DOI: 10.1002/alz.078130 ISSN: 1552-5260

APOE E4 as a moderator for gait speed and executive function

See Ann Soo, Gurveen Kaur Sandhu, Fatin Zahra Zailan, Yi Jin Leow, Faith Phemie Hui En Lee, Smriti Ghildiyal, Chen Ling Koh, Nagaendran Kandiah
  • Psychiatry and Mental health
  • Cellular and Molecular Neuroscience
  • Geriatrics and Gerontology
  • Neurology (clinical)
  • Developmental Neuroscience
  • Health Policy
  • Epidemiology



Gait speed has been found to be associated with cognitive function (Liu, 2022) with slower walking speed related to poorer cognition (Hoogendijik, 2020). Slower gait speed was found to be associated with poorer global cognitive function, verbal memory and executive function (Watson, 2010). Additionally, APOE E4 carriers with slow gait speed have been found to perform worse on the MMSE than APOE E4 carriers without slow gait and APOE E4 non‐carriers with slow gait (Sakurai, 2017).

We aim to evaluate the moderating effects of APOE E4 status on gait speed and cognition in a pre‐dementia community population in Singapore.


We recruited 534 participants from the community who completed a detailed neuropsychological assessment and APOE genotyping. To test for the moderating effects of APOE E4 with gait speed and cognition, we performed a multiple generalized linear model controlling for covariates of age, sex and education.


The cohort included 186 subjects with subjective cognitive decline and 348 mild cognitive impairment subjects from Dementia Research Centre (Singapore). Mean age of the cohort was 62.55, SD = 9.55, mean education years was 13.97, SD = 3.45 and majority were women (57.1%). The presence of slow gait speed among our cohort was 4.7% and there were 12.6% APOE E4 carriers. There were no significant differences in walking gait between APOE E4 carriers and non‐carriers (p = 0.235). APOE E4 moderated the effect of slow gait speed on executive function. APOE E4 non‐carrier interacted with slow gait speed, resulting in worse performance on the trail making task B (β = 71.97, p = 0.003), digit span backwards (β = ‐2.23, p = 0.037), and colour trails 2 (β = 64.01, p<0.001).


APOE E4 status moderates the effect of slow gait speed on executive function. APOE E4 non‐carriers with slow gait speed are at risk for poorer executive function.

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