The interaction effects of age, APOE and common environmental risk factors on human brain structure

Cereb Cortex. 2024 Jan 14;34(1):bhad472. doi: 10.1093/cercor/bhad472.


Mounting evidence suggests considerable diversity in brain aging trajectories, primarily arising from the complex interplay between age, genetic, and environmental risk factors, leading to distinct patterns of micro- and macro-cerebral aging. The underlying mechanisms of such effects still remain unclear. We conducted a comprehensive association analysis between cerebral structural measures and prevalent risk factors, using data from 36,969 UK Biobank subjects aged 44-81. Participants were assessed for brain volume, white matter diffusivity, Apolipoprotein E (APOE) genotypes, polygenic risk scores, lifestyles, and socioeconomic status. We examined genetic and environmental effects and their interactions with age and sex, and identified 726 signals, with education, alcohol, and smoking affecting most brain regions. Our analysis revealed negative age-APOE-ε4 and positive age-APOE-ε2 interaction effects, respectively, especially in females on the volume of amygdala, positive age-sex-APOE-ε4 interaction on the cerebellar volume, positive age-excessive-alcohol interaction effect on the mean diffusivity of the splenium of the corpus callosum, positive age-healthy-diet interaction effect on the paracentral volume, and negative APOE-ε4-moderate-alcohol interaction effects on the axial diffusivity of the superior fronto-occipital fasciculus. These findings highlight the need of considering age, sex, genetic, and environmental joint effects in elucidating normal or abnormal brain aging.

Keywords: APOE; Alzheimer’s disease; DTI & ROI volumes; brain aging; lifestyle.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Aging / genetics
  • Alzheimer Disease* / genetics
  • Apolipoprotein E4* / genetics
  • Apolipoproteins E / genetics
  • Brain / diagnostic imaging
  • Female
  • Genotype
  • Humans
  • Risk Factors


  • Apolipoprotein E4
  • Apolipoproteins E
  • ApoE protein, human