Lifestyle behavior pattern is associated with different levels of risk for incident dementia and Alzheimer's disease: the Cache County study.
OBJECTIVE
To identify distinct behavioral patterns of diet, exercise, social interaction, church attendance, alcohol consumption, and smoking and to examine their association with subsequent dementia risk.


METHODS
Longitudinal, population-based dementia study.


METHODS
Rural county in northern Utah, at-home evaluations.


METHODS
Two thousand four hundred ninety-one participants without dementia (51% male, average age 73.0 ± 5,7; average education 13.7 ± 4.1 years) initially reported no problems in activities of daily living and no stroke or head injury within the past 5 years.


METHODS
Six dichotomized lifestyle behaviors were examined (diet: high ≥ median on the Dietary Approaches to Stop Hypertension scale; exercise: ≥5 h/wk of light activity and at least occasional moderate to vigorous activity; church attendance: attending church services at least weekly; social Interaction: spending time with family and friends at least twice weekly; alcohol: currently drinking alcoholic beverages ≥ 2 times/wk; nonsmoker: no current use or fewer than 100 cigarettes ever). Latent class analysis (LCA) was used to identify patterns among these behaviors. Proportional hazards regression modeled time to dementia onset as a function of behavioral class, age, sex, education, and apolipoprotein E status. Follow-up averaged 6.3 ± 5.3 years, during which 278 cases of incident dementia (200 Alzheimer's disease (AD)) were diagnosed.


RESULTS
LCA identified four distinct lifestyle classes. Unhealthy-religious (UH-R; 11.5%), unhealthy-nonreligious (UH-NR; 10.5%), healthy-moderately religious (H-MR; 38.5%), and healthy-very religious (H-VR; 39.5%). UH-NR (hazard ratio (HR) = 0.54, P = .028), H-MR (HR = 0.56, P = .003), and H-VR (HR = 0.58, P = .005) had significantly lower dementia risk than UH-R. Results were comparable for AD, except that UH-NR was less definitive.


CONCLUSIONS
Functionally independent older adults appear to cluster into subpopulations with distinct patterns of lifestyle behaviors with different levels of risk for subsequent dementia and AD.
Department of Family Consumer and Human Development, Utah State University, Logan, Utah 84322, USA. maria.norton@usu.edu
Maria C
MC
Norton
Jeffrey
J
Dew
Heeyoung
H
Smith
Elizabeth
E
Fauth
Kathleen W
KW
Piercy
John C S
JC
Breitner
JoAnn
J
Tschanz
Heidi
H
Wengreen
Kathleen
K
Welsh-Bohmer
D000368:Aged; D000428:Alcohol Drinking / Q000453:epidemiology; D000544:Alzheimer Disease / Q000453:epidemiology*; D003704:Dementia / Q000453:epidemiology*; D004032:Diet; D005260:Female; D015577:Geriatric Assessment; D006801:Humans; D007407:Interviews as Topic; D008019:Life Style; D008137:Longitudinal Studies; D008297:Male; D009043:Motor Activity; D016016:Proportional Hazards Models; D012067:Religion; D012307:Risk Factors; D012907:Smoking / Q000453:epidemiology; D012944:Social Support; D014589:Utah / Q000453:epidemiology