September 28, 2023

Memory decline was slower for more mature grown ups who experienced a balanced way of living, even for folks with large genetic danger for Alzheimer’s sickness, info from a Chinese analyze confirmed.

Individuals 60 and more mature who had at minimum four of 6 favorable way of living things — wholesome eating plan, exercising, social speak to, cognitive exercise, and no cigarette smoking or consuming — had slower memory decrease than individuals who experienced no far more than one healthful issue, according to Jianping Jia, MD, PhD, of Xuanwu Healthcare facility of Cash Clinical College in Beijing, and co-authors.

Above 10 yrs, memory decline was .28 points much less on the Auditory Verbal Discovering Exam (AVLT) in the favorable life style group in comparison with the unfavorable group (.028 details/calendar year, 95% CI .023-.032, P<0.001), Jia and co-authors reported in The BMJ.

People who carried the apolipoprotein E ε4 (APOE4) allele also had slower memory decline with a favorable lifestyle (0.027 points/year, 95% CI 0.023-0.031) or an average lifestyle with two or three healthy factors (0.014 points/year, 95% CI 0.010-0.019), compared with an unfavorable one. Similar results were seen for non-APOE4 carriers.

“APOE4 is the strongest known risk factor for Alzheimer’s disease and related dementias, and within the context of ongoing and future targeted prevention trials, this outcome is particularly important,” noted Séverine Sabia, PhD, of Université de Paris, and Archana Singh-Manoux, PhD, of University College London, in an accompanying editorial.

“These results support the notion that lifestyle change might counteract the deleterious effect of APOE4 on cognitive decline and dementia,” Sabia and Singh-Manoux added.

Previous research has shown that APOE4 affects cognitive decline, but it does not negate all the benefits of a healthy lifestyle. In the U.S., healthy lifestyle scores in midlife have been associated with better cognition in later years, even among APOE4 carriers. And in the FINGER trial, APOE4 carriers who participated in an intervention comprising diet, exercise, cognitive training, and vascular risk management performed better than controls on annual cognitive tests.

Jia and co-authors analyzed data for 29,072 adults in the COAST study who initially tested normal for cognitive function. Mean age was about 72 48.5% in the cohort were women, and 20.4% were APOE4 carriers.

At baseline in 2009, participants completed the AVLT they had assessments again in 2012, 2014, 2016, and 2019. Lifestyle scores and health-related covariates also were determined at baseline and each follow-up visit.

The AVLT measured immediate recall, short-delay and long-delay recall, and long-delay recognition. Scores of immediate recall range from 0-60, while scores of all other tests range from 0-15. The researchers constructed a composite z score for memory function by averaging z scores for each part of the AVLT.

Of the six healthy lifestyle components, diet had the strongest association with memory (β 0.016, 95% CI 0.014-0.017, P<0.001), followed by cognitive activity, physical exercise, and social contact.

“Although each lifestyle factor contributed differentially to slowing memory decline, our results showed that participants who maintained more healthy lifestyle factors had a significantly slower memory decline than those with fewer healthy lifestyle factors,” Jia and co-authors wrote. “This information could be useful in making personal choices that can help to protect against memory decline, and our results provide further evidence that memory loss is potentially modifiable.”

Cognitive decline is likely influenced by several variables, Sabia and Singh-Manoux observed.

“The multifactorial risk paradigm introduced by the Framingham study has led to a substantial reduction in cardiovascular disease,” they pointed out. “A similar approach should be taken with dementia prevention, identifying not only the factors that matter most but also the threshold at which they matter, and the age when intervention is likely to be most effective, as the World Health Organization underlined in its recent report on brain health.”

The study has several limitations, Jia and colleagues acknowledged. Lifestyle factors were based on self-reported data. In addition, memory was assessed with one test only — a test that doesn’t comprehensively reflect overall memory function, the researchers noted.

“However, the Auditory Verbal Learning Test is an effective instrument for memory assessment, and we used a composite score based on four Auditory Verbal Learning Test subscales to represent memory conditions to the greatest extent possible,” they wrote.

  • Judy George covers neurology and neuroscience news for MedPage Today, writing about brain aging, Alzheimer’s, dementia, MS, rare diseases, epilepsy, autism, headache, stroke, Parkinson’s, ALS, concussion, CTE, sleep, pain, and more. Follow


Funding for this study was from the National Natural Science Foundation of China, National Key Scientific Instrument and Equipment Development Project, Beijing Scholars Program, China Canada Joint Initiative on Alzheimer’s Disease and Related Disorders, Beijing Municipal Administration of Hospitals, National Science and Technology Foundation, Beijing Natural Science Foundation, and Beijing Municipal Science and Technology Commission.

Jia and co-authors disclosed support from Xuanwu Hospital of Capital Medical University. They reported no conflicts of interest.

Sabia reported grant funding from the French National Research Agency. Singh-Manoux has received grants from the National Institute on Aging of the NIH.

Primary Source


Source Reference: Jia J, et al “Association between healthy lifestyle and memory decline in older adults: 10 year, population based, prospective cohort study” BMJ 2023 DOI: 10.1136/bmj-2022-072691.

Secondary Source


Source Reference: Sabia S, Singh-Manoux A “Healthy lifestyles for dementia prevention: An increasingly urgent public health priority” BMJ 2023 DOI: 10.1136/bmj.p117.