Healthy lifestyle and the risk of Alzheimer dementia Findings from 2 longitudinal studies
Healthy lifestyle and the risk of Alzheimer dementia Findings from 2 longitudinal studies
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DOI：
10.1212/wnl.0000000000009816
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发表时间：
2020-07-28
期刊：
影响因子：
9.9
通讯作者：
Morris, Martha C.
中科院分区：
文献类型：
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作者：
Dhana, Klodian;Evans, Denis A.;Morris, Martha C.
目的量化健康生活方式对阿尔茨海默病风险的影响。方法利用芝加哥健康与老龄化项目(CHAP；n=1,845)和Rush Memory and Aging Project(MAP；n=920)的数据，我们在不吸烟的基础上定义了健康生活方式得分。=150分钟/周，中等强度的体力活动，轻度到中度的酒精摄入，高质量的地中海式饮食干预神经退行性延迟饮食(40%以上)，以及参与晚年认知活动(40%以上)，总分从0到5。每个队列使用Cox比例风险模型估计阿尔茨海默病生活方式得分的危险比(HR)和95%可信区间(CI)，并使用随机效应荟萃分析对结果进行汇总。结果在中位随访期间，第5.8章和MAP 6.0年，分别有379名和229名参与者患有阿尔茨海默病。在多变量调整的模型中，每增加一个健康生活方式因素，阿尔茨海默病在两个队列中的合并HR(95%CI)为0.73(95%CI 0.66-0.80)。与具有0~1个健康生活方式因素的参与者相比，具有2~3个健康生活方式因素的参与者患阿尔茨海默病的风险降低37%(合并HR 0.63，95%CI 0.47~0.84)，而具有4~5个健康生活方式因素的参与者患阿尔茨海默病的风险降低60%(合并HR 0.40，95%CI 0.28~0.56)。结论健康生活方式作为一个综合得分与阿尔茨海默病的风险显著降低。
ObjectiveTo quantify the impact of a healthy lifestyle on the risk of Alzheimer dementia.MethodsUsing 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.ResultsDuring 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.ConclusionA healthy lifestyle as a composite score is associated with a substantially lower risk of Alzheimer's dementia.