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New findings show that even in the presence of the APOE ε4 allele, older adults with a healthy lifestyle experience slower memory decline than those without a healthy lifestyle.1
This study was authored by Jianping Jia, MD, PhD, Department of Neurology, Innovation Center for Neurological Diseases, Xuanwu Hospital, Capital Medical Center, China.
This study was designed to assess lifestyle factors in the role of memory decline in older adults using the World Health Organization/University of California, Los Angeles (UCLA) Auditory Verbal Learning Test and Mini-Mental State Examination. .
“We used data from a large population-based cohort (Chinese Cognition and Aging Study; COAST) to show that adherence to a combination of healthy lifestyle factors correlated with cognitively normal older adults. , to investigate whether it is associated with slower memory decline in older people who are genetically susceptible to memory decline,” Jia and colleagues write.
Researchers tested participants over the age of 60 who had apolipoprotein E (APOE) genotyping at baseline in 2009 and were found to have normal cognition.
Investigators used a set of six healthy lifestyle elements to determine the health status of participants and followed them up until death, discontinuation, or until December 2019. The six elements include:
- Healthy diet (adherence to at least 7 of 12 covered foods)
- Regularly engaged in 150 minutes or more of moderate-intensity exercise or 75 minutes or more of vigorous activity per week
- an active social life (at least twice a week),
- vigorous cognitive activity (more than twice a week),
- Never smoked (or no longer smoked)
- never drink alcohol
Investigators classified study participants into a “preferred” group if they had at least four healthy lifestyle factors. If she had 2–3 of these elements, she belonged to the “average” group, and if she had 0–1, she belonged to the “unfavorable” group.
The team recruited 29,072 participants with an average age of 72.23 years. Of those 29,072 hers, approximately 49% (n = 14,113) were female and 20.43% (n = 5939) were her APOE ε4 carriers.
The team determined participants’ memory function through the World Health Organization/UCLA Auditory Verbal Learning Test. They determined global cognition using the Mini-Mental State Examination.
The results of this study show that a healthy lifestyle is associated with slower cognitive decline, with people in favorable groups experiencing slower memory decline than members of unfavorable groups. (decrease of 0.028 points/year, 95% confidence interval). [CI] 0.023-0.032, P.<0.001).
The researchers found that APOE ε4 carriers in the lifestyle-favorable group (0.027, 95% CI, 0.023–0.031) and the average group (0.014, 0.010–0.019) had lower memory than participants in the unfavorable group. They reported that they also found the rate to be low. .
Similar data were reported for non-APOE ε4 carriers and observed among participants with a preferred average lifestyle.
The team added that participants’ APOE ε4 status and lifestyle profiles showed no substantial interaction effects on subjects’ memory (P.=0.52).
“The results of this study are consistent with adherence to a healthy lifestyle and positive outcomes such as quitting or having smoked before, abstinence from alcohol, healthy eating, regular exercise, positive cognitive activity and social contact. provide strong evidence that a combination of different behaviors are associated with slower rates of memory decline,” they wrote. “Importantly, our study provides evidence that these effects also include individuals with her APOE ε4 allele.”
- Jia J, Zhao T, Liu Z, Liang Y, Li F, Li Y et al. Association between healthy lifestyle and memory decline in older adults: a 10-year, population-based, prospective cohort study BMJ 2023; 380:e072691 doi: 10.1136/bmj-2022-072691.
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