A Healthy Lifestyle Might Delay Memory Decline In Older Adults
Feb. 2, 2023 -- A new study suggests that following a healthy lifestyle is linked to slower memory decline in older adults, even in people with the apolipoprotein E4 (APOE4) gene, one of the strongest known risk factors for Alzheimer’s disease and related dementias.
A team of investigators in China analyzed 10-year data on over 29,000 older adults with an average age of 72 years. Of these, a fifth were carriers of the APOE4 gene.
The investigators created a healthy lifestyle score by combining how much participants engaged in six activities: healthy diet, regular exercise, active social contact, cognitive activity, nonsmoking, and avoiding alcohol. Participants were grouped into having "favorable," "average," and "unfavorable" lifestyles.
After adjusting for health, economic, and social factors, the researchers found that each individual healthy behavior was associated with a slower-than-average decline in memory during the decade, with a healthy diet emerging as the strongest deterrent, followed by cognitive activity and then physical exercise.
Those with "favorable" or "average" lifestyle showed slower memory decline, regardless of whether or not they had the APOE4 gene.
"A healthy lifestyle is associated with slower memory decline, even in the presence of the APOE4 allele," wrote Jianping Jia, MD, PhD, of the Innovation Center for Neurological Disorders and Department of Neurology, Xuan Wu Hospital, Capital Medical University in Beijing, China, and co-authors.
"This study might offer important information to protect older adults against memory decline," they wrote.
The study was published online Jan. 25 in the BMJ.
Senior Moments?
Memory "continuously declines as people age," but age-related memory decline doesn’t necessarily mean the person is developing dementia, according to the authors.
Factors affecting memory include aging, APOE4 genotype, chronic diseases, and lifestyle patterns. In particular, the role of lifestyle has been "receiving increasing attention" because, unlike a person’s genes or certain health conditions, lifestyle can be changed.
The researchers wanted to understand the role of a healthy lifestyle in possibly slowing memory decline, including in people with the APOE4 genotype. So they drew on data from the China Cognition and Ageing Study, which began in 2009 and ended in 2019.
At baseline, those in the study who were considered "cognitively normal" completed tests of cognition and memory and also provided information about their lifestyle, health, and economic and social factors. They were then reassessed in 2012, 2014, 2016, and at the conclusion of the study. The long follow-up period allowed for evaluation of individual lifestyle factors on memory function over time.
"Lifestyle" consisted of six factors:
The people's lifestyle was scored based on the number of healthy factors they engaged in, with "favorable" lifestyle consisting of four to six healthy factors, "average" lifestyle consisting of two to three healthy factors, and "unfavorable" lifestyle consisting of one to two healthy factors.
Public Health Implications
During the 10-year period, 7,164 people in the study died while 3,567 discontinued participation.
Compared with the group that had unfavorable lifestyles, memory decline in the favorable lifestyle group was 0.28 points slower over the decade-long study, and memory decline in the average group was 0.16 points lower.
Those with favorable or average lifestyle were almost 90% and 30% respectively less likely to develop dementia or mild cognitive impairment, compared to those with an unfavorable lifestyle.
The authors noted some limitations in their findings. For one, the study was observational, meaning that we don’t know whether the healthy lifestyle actually caused slower memory decline, or whether the association might be due to something else.
Still, the findings "might offer important information for public health to protect older adults against memory decline," especially since the study "provides evidence that these effects also include individuals with the APOE4 allele," the study authors said.
'Important and Encouraging' Findings
Severine Sabia, PhD, a senior researcher at the Université Paris Cité, INSERM Institut National de la Santé et de la Recherche Medicalé in France, called the findings "important and encouraging."
That said, Sabia, who is also the co-author of an accompanying editorial, notes that "there remain important research questions that need to be investigated in order to identify key behaviors, which combination [of behaviors], the cut-off of risk, and when to intervene."
Healthy Lifestyle Linked To Slower Memory Decline In Older Adults
A healthy lifestyle, in particular a healthy diet, is associated with slower memory decline, finds a decade-long study of older adults in China, published today in The BMJ.
Even for carriers of the apolipoprotein E (APOE) gene—the strongest known risk factor for Alzheimer's disease and related dementias—a healthy lifestyle was found to slow memory loss.
Memory continuously declines as people age, but evidence from existing studies is insufficient to assess the effect of a healthy lifestyle on memory in later life. And given the many possible causes of memory decline, a combination of healthy behaviors might be needed for an optimal effect.
To explore this further, researchers analyzed data from 29,000 adults aged at least 60 years (average age 72; 49% women) with normal cognitive function who were part of the China Cognition and Aging Study.
At the start of the study in 2009, memory function was measured using the Auditory Verbal Learning test (AVLT) and participants were tested for the APOE gene (20% were found to be carriers). Follow-up assessments were then conducted over the next 10 years in 2012, 2014, 2016, and 2019.
