@Article{info:doi/10.2196/14617,
author="Tsolaki, Anthoula C
and Tsolaki, Magda
and Pandria, Niki
and Lazarou, Eftychia
and Gkatzima, Olymbia
and Zilidou, Vasiliki
and Karagianni, Maria
and Iakovidou-Kritsi, Zafiroula
and Kimiskidis, Vasilios K
and Bamidis, Panagiotis D",
title="Web-Based Intervention Effects on Mild Cognitive Impairment Based on Apolipoprotein E Genotype: Quasi-Experimental Study",
journal="J Med Internet Res",
year="2020",
month="May",
day="7",
volume="22",
number="5",
pages="e14617",
keywords="mild cognitive impairment; APOE $\epsilon$4; computerized training; exergaming; Alzheimer disease",
abstract="Background: Apolipoprotein E (APOE) $\epsilon$4 allele is a major genetic risk factor for Alzheimer disease and mild cognitive impairment (MCI). Computer-based training programs can improve cognitive performance in elderly populations. However, the effects of computer-based interventions on MCI APOE $\epsilon$4 carriers have never been studied before. Objective: The effects of different web-based interventions and the APOE isoform-specific differences in training outcomes are investigated. Methods: Using a quasi-experimental study design, 202 participants with MCI aged 60 years and older took part in three different intervention programs (physical and cognitive [Long-Lasting Memories, or LLM], cognitive [Active Control, or AC], or physical intervention [Physical Training Control, or PTC]) via an innovative information and communication technologies exergaming platform. Participants in each interventional group were subdivided into APOE $\epsilon$4 carriers and non--APOE $\epsilon$4 carriers. All participants underwent an extensive neuropsychological evaluation before and after the training, blood tests, and brain imaging. Results: All interventions resulted in multiple statistically significant cognitive benefits after the intervention. Verbal learning (California Verbal Learning Test: immediate recall test score---LLM: P=.04; AC: P<.001), working memory (digit span forward and backward test scores---AC: P=.03; PTC: P=.02 and P=.006, respectively), and long-term memory (California Verbal Learning Test: delayed recall test score---LLM: P=.02; AC: P=.002; and PTC: P=.02) were improved. There was no statistically significant difference among the intervention effects. APOE $\epsilon$4 presence moderates intervention effects as the LLM intervention improved only their task-switching processing speed (Trail Making Test, Part B: P=.03) and the PTC intervention improved only the working memory (digit span backward: P=.03). No significant performance alteration was noted for the APOE $\epsilon$4+ cognitive AC training group. Conclusions: None of the applied interventions could be identified as the optimal one; it is suggested, however, that combined cognitive and physical training and physical training via exergaming may be more effective for the high-risk MCI $\Alpha$POE $\epsilon$4+ subgroup. ",
issn="1438-8871",
doi="10.2196/14617",
url="https://www.jmir.org/2020/5/e14617",
url="https://doi.org/10.2196/14617",
url="http://www.ncbi.nlm.nih.gov/pubmed/32379048"
}