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Comparative Study
. 2012 Jan;60(1):118-23.
doi: 10.1111/j.1532-5415.2011.03768.x. Epub 2011 Dec 28.

Lifestyle and the risk of dementia in Japanese-american men

Rebecca P Gelber  1 , Helen Petrovitch, Kamal H Masaki, Robert D Abbott, George Webster Ross, Lenore J Launer, Lon R White
Affiliations
Comparative Study

Lifestyle and the risk of dementia in Japanese-american men

Rebecca P Gelber et al. J Am Geriatr Soc. 2012 Jan.

Abstract

Objectives: To determine whether adhering to a healthy lifestyle in midlife may reduce the risk of dementia.

Design: Case-control study nested in a prospective cohort.

Setting: The Honolulu-Asia Aging Study, Oahu, Hawaii.

Participants: Three thousand four hundred sixty-eight Japanese-American men (mean age 52 in 1965-1968) examined for dementia 25 years later.

Measurements: Men at low risk were defined as those with the following midlife characteristics: nonsmoking, body mass index (BMI) less than 25.0 kg/m(2) , physically active, and having a healthy diet (based on alcohol, dairy, meat, fish, fruits, vegetables, cereals, and ratio of monounsaturated to saturated fat). Logistic regression was used to calculate odds ratios (ORs) and 95% confidence intervals (CIs) for developing overall dementia, Alzheimer's disease (AD), and vascular dementia (VaD), adjusting for potential confounders.

Results: Dementia was diagnosed in 6.4% of men (52.5% with AD, 35.0% with VaD). Examining the risk factors individually, BMI was most strongly associated with greater risk of overall dementia (OR = 1.87, 95% CI = 1.26-2.77; BMI > 25.0 vs <22.6 kg/m(2) ). All of the individual risk factors except diet score were significantly associated with VaD, whereas none were significantly associated with AD alone. Men with all four low-risk characteristics (7.2% of the cohort) had the lowest OR for overall dementia (OR = 0.36, 95% CI = 0.15-0.84). There were no significant associations between the combined low-risk characteristics and the risk of AD alone.

Conclusion: Among Japanese-American men, having a healthy lifestyle in midlife is associated with a lower risk of dementia in late life.

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Conflict of interest statement

Conflict of Interest: The authors have no relevant conflicts of interest.

Figures

Figure 1
Figure 1. Modifiable risk factor combinations and odds ratios (OR) for dementia according to APOE e4 status
* Model adjusts for age, years of education, and childhood years spent in Japan. Model for low-risk subgroup 2 also adjusts for diet score, BMI, and physical activity. Model for subgroup 3 also adjusts for BMI and physical activity. Model for subgroup 4 also adjusts for physical activity. †Low-risk subgroup: 1= nonsmoking; 2= nonsmoking and diet scores in the highest 40%; 3= nonsmoking, diet scores in the highest 40%, and BMI <25.0 kg/m2; 4= nonsmoking, diet scores in the highest 40%, BMI <25.0 kg/m2, and high physical activity. Ref= referent group.
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