Gait and balance in apolipoprotein Ɛ4 allele carriers in older adults and Parkinson's disease

Rosie Morris; Douglas N Martini; Valerie E Kelly; Katrijn Smulders; Katrina Ramsey; Amie Hiller; Kathryn A Chung; Shu-Ching Hu; Cyrus P Zabetian; Kathleen L Poston; Ignacio F Mata; Karen L Edwards; Jodi Lapidus; Brenna Cholerton; Thomas J Montine; Joseph F Quinn; Fay Horak

doi:10.1016/j.prdoa.2023.100201

Gait and balance in apolipoprotein Ɛ4 allele carriers in older adults and Parkinson's disease

Clin Park Relat Disord. 2023 May 17:9:100201. doi: 10.1016/j.prdoa.2023.100201. eCollection 2023.

Authors

Rosie Morris^{1

2}, Douglas N Martini^{1

3}, Valerie E Kelly⁴, Katrijn Smulders⁵, Katrina Ramsey⁶, Amie Hiller^{1

4}, Kathryn A Chung^{1

4}, Shu-Ching Hu^{5

7}, Cyrus P Zabetian^{5

7}, Kathleen L Poston⁸, Ignacio F Mata^{5

7

9}, Karen L Edwards¹⁰, Jodi Lapidus⁶, Brenna Cholerton¹¹, Thomas J Montine¹¹, Joseph F Quinn^{1

4}, Fay Horak^{1

4

12

13}

Affiliations

¹ Department of Neurology, Oregon Health and Science University, Portland, OR, USA.
² Department of Sport, Exercise and Rehabilitation, Northumbria University, Newcastle-upon-Tyne, UK.
³ Department of Kinesiology, University of Massachusetts Amherst, Amherst, MA, USA.
⁴ Department of Rehabilitation Medicine, University of Washington School of Medicine, Seattle, WA, USA.
⁵ Sint Maartenskliniek Research Department, Nijmegen, the Netherlands.
⁶ School of Public Health, Oregon Health and Science University, Portland, OR, USA.
⁷ Portland Veterans Affairs Health Care System, Portland, OR, USA.
⁸ Department of Neurology, University of Washington School of Medicine, Seattle, WA, USA.
⁹ Veterans Affairs Puget Sound Health Care System, Seattle, WA, USA.
¹⁰ Department of Neurology and Neurological Sciences, Stanford School of Medicine, Palo Alto, CA, US.
¹¹ Lerner Research Institute, Genomic Medicine, Cleveland Clinic Foundation, Cleveland, OH, USA.
¹² Department of Epidemiology and Biostatistics, University of California, Irvine, CA, USA.
¹³ Department of Pathology, Stanford University School of Medicine, Palo Alto, CA, USA.

Abstract

Background: Gait and balance impairments are among the most troublesome and heterogeneous in Parkinson's disease (PD). This heterogeneity may, in part, reflect genetic variation. The apolipoprotein E (APOE) gene has three major allelic variants (ε2, ε3 and ε4). Previous work has demonstrated that older adult (OA) APOE ε4 carriers demonstrate gait deficits. This study compared gait and balance measures between APOE ε4 carriers and non-carriers in both OA and PD.

Methods: 334 people with PD (81 APOE ε4 carriers and 253 non-carriers) and 144 OA (41 carriers and 103 non-carriers) were recruited. Gait and balance were assessed using body-worn inertial sensors. Two-way analyses of covariance (ANCOVA) compared gait and balance characteristics between APOE ε4 carriers and non-carriers in people with PD and OA, controlling for age, gender, and testing site.

Results: Gait and balance were worse in people with PD compared to OA. However, there were no differences between APOE ε4 carriers and non-carriers in either the OA or PD group. In addition, there were no significant group (OA/PD) by APOE ε4 status (carrier/non-carrier) interaction effects for any measures of gait or balance.

Conclusions: Although we found expected impairments in gait and balance in PD compared to OA, gait and balance characteristics did not differ between APOE ε4 carriers and non-carriers in either group. While APOE status did not impact gait and balance in this cross-sectional study, future work is needed to determine whether progression of gait and balance deficits is faster in PD APOE Ɛ4 carriers.

Keywords: APOE; Balance; Gait; Older adults; Parkinson’s disease.

Abstract

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