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

Klodian Dhana, Denis A. Evans, Kumar B. Rajan, David A. Bennett, Martha C. Morris

Research output: Contribution to journalArticlepeer-review

13 Scopus citations

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.

Original languageEnglish (US)
Pages (from-to)e374-e383
JournalNeurology
Volume95
Issue number4
DOIs
StatePublished - Jul 28 2020

ASJC Scopus subject areas

  • Clinical Neurology

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