Why a Healthy Lifestyle Is Not Enough to Prevent Dementia

Summary: The opportunities for a healthy lifestyle are unequally distributed and being socially disadvantaged with a higher risk of developing Alzheimer’s disease.

Source: University of Leipzig

Dementia is on the rise in Germany. In the absence of treatment options, the focus is shifting to preventing dementia. In particular, a healthy lifestyle is considered beneficial for brain health.

A study by the Faculty of Medicine now shows that opportunities for a healthy lifestyle are unequally distributed: being socially disadvantaged is associated with a higher risk of dementia. The current findings have been published in the Journal of Alzheimer’s Disease.

As the population ages, dementia is on the rise. Currently, about 1.8 million people in Germany suffer from dementia. Population statistics predict an increase to around three million by 2050. International research demonstrates great potential for dementia prevention based on modifiable health and lifestyle factors, such as hypertension, obesity, physical and mental activity, and diet. In other words: a healthy lifestyle is good for brain health.

“But the opportunities are unequally distributed,” says Dr. Susanne Röhr, head of the current study and a researcher at the Institute of Social Medicine, Occupational Medicine and Public Health (ISAP) at Leipzig University. “Socially disadvantaged individuals, such as those on low incomes, tend to have a higher risk of dementia.”

The researchers used data from more than 6,200 participants in the LIFE Adult study at the Leipzig Research Center for Civilization Diseases. The proportion of women and men was the same. The subjects were between 40 and 79 years old and were not affected by dementia.

The large data base of the population-based cohort study enables the Leipzig scientists to map a complex lifestyle index with twelve modifiable risk factors for dementia.

These include hypertension, physical activity, smoking, obesity, and dietary habits. Subsequently, the influence of the index on the relationship between socio-economic factors such as education, occupational status, and household income, and mental performance and results of neuropsychological tests, is examined.

The results of the current study show that differences in mental performance due to social inequalities are related to modifiable health and lifestyle factors for dementia. Image is in the public domain

The results of the current study show that differences in mental performance due to social inequalities are related to modifiable health and lifestyle factors for dementia.

“This suggests that lifestyle interventions could mitigate social inequalities in cognitive performance,” adds Professor Steffi Riedel-Heller, director at ISAP.

According to the researchers, however, health and lifestyle factors only explain differences in mental performance due to socio-economic factors to a small extent. The study findings therefore also suggest that the greater emphasis may be on the social conditions themselves.

“Political measures aimed at reducing social inequalities could therefore contribute significantly to reducing the risk of dementia,” says Dr. Röhr.

About this lifestyle and dementia research news

Author: Press Office
Source: University of Leipzig
Contact: Press Office – University of Leipzig
Image: The image is in the public domain

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Original Research: Closed access.
“Socioeconomic Inequalities in Cognitive Functioning Only to a Small Extent Attributable to Modifiable Health and Lifestyle Factors in Individuals Without Dementia” by Susanne Röhr et al. Journal of Alzheimer’s Disease


Abstract

Socioeconomic Inequalities in Cognitive Functioning Only to a Small Extent Attributable to Modifiable Health and Lifestyle Factors in Individuals Without Dementia

Background: There are socioeconomic inequalities in dementia risk. Underlying pathways are not well known. Objective: To investigate whether modifiable health and lifestyle factors for brain health mediate the association of socioeconomic status (SES) and cognitive functioning in a population without dementia.

Methods: The “LIfestyle for BRAin health” (LIBRA) score was computed for 6,203 baseline participants of the LIFE-Adult-Study. LIBRA predicts dementia in midlife and early late life, based on 12 modifiable factors. Associations of SES (education, net equivalence income, and occupational status) and LIBRA with cognitive functioning (composite score) were investigated using adjusted linear regression models. Bootstrapped structural equation modeling (SEM) was used to investigate whether LIBRA mediated the association of SES and cognitive functioning.

Results: Participants were M = 57.4 (SD = 10.6, range: 40-79) years old; 50.3% were female. Both, SES (Wald: F(2)=52.5, p < 0.001) and LIBRA (Wald: F(1)=5.9, p < 0.05) were independently associated with cognitive functioning; there was no interaction (Wald: F(2)=2.9, p = 0.060). Lower SES and higher LIBRA scores indicate lower cognitive functioning. LIBRA partially mediated the association of SES and cognitive functioning (IE: =0.02, 95% CI [0.02, 0.03], p < 0.001). The proportion mediated was 12.7%.

Conclusion: Differences in cognitive functioning due to SES can be partially attributed to differences in modifiable health and lifestyle factors; but to a small extent. This suggests that lifestyle interventions could attenuate socioeconomic inequalities in cognitive functioning. However, directly intervening on the social determinants of health may yield greater benefits for dementia risk reduction.

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