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Abstract
Objective To quantify the impact of a healthy lifestyle on the risk of Alzheimer dementia.
Methods Using data from the Chicago Health and Aging Project (CHAP; n = 1,845) and the Rush Memory and Aging Project (MAP; n = 920), we defined a healthy lifestyle score on the basis of nonsmoking, ≥150 min/wk moderate/vigorous-intensity physical activity, light to moderate alcohol consumption, high-quality Mediterranean-DASH Diet Intervention for Neurodegenerative Delay diet (upper 40%), and engagement in late-life cognitive activities (upper 40%), giving an overall score ranging from 0 to 5. Cox proportional hazard models were used for each cohort to estimate the hazard ratio (HR) and 95% confidence interval (CI) of the lifestyle score with Alzheimer dementia, and a random-effect meta-analysis was used to pool the results.
Results During a median follow-up of 5.8 years in CHAP and 6.0 years in MAP, 379 and 229 participants, respectively, had incident Alzheimer dementia. In multivariable-adjusted models, the pooled HR (95% CI) of Alzheimer dementia across 2 cohorts was 0.73 (95% CI 0.66–0.80) per each additional healthy lifestyle factor. Compared to participants with 0 to 1 healthy lifestyle factor, the risk of Alzheimer dementia was 37% lower (pooled HR 0.63, 95% CI 0.47–0.84) in those with 2 to 3 healthy lifestyle factors and 60% lower (pooled HR 0.40, 95% CI 0.28–0.56) in those with 4 to 5 healthy lifestyle factors.
Conclusion A healthy lifestyle as a composite score is associated with a substantially lower risk of Alzheimer's dementia.
Glossary
- BMI=
- body mass index;
- CESD=
- Center for Epidemiologic Studies Depression;
- CHAP=
- Chicago Health and Aging Project;
- CI=
- confidence interval;
- FINGER=
- Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability;
- HR=
- hazard ratio;
- MAP=
- Memory and Aging Project;
- MIND=
- Mediterranean-DASH Diet Intervention for Neurodegenerative Delay
Footnotes
Go to Neurology.org/N for full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the article.
- Received July 11, 2019.
- Accepted in final form January 5, 2020.
- © 2020 American Academy of Neurology
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- Author response: Healthy lifestyle and the risk of Alzheimer dementia: Findings from 2 longitudinal studies
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