LOS ANGELES — There are five low-risk lifestyle factors that each decrease the risk for dementia in Alzheimer disease, and adherence to 4 of 5 of these factors produces a 59% lower risk for dementia in Alzheimer disease, according to research presented at the Alzheimer’s Association International Conference 2019, held July 14 to 18, in Los Angeles, California.

Previous epidemiological studies identified healthy lifestyle factors that can lower an individual’s risk for developing dementia in Alzheimer disease; this study investigates the extent to which combining those factors reduces dementia risk. Data analyzed were obtained from 2 prospective cohort studies, the Rush Memory and Aging Project (MAP, n=920), and the Chicago Health and Aging Project (CHAP, n=1431).

A low-risk lifestyle score was defined based on the following 5 factors: at least 150 minutes per week of moderate/vigorous leisure physical activity, light to moderate alcohol consumption (1-15 g/day in women and 1-30 g/day in men), never smoker, engagement in late-life cognitive activities (upper 40%), and high-quality MIND diet (upper 40% of score distribution), for an overall score ranging from 0 to 5. Sample-weight adjusted Cox proportional hazard models were used to estimate the hazard ratio (HR) and 95% confidence interval (CI) of the low-risk lifestyle score with dementia for each cohort after adjusting for education, sex, age, race, history of cardiovascular disease, and Apolipoprotein E4 (APOE e4) status. The findings were pooled using a random effect meta-analysis.

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During a median follow-up of 9.1 years, 293 participants in CHAP (20.5%) had incident dementia in Alzheimer disease; during a median follow-up of 6.0 years in MAP, 229 participants (24.9%) had incident dementia in Alzheimer disease. Pooled HR of dementia across the 2 cohorts was 0.78 per each additional low-risk lifestyle factor (95% CI, 0.71-0.86). Compared with participants with 0 or 1 low-risk factor, incident dementia risk was 39% lower (HR, 0.61; 95% CI, 0.48-0.78) for participants with 2 or 3 low-risk factors and 59% lower (HR, 0.41; 95% CI, 0.28-0.58) in participants with 4 or 5 low-risk factors. These associations were similar across race and gender but were modified in CHAP by APOE e4 status. Study investigators concluded, “Although the risk for [dementia in Alzheimer disease] decreases with the adoption of each low-risk lifestyle factor, our study underscores the importance of adherence to all five low-risk lifestyle factors for maximum health benefit, and as an effective strategy for lowering the risk for [dementia in Alzheimer disease].”


Dhana K. Impact of healthy lifestyle factors on the risk for Alzheimer’s dementia; findings from two prospective cohort studies. Presented at: The Alzheimer’s Association International Conference; July 14-18, 2019; Los Angeles, CA. Abstract PT, O1-06-01.