Identifying lifestyle factors that promote brain resilience in ApoE4 carriers

Apolipoprotein (ApoE) E4 (e4) carriers are at increased risk for Alzheimer’s disease (AD) (Strittmatter, 2012), which is often characterized by accelerated hippocampal atrophy and cognitive decline after 65 (Reinvang, 2013). However, not all e4 carriers develop AD. In those at heightened genetic risk, it is important to evaluate lifestyle factors that might slow brain aging, and delay dementia onset. Poorer sleep quality, physical activity, and diet have been associated with several AD‐related processes ‐ including increased beta‐amyloid burden, decline in vascular integrity, reduced glucose metabolism, and neuronal dysfunction (Mander 2017, Radak 2010, Sezgin 2014). Smoking (Durazzo, 2014) and excessive alcohol consumption (Venkataraman, 2017) have also been shown to promote AD pathology and risk. Moreover, social contact and education may enhance cognitive reserve (Livingston, 2020). Here, we investigated the role of these factors in promoting structural brain resilience in a population susceptible to AD from the UK Biobank (UKB; Miller, 2016).