 2014 years. PA and CA was assessed using scores that reflected participation in various activities, and a total activity (TA) score was calculated as the sum of PA and CA scores. Diet quality was assessed with the SHE-index. Participants were categorized into lifestyle groups based on combinations of activity levels and SHE-index. The APOE genotype was categorized as APOEε4 carriers versus non-carriers. Cognitive function was evaluated using the Mini-Mental State Examination at baseline and follow-up. Adjusted Cox proportional hazards models was used to estimate the association and interaction between lifestyle and APOE genotype on the risk of cognitive impairment. RESULTS: During a mean follow-up time of 5.27 ± 3.67 years, 5713 participants developed cognitive impairment. Participants with higher levels of TA, PA, or CA, combined with a healthy diet, consistently exhibited the lowest risk of cognitive impairment, with hazard ratios (HR) of 0.65 [95% confidence intervals (CIs): 0.60-0.71] for TA, 0.72 (95% CI: 0.66-0.78) for PA, and 0.73 (95% CI: 0.67-0.79) for CA. This protective effect remained consistent across APOEε4 geno...