Five Healthy Lifestyle Factors Associated with Reduced Alzheimer’s Risk

A recent observational study reported that elderly people who practiced 4 or all 5 healthy behaviors had a 60% lower risk of developing Alzheimer’s disease compared to those who practiced none or just 1 healthy behavior [1].

These findings come from a large study of two longitudinal cohorts in Chicago. From the Chicago Health and Aging Project, 1,845 participants (average age, 73.2) were enrolled and followed for up to 17 years. In this cohort, 46.8% were non-Hispanic white and 53.2% were black. From the Rush Memory and Aging Project, 920 participants (average age, 81.1) were enrolled and followed for up to 14 years. In this cohort, the vast majority (94.5%) were non-Hispanic white.

The healthy lifestyle score was obtained for each participant and was based on 5 factors, each counting as 1 point and summed, with a total score ranging from 0 to 5:

1. Not smoking
   Never or former smokers received 1 point while current smokers received no points.
2. Moderate/vigorous-intensity exercise activities
   Physical activity was assessed by the time spent in any of the five moderate or vigorous activities: walking for exercise, gardening or yard work, calisthenics or general exercise, bicycle riding, or swimming. Participants who spent more than 150 minutes per week doing moderate/vigorous-intensity exercise received 1 point and those who did not received no points.
3. Light to moderate alcohol consumption
   Women who consumed up to one alcoholic drink a day and men who consumed up to two drinks a day received 1 point and those who consumed more or none received no points.
4. High quality brain-healthy diet
   Diet quality was calculated based on adherence to the Mediterranean, DASH, and MIND diets. More specifically, someone with a high quality diet consumed high amounts from the ten brain healthy food groups (green leafy vegetables, other vegetables, nuts, berries, beans, whole grains, seafood, poultry, olive oil, and wine) and avoided five unhealthy food groups (red meats, butter and stick margarine, cheese, pastries and sweets, and fried/fast food). Participants who scored in the top 40% in diet quality received 1 point and those who scored below received no points.
5. Engagement in late-life cognitive activities
   Cognitively stimulating activities were assessed by the amount of time spent in the past year on seven activities: reading, writing letters, visiting a library, and playing games such as chess or checkers. Participants who scored in the top 40% received 1 point, whereas those scoring below received no points.

Participants with 2 or 3 healthy behaviors made up the majority in both cohorts. Across both cohorts, the risk of developing Alzheimer’s disease was 37% lower in those with 2 or 3 healthy behaviors and 60% lower in those with 4 or 5 healthy behaviors compared to participants with none or 1 healthy behavior. The association between healthy lifestyle and lower Alzheimer’s risk was consistent and of similar magnitude across men and women, and also across non-Hispanic white and black people.

Because this study was an observational study and not a randomized controlled clinical trial, it was not designed to prove that these five healthy behaviors are responsible for the large reductions in Alzheimer’s risk. People who practice these five healthy habits may be practicing many other healthy habits that protect their brain. Although not designed to prove cause and effect, it is worth emphasizing that the positive association seen between healthy behavior and reduced Alzheimer’s risk remained significant even after controlling for factors associated with Alzheimer’s risk, such as age, sex, educational attainment, genetic risk factor (e.g., APOE), and cardiovascular diseases.

The results of this study are very encouraging in that there are concrete steps you can take that may significantly reduce your risk for Alzheimer’s disease. Just adding 1 out of the 5 healthy behaviors may make a meaningful difference. These findings are also very much in line with our seven steps for brain health.

1. Dhana K, Evans DA, Rajan KB et al. (in press) Healthy lifestyle and the risk of Alzheimer dementia: Findings from 2 longitudinal studies. Neurology 

Get the latest brain health news: