Department of Nutrition and Dietetics, Harokopio University, 17671 Athens, Greece.
1st Department of Neurology, Aiginition Hospital, National and Kapodistrian University of Athens Medical School, 11528 Athens, Greece.
Nutrients. 2022 Jul 8;14(14):2818. doi: 10.3390/nu14142818.
The aim of the current study was to investigate whether a Total Lifestyle Index (TLI), including adherence to the Mediterranean diet, sleep duration, physical activity and engagement in activities of daily living, is associated with cognitive health over time and dementia risk, in a representative cohort of older people. A total of 1018 non-demented community-dwelling older adults ≥65 years old (60% women) from the HELIAD study were included. A comprehensive neurological and neuropsychological assessment was conducted at baseline and at the 3-year follow-up evaluating cognitive functioning, and a dementia diagnosis was set. Diet, physical activity, sleep duration and engagement in activities of daily living were assessed using standard, validated questionnaires at baseline. Sixty-one participants developed dementia at follow-up; participants who developed dementia were older and had fewer years of education compared with participants with normal cognition. With the exception of sleep duration, participants with normal cognition at follow-up scored higher in the individual lifestyle factors compared to those who developed dementia. Regarding TLI, values were lower for participants with dementia compared with those with normal cognition. Each additional unit of the TLI was associated with 0.5% of a standard deviation less decline per year of the Global Cognition score, whereas for each additional unit of the TLI, the risk for dementia was reduced by 0.2% per year (p < 0.05). Our results suggest that greater adherence to a healthy lifestyle pattern is associated with a slower decline of cognitive function and reduced dementia risk.
本研究旨在探讨综合生活方式指数（TLI），包括对地中海饮食的依从性、睡眠时长、身体活动和日常活动参与度，是否与老年人的认知健康和痴呆风险有关。研究共纳入了 1018 名无痴呆的社区居住老年人（≥65 岁，女性占 60%），这些老年人来自 HELIAD 研究。在基线和 3 年随访时进行了全面的神经学和神经心理学评估，以评估认知功能，并确定痴呆诊断。在基线时，使用标准的、经过验证的问卷评估饮食、身体活动、睡眠时长和日常活动参与度。在随访中，有 61 名参与者患上了痴呆症；与认知正常的参与者相比，患有痴呆症的参与者年龄更大，受教育年限更少。除了睡眠时长，认知正常的参与者在个体生活方式因素方面的得分均高于那些发展为痴呆症的参与者。就 TLI 而言，与认知正常的参与者相比，痴呆症患者的 TLI 值更低。TLI 每增加一个单位，每年全球认知评分的下降幅度就会减少 0.5%，而 TLI 每增加一个单位，痴呆症的风险就会降低 0.2%（p < 0.05）。我们的研究结果表明，更健康的生活方式与认知功能下降速度较慢和痴呆风险降低有关。