A healthy lifestyle score combining six factors was then calculated: healthy diet, regular exercise, active social contact (eg. Seeing friends and family), cognitive activity (eg. Writing, reading, playing mahjong), non-smoking, and never drinking alcohol.
Based on their score, ranging from 0 to 6, participants were put into favorable (4 to 6 healthy factors), average (2 to 3 healthy factors), or unfavorable (0 to 1 healthy factors) lifestyle groups and into APOE carrier and non-carrier groups.
After accounting for a range of other health, economic and social factors, the researchers found that each individual healthy behavior was associated with a slower than average decline in memory over 10 years.
A healthy diet had the strongest effect on slowing memory decline, followed by cognitive activity and then physical exercise.
Compared with the group that had unfavorable lifestyles, memory decline in the favorable lifestyle group was 0.28 points slower over 10 years based on a standardized score (z score) of the AVLT, and memory decline in the average lifestyle group was 0.16 points slower.
Participants with the APOE gene with favorable and average lifestyles also experienced a slower rate of memory decline than those with an unfavorable lifestyle (0.027 and 0.014 points per year slower, respectively).
What's more, those with favorable or average lifestyles were almost 90% and almost 30% less likely to develop dementia or mild cognitive impairment relative to those with an unfavorable lifestyle, and the APOE group had similar results.
This is an observational study so can't establish cause and the researchers acknowledge some limitations, such as the potential for measurement errors due to self-reporting of lifestyle factors, and the possibility of selection bias, as some participants did not return for follow-up evaluations.
But this was a large study with a long follow-up period, allowing for evaluation of individual lifestyle factors on memory function over time. And findings remained significant after further analyses, suggesting that they are robust.
As such, the researchers say their results provide strong evidence that adherence to a healthy lifestyle with a combination of positive behaviors is associated with a slower rate of memory decline, even for people who are genetically susceptible to memory decline.
They suggest further research could focus on the effects of a healthy lifestyle on memory decline across the lifespan, acknowledging that memory problems can also affect younger people, not included in this study. "These results might offer important information for public health initiatives to protect older adults against memory decline," they conclude.
"Prevention is important, given the absence of effective treatments for Alzheimer's disease and related dementias," say researchers in a linked editorial.
However, they point out that these results do not help to determine which among the six health behaviors included in the score (or specific combination) is the best target for dementia prevention, or when in the life course to focus prevention efforts. Further insight is also needed to determine whether the differences in memory decline observed in this study are clinically meaningful, they add.
They suggest a similar approach that led to a substantial reduction in cardiovascular disease 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."
More information: Association between healthy lifestyle and memory decline in older adults: 10 year, population based, prospective cohort study, The BMJ (2023). DOI: 10.1136/bmj-2022-072691
Citation: Healthy lifestyle linked to slower memory decline in older adults (2023, January 25) retrieved 2 February 2023 from https://medicalxpress.Com/news/2023-01-healthy-lifestyle-linked-slower-memory.Html
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Study Recommends 6 Lifestyle Changes To Slow Memory Decline
© Adobe.Com A new study says that dementia can be delayed with lifestyle changes like healthy eating, physical and cognitive exercise, social interaction and not smoking or drinking.A new study suggests that older adults can slow their memory loss with six healthy habits: healthy eating, physical exercise, social interaction, cognitive activity and abstaining from smoking and drinking.
Although there have been many studies that link lifestyle to memory decline, most focus on only one habit; this study claims to be the first to include multiple behaviors.
Chinese researches conducted the study, published Wednesday in the BMJ , by following more than 29,200 participants, ages 60 and up, for 10 years.
What were the results of the study?Diet was found to be the most controllable factor of the six. Participants who ate seven of 12 healthy food items daily experienced slower memory decline than those who did not.
Following diet in order of effect on memory is cognitive activity at least twice a week. These activities include reading, writing and even playing cards and other games.
Then comes consistent physical activity. The study deemed a healthy amount of weekly exercise to be at least 150 minutes of moderate intensity or 75 minutes of vigorous intensity.
RelatedSocial interaction at least twice a week was fourth on the list. The social activities that evidently helped slow memory decline included attending meetings or parties, visiting friends or relatives, traveling and chatting online.
The last factors were an abstinence from smoking and alcohol. The memories of participants who had smoked more than three years prior or drank only occasionally faired better than those who smoked during the study or drank heavily.
The study emphasized that all this was true even for the older adults who possessed the APOE gene, which is associated with Alzheimer’s disease.
How did the study work?Participants enrolled in the study in 2009 and were given memory tests in 2012, 2014, 2016 and 2019. The memory tests entailed hearing 15 nouns and being asked to repeat them immediately after, three minutes after and 30 minutes after.
The researchers categorized participants into groups based on how many of the six healthy habits they consistently demonstrated: four to six habits was “favorable,” two to three was “average” and zero to one was “unfavorable.” As implied by the names, the memories of those in the favorable group declined slowest.
The introduction of the study notes that memory decline in old age does not always indicate the onset of dementia and can be reversed — perhaps making these six lifestyle adjustments is a good place to start.
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