title: Clustering of midlife lifestyle behaviors and subsequent cognitive function: a longitudinal study.
abstract: OBJECTIVE
  We examined the association between individual and clustered lifestyle behaviors in middle age and later in cognitive functioning.
  
  
  METHODS
  Middle-aged participants (n = 2430) in the Supplémentation en Vitamines et Minéraux Antioxydant study self-reported their low physical activity, sedentary behavior, alcohol use, smoking, low fruit and vegetable consumption, and low fish consumption. We assessed cognition 13 years later via 6 neuropsychological tests. After standardization, we summed the scores for a composite cognitive measure. We estimated executive functioning and verbal memory scores using principal component analysis. We estimated the mean differences (95% confidence intervals [CIs]) in cognitive performance by the number of unhealthy behaviors using analysis of covariance. We identified latent unhealthy behavior factor via structural equation modeling.
  
  
  RESULTS
  Global cognitive function and verbal memory were linearly, negatively associated with the number of unhealthy behaviors: adjusted mean differences = -0.36 (95% CI = -0.69, -0.03) and -0.46 (95% CI = -0.80, -0.11), respectively, per unit increase in the number of unhealthy behaviors. The latent unhealthy behavior factor with low fruit and vegetable consumption and low physical activity as main contributors was associated with reduced verbal memory (RMSEA = 0.02; CFI = 0.96; P = .004). No association was found with executive functioning.
  
  
  CONCLUSIONS
  Comprehensive public health strategies promoting healthy lifestyles might help deter cognitive aging.
authors.affiliation: Emmanuelle Kesse-Guyot, Valentina A. Andreeva, Camille Lassale, Serge Hercberg, and Pilar Galan are with the Université Paris 13, Sorbonne Paris Cité, Equipe de Recherche en Epidémiologie Nutritionnelle (EREN), Centre d'Epidémiologie et Biostatistiques Paris Nord, Inserm (U1153), Inra (U1125), Cnam, Université Paris 5, Université Paris 7, Bobigny, France.
authors.forename: Emmanuelle
authors.initials: E
authors.lastname: Kesse-Guyot
authors.forename: Valentina A
authors.initials: VA
authors.lastname: Andreeva
authors.forename: Camille
authors.initials: C
authors.lastname: Lassale
authors.forename: Serge
authors.initials: S
authors.lastname: Hercberg
authors.forename: Pilar
authors.initials: P
authors.lastname: Galan
mesh_terms: D000368:Aged; D003071:Cognition; D003072:Cognition Disorders / Q000453:epidemiology / Q000209:etiology; D004032:Diet; D005260:Female; D006801:Humans; D008019:Life Style; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009043:Motor Activity; D009483:Neuropsychological Tests; D057185:Sedentary Behavior