Studies point to the role of lifestyle factors in Alzheimer’s risk and disparities

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As rates of Alzheimer’s and other forms of dementia continue to rise in the United States, new evidence suggests that lifestyle factors such as diet, exercise, and sleep play an important role in reducing the risk of developing the disease. dementia. The researchers say two new studies offer particular insights into the factors that may contribute to the disproportionate burden of dementia in non-white, low-income US populations.

“Our findings support the beneficial role of healthy lifestyles in the prevention of Alzheimer’s disease and related dementias among older Americans, including those with socioeconomic disadvantages and a high risk of dementia,” said Danxia Yu, Ph.D. , assistant professor of the Division of Epidemiology at Vanderbilt University Medical Center, lead author of the study. “We should recognize that it is difficult for people facing systemic and structural disadvantages to maintain a healthy lifestyle or make lifestyle changes. It is vital to establish public health strategies to make lifestyle changes possible for all, in particular. disadvantaged populations “.

Yu and his team will present the results of two studies online at Nutrition 2022 Live Online, the American Society for Nutrition’s flagship annual meeting to be held June 14-16. The research was published online June 13, 2022, in Neurologythe medical journal of the American Academy of Neurology.

The research comes from the Southern Community Cohort Study, a long-term research study launched in 2001 to investigate the root causes of various diseases and health disparities. About 85,000 participants were recruited from community health centers in the southeastern United States, and two-thirds of the participants are black, giving the study the highest representation of African Americans of any large US research cohort. The researchers used Medicare complaints data to track Alzheimer’s diagnoses among participants over the age of 65.

For the first study, the researchers drew data from 17,209 older study participants, of whom 1,694 were diagnosed with Alzheimer’s disease or related dementias during a median 4-year follow-up. They evaluated five lifestyle factors: smoking, alcohol consumption, leisure time physical activity, sleep hours, and diet quality, both individually and in combination. Results showed that healthy choices (no smoking, strenuous physical activity, low to moderate alcohol consumption, adequate sleep and a high quality diet) were individually associated with an 11-25% reduced risk of Alzheimer’s disease. and related dementias. When combined, a composite score of these five lifestyle factors was associated with a 36% risk reduction in the top quartile versus the bottom quartile. These associations were independent of the participants’ age, gender, race, education, income, and underlying chronic illnesses.

For the second study, the researchers drew data from 14,500 older study participants, of whom 1,402 developed Alzheimer’s or related dementias. In this group, they analyzed the intake of four main classes of dietary polyphenols – flavonoids, phenolic acids, stilbenes and lignans – and their subclasses, using a validated food frequency questionnaire and polyphenol database. Polyphenols are a broad class of compounds commonly found in tea, red wine, chocolate, berries, and other foods, and have been associated with a variety of health benefits. In this study, the researchers found a significant difference in polyphenol intake between racial groups, with white participants consuming a median of about twice the amount of total polyphenols than black participants each day. Overall, there was no significant association between total dietary polyphenol intake and the incidence of Alzheimer’s disease and related dementias in either race; however, some flavonoids were associated with reduced risk among black participants but not white participants. The results showed that black participants in the top quartile for tea consumption had a 28% lower Alzheimer’s incidence than black participants in the lowest quartile for tea consumption.

Although both studies are observational and did not evaluate the mechanisms behind the associations, the researchers said that healthy lifestyles, including healthy eating, can help protect brain health by improving glucose and lipid metabolism and reducing inflammation and psychological stress. Yu said more research is needed to further clarify the relationship between lifestyle factors and Alzheimer’s disease across different populations.

“Black Americans and people with low socioeconomic status are disproportionately affected by the disease, but they have been largely underrepresented in epidemiological studies,” Yu said. “Identifying modifiable factors for the prevention of Alzheimer’s disease and related dementias among low-income people of different races and ethnicities is a critical public health problem.”

A healthy lifestyle is associated with several years without Alzheimer’s

More information:
Jae Jeong Yang et al, Association of Healthy Lifestyles with Risk of Alzheimer’s Disease and Related Dementias in Low-income Black and White Americans, Neurology (2022). DOI: 10.1212 / WNL.0000000000200774

Yi Guan et al, Association of Diabetes and Hypertension with Structural Integrity and Brain Cognition in the Boston Puerto Rican Health Study Cohort, Neurology (2022). DOI: 10.1212 / WNL.0000000000200120

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