Healthy lifestyle and the risk of Alzheimer dementia

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mike
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Healthy lifestyle and the risk of Alzheimer dementia

Postby mike » Wed Jun 24, 2020 8:50 am

I have been otherwise preoccupied as of late, but this seemed like just the kind of research needed to support the notion of Alzheimer's Prevention. This is just the abstract, I'll see if I can find the whole study.

Findings from 2 longitudinal studies

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.

https://n.neurology.org/content/early/2 ... 0000009816

Edit - Here is a much better discussion

https://www.nih.gov/news-events/news-re ... lzheimer's.
Sonoma Mike
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Re: Healthy lifestyle and the risk of Alzheimer dementia

Postby NF52 » Wed Jun 24, 2020 9:52 am

mike wrote:I have been otherwise preoccupied as of late, but this seemed like just the kind of research needed to support the notion of Alzheimer's Prevention. This is just the abstract, I'll see if I can find the whole study.

Findings from 2 longitudinal studies

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.

https://n.neurology.org/content/early/2 ... 0000009816

Edit - Here is a much better discussion

https://www.nih.gov/news-events/news-re ... lzheimer's.
Hi Mike,
I agree that this is just the kind of news we need! Thanks for finding the more extended discussion. The full article is behind a pay wall, but the article you cited provides some important details and also some great data on non-drug National Institute on Aging (NIA)-sponsored studies:
I appreciate the detail on the need to combine key factors to get to the 60% reduction in risk. (No data before the paywall on ApoE 4 results.)
The researchers scored each participant based on five healthy lifestyle factors, all of which have important health benefits:
    At least 150 minutes per week of moderate- to vigorous-intensity physical activity – Physical activity is an important part of healthy aging.
    Not smoking – Established research has confirmed that even in people 60 or older who have been smoking for decades, quitting will improve health.
    Light-to-moderate alcohol consumption – Limiting use of alcohol may help cognitive health.
    A high-quality, Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND) diet, which combines the Mediterranean diet and Dietary Approaches to Stop Hypertension (DASH) diet – The MIND diet focuses on plant-based foods linked to dementia prevention.
    Engagement in late-life cognitive activities – Being intellectually engaged by keeping the mind active may benefit the brain.
“This population-based study helps paint the picture of how multiple factors are likely playing parts in Alzheimer’s disease risk,” said Dallas Anderson, Ph.D., program director in the Division of Neuroscience at NIA. “It’s not a clear cause and effect result, but a strong finding because of the dual data sets and combination of modifiable lifestyle factors that appear to lead to risk reduction.” NIA is currently funding more than 230 active clinical trials on Alzheimer’s and related dementias. Of those, more than 100 are nondrug interventions, such as exercise, diet, cognitive training, sleep, or combination therapies. People interested in participating in clinical trials can find more information on the NIA website
Combination of healthy lifestyle traits may substantially reduce Alzheimer’s
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Re: Healthy lifestyle and the risk of Alzheimer dementia

Postby DoubleBond » Wed Jun 24, 2020 3:10 pm

Yes, the paper shows that healthy lifestyle benefits APOE4 too - not to the same degree as APOE3, but still quite substantially.

In terms of hazard ratio HR for each of the 5 healthy behaviors:
In the stratified analyses by the presence of the APOE e4 allele, the pooled HR among noncarriers was 0.68 (95% CI 0.58–0.80) and in carriers was 0.80 (95% CI 0.68–0.94). In the CHAP cohort, notably, a strong HR was observed among non–APOE e4 allele carriers (HR 0.62, 95% CI 0.49–0.77) compared to APOE e4 allele carriers (HR 0.82, 95%CI 0.64–1.05)


So if you observe all 5 healthy behaviors, the risk reduction is at least 0.82 *0.82*0.82*0.82 *0.82 ~ 0.37
Not too bad, in my opinion :-)

And the behaviors are not too difficult to do. I wonder what are the HRs for the more stringent behaviors like keto-adaptation, intermittent fasting, multiday fasting, etc?


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