Lifestyle and the Risk of Dementia in Japanese‐American Men

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 on Oahu, Hawaii. Participants 3468 Japanese American men (mean age 52, 1965–1968) examined for dementia after 25 years. Measurements Men at low risk were defined as those with the following midlife characteristics: nonsmoking, body mass index <25.0 kg/m2, physically active, and having a healthy diet (based on alcohol, dairy, meat, fish, fruit, vegetables, cereals, and monounsaturated-to-saturated fat). Logistic regression was used to calculate odds ratios (OR) and 95% confidence intervals (CI) 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 increased risk of overall dementia (OR, 1.87; 95% CI, 1.26–2.77; BMI >25.0 vs. <22.6 kg/m2). 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 cohort) had the lowest OR for overall dementia (OR, 0.36; 95% CI, 0.15–0.84), as compared to other men. There were no significant associations between the combined low-risk characteristics and the risk of AD alone. Conclusion Having a healthy lifestyle in midlife is associated with a lower risk of dementia in late life among Japanese American men.

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