Healthy lifestyle and the risk of Alzheimer dementia: Findings from 2 longitudinal studies

Neurology. 2020 Jul 28;95(4):e374-e383. doi: 10.1212/WNL.0000000000009816. Epub 2020 Jun 17.

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.

Publication types

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

MeSH terms

  • Aged
  • Alcohol Drinking
  • Alzheimer Disease / epidemiology*
  • Cohort Studies
  • Diet, Mediterranean
  • Exercise
  • Female
  • Healthy Lifestyle*
  • Humans
  • Incidence
  • Longitudinal Studies
  • Male
  • Risk Factors