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Sakurai R, Pieruccini‐Faria F, Cornish B, Fraser J, Binns MA, Beaton D, Dilliott AA, Kwan D, Ramirez J, Tan B, Scott CJM, Sunderland KM, Tartaglia C, Finger E, Zinman L, Freedman M, McLaughlin PM, Swartz RH, Symons S, Lang AE, Bartha R, Black SE, Masellis M, Hegele RA, McIlroy W, Montero‐Odasso M. Link among apolipoprotein E E4, gait, and cognition in neurodegenerative diseases: ONDRI study. Alzheimers Dement 2024; 20:2968-2979. [PMID: 38470007 PMCID: PMC11032526 DOI: 10.1002/alz.13740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Revised: 12/08/2023] [Accepted: 12/14/2023] [Indexed: 03/13/2024]
Abstract
INTRODUCTION Apolipoprotein E E4 allele (APOE E4) and slow gait are independently associated with cognitive impairment and dementia. However, it is unknown whether their coexistence is associated with poorer cognitive performance and its underlying mechanism in neurodegenerative diseases. METHODS Gait speed, APOE E4, cognition, and neuroimaging were assessed in 480 older adults with neurodegeneration. Participants were grouped by APOE E4 presence and slow gait. Mediation analyses were conducted to determine if brain structures could explain the link between these factors and cognitive performance. RESULTS APOE E4 carriers with slow gait had the lowest global cognitive performance and smaller gray matter volumes compared to non-APOE E4 carriers with normal gait. Coexistence of APOE E4 and slow gait best predicted global and domain-specific poorer cognitive performances, mediated by smaller gray matter volume. DISCUSSION Gait slowness in APOE E4 carriers with neurodegenerative diseases may indicate extensive gray matter changes associated with poor cognition. HIGHLIGHTS APOE E4 and slow gait are risk factors for cognitive decline in neurodegenerative diseases. Slow gait and smaller gray matter volumes are associated, independently of APOE E4. Worse cognition in APOE E4 carriers with slow gait is explained by smaller GM volume. Gait slowness in APOE E4 carriers indicates poorer cognition-related brain changes.
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Affiliation(s)
- Ryota Sakurai
- Research Team for Social Participation and Healthy AgingTokyo Metropolitan Institute for Geriatrics and GerontologyItabashi‐kuTokyoJapan
- Gait & Brain Lab, St. Joseph' Health Care London, Lawson Health Research, Western University, Division of Geriatric MedicineLondonOntarioCanada
| | - Frederico Pieruccini‐Faria
- Gait & Brain Lab, St. Joseph' Health Care London, Lawson Health Research, Western University, Division of Geriatric MedicineLondonOntarioCanada
- Department of MedicineDivision of Geriatric MedicineParkwood HospitalWestern University, Parkwood InstituteLondonOntarioCanada
| | - Benjamin Cornish
- Neuroscience, Mobility and Balance Lab, Department of Kinesiology and Health SciencesUniversity of WaterlooWaterlooOntarioCanada
| | - Julia Fraser
- Neuroscience, Mobility and Balance Lab, Department of Kinesiology and Health SciencesUniversity of WaterlooWaterlooOntarioCanada
| | - Malcolm A. Binns
- Rotman Research Institute, Baycrest Health SciencesTorontoOntarioCanada
| | - Derek Beaton
- Data Science and Advanced Analytics, St. Michael's Hospital, Unity Health TorontoTorontoOntarioCanada
| | - Allison Ann Dilliott
- Department of Neurology and NeurosurgeryMontreal Neurological Institute, McGill UniversityMontréalQuebecCanada
| | - Donna Kwan
- Centre for Neuroscience Studies, Queen's UniversityKingstonOntarioCanada
| | - Joel Ramirez
- L.C. Campbell Cognitive Neurology Research Unit, Hurvitz Brain Sciences Program, Department of Medicine (Neurology)Sunnybrook Research Institute, Sunnybrook HSC, University of TorontoTorontoOntarioCanada
| | - Brian Tan
- Rotman Research Institute, Baycrest Health SciencesTorontoOntarioCanada
| | | | | | - Carmela Tartaglia
- Krembil Brain InstituteUniversity Health Network Memory Clinic, Toronto Western HospitalTorontoOntarioCanada
- Tanz Centre for Research in Neurodegenerative Diseases, University of TorontoTorontoOntarioCanada
| | - Elizabeth Finger
- Department of Clinical Neurological SciencesSchulich School of Medicine and Dentistry, Western UniversityLondonOntarioCanada
| | - Lorne Zinman
- Sunnybrook Research Institute, Sunnybrook Health Sciences CentreTorontoOntarioCanada
- Department of Medicine (Neurology)University of TorontoTorontoOntarioCanada
| | - Morris Freedman
- Rotman Research Institute, Baycrest Health SciencesTorontoOntarioCanada
- Department of Medicine (Neurology)University of TorontoTorontoOntarioCanada
- Division of NeurologyBaycrest Health SciencesTorontoOntarioCanada
| | - Paula M. McLaughlin
- Halifax Clinical Psychology Residency ProgramNova Scotia Health AuthorityHalifaxNova ScotiaCanada
| | - Richard H. Swartz
- Sunnybrook Research Institute, Sunnybrook Health Sciences CentreTorontoOntarioCanada
- Department of Medicine (Neurology)University of TorontoTorontoOntarioCanada
| | - Sean Symons
- L.C. Campbell Cognitive Neurology Research Unit, Hurvitz Brain Sciences Program, Department of Medicine (Neurology)Sunnybrook Research Institute, Sunnybrook HSC, University of TorontoTorontoOntarioCanada
| | - Anthony E. Lang
- Division of NeurologyDepartment of MedicineEdmond J Safra Program in Parkinson's Disease and Morton and Gloria Shulman Movement Disorders ClinicToronto Western HospitalUniversity of TorontoTorontoOntarioCanada
| | - Robert Bartha
- Department of Medical BiophysicsSchulich School of Medicine and Dentistry, Robarts Research Institute, Western UniversityLondonOntarioCanada
| | - Sandra E. Black
- L.C. Campbell Cognitive Neurology Research Unit, Hurvitz Brain Sciences Program, Department of Medicine (Neurology)Sunnybrook Research Institute, Sunnybrook HSC, University of TorontoTorontoOntarioCanada
| | - Mario Masellis
- L.C. Campbell Cognitive Neurology Research Unit, Hurvitz Brain Sciences Program, Department of Medicine (Neurology)Sunnybrook Research Institute, Sunnybrook HSC, University of TorontoTorontoOntarioCanada
| | - Robert A. Hegele
- Schulich School of Medicine and Dentistry, Western UniversityLondonOntarioCanada
- Robarts Research Institute, Western UniversityLondonOntarioCanada
| | - William McIlroy
- Neuroscience, Mobility and Balance Laboratory, Department of Kinesiology and Health SciencesUniversity of WaterlooWaterlooOntarioCanada
| | - ONDRI Investigators
- Research Team for Social Participation and Healthy AgingTokyo Metropolitan Institute for Geriatrics and GerontologyItabashi‐kuTokyoJapan
| | - Manuel Montero‐Odasso
- Gait & Brain Lab, St. Joseph' Health Care London, Lawson Health Research, Western University, Division of Geriatric MedicineLondonOntarioCanada
- Gait and Brain Lab, Division of Geriatric Medicineand Lawson Health Research InstituteParkwood Institute, Western UniversityLondonOntarioCanada
- Division of Geriatric MedicineDepartment of MedicineSchulich School of Medicine and Dentistry, Western University, Parkwood InstituteLondonOntarioCanada
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