From the Rush Institute for Healthy Aging (K.D., D.A.E., M.C.M.) and Rush Alzheimer's Disease Center (D.A.B.), Rush University Medical Center, Chicago, IL; and Department of Public Health Sciences (K.B.R.), University of California at Davis.
Neurology. 2020 Jul 28;95(4):e374-e383. doi: 10.1212/WNL.0000000000009816. Epub 2020 Jun 17.
To quantify the impact of a healthy lifestyle on the risk of Alzheimer dementia.
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.
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.
A healthy lifestyle as a composite score is associated with a substantially lower risk of Alzheimer's dementia.
量化健康生活方式对阿尔茨海默病痴呆风险的影响。
利用芝加哥健康老龄化项目（CHAP；n=1845）和拉什记忆与衰老项目（MAP；n=920）的数据，我们根据不吸烟、每周至少 150 分钟中等/剧烈强度体育锻炼、适量饮酒、地中海-得舒饮食干预对神经退行性延迟（DASH）饮食（最高 40%）、晚年认知活动（最高 40%）定义了健康生活方式评分，总分 0-5 分。使用 Cox 比例风险模型对每个队列进行分析，以估计生活方式评分与阿尔茨海默病痴呆的风险比（HR）和 95%置信区间（CI），并使用随机效应荟萃分析对结果进行汇总。
在 CHAP 的中位随访 5.8 年和 MAP 的中位随访 6.0 年期间，分别有 379 名和 229 名参与者发生了阿尔茨海默病痴呆。在多变量调整模型中，2 个队列的阿尔茨海默病痴呆的合并 HR（95%CI）为每增加一个健康生活方式因素，HR 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发生阿尔茨海默病痴呆的风险降低了 37%（合并 HR 0.63，95%CI 0.47-0.84），具有 4-5 个健康生活方式因素的参与者发生阿尔茨海默病痴呆的风险降低了 60%（合并 HR 0.40，95%CI 0.28-0.56）。
作为一个综合评分，健康的生活方式与阿尔茨海默病痴呆的风险显著降低相关。
