PT  - JOURNAL ARTICLE
AU  - Dhana, Klodian
AU  - Evans, Denis A.
AU  - Rajan, Kumar B.
AU  - Bennett, David A.
AU  - Morris, Martha C.
TI  - Healthy lifestyle and the risk of Alzheimer dementia
AID  - 10.1212/WNL.0000000000009816
DP  - 2020 Jul 28
TA  - Neurology
PG  - e374--e383
VI  - 95
IP  - 4
4099  - http://n.neurology.org/content/95/4/e374.short
4100  - http://n.neurology.org/content/95/4/e374.full
SO  - Neurology2020 Jul 28; 95
AB  - 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.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