Why a healthy lifestyle is not enough to prevent dementia

Summary: Opportunities for a healthy lifestyle are unevenly distributed and the socially disadvantaged have 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 shifts 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 unevenly distributed: social disadvantage is associated with a higher risk of dementia. The present findings are published in Journal of Alzheimer’s Disease.

As the population ages, dementia is increasing. Currently, around 1.8 million people in Germany suffer from dementia. Population statistics predict an increase to around three million by 2050. International research shows 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 unevenly distributed,” says Dr. Susanne Röhr, leader of the current study and a researcher at the Institute for Social Medicine, Occupational Medicine and Public Health (ISAP) at the University of Leipzig. “Disadvantaged people, 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 study for adults at the Leipzig Research Center for Diseases of Civilization. The proportion of women and men is equal. The subjects were between the ages of 40 and 79 and were not affected by dementia.

The large database of the population-based cohort study allowed 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 socioeconomic factors such as education, occupational status, and household income and mental performance and neuropsychological test scores was examined.

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

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

“This suggests that lifestyle interventions can moderate social inequalities in cognitive performance,” adds Professor Steffi Riedel-Heller, Director of ISAP.

However, health and lifestyle factors explained differences in mental performance due to socioeconomic factors only to a small extent, according to the researchers. Therefore, the survey results also suggest that greater emphasis may be placed on the social conditions themselves.

“Policy measures aimed at reducing social inequalities could make a significant contribution to reducing the risk of dementia,” says Dr Rohr.

For this lifestyle and dementia research news

Author: Press office
source: University of Leipzig
Contact: Press Office – University of Leipzig
Image: Image is in the public domain

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Original Research: Closed access.
“Socioeconomic Inequalities in Cognitive Functioning Only Minorly Due to Modifiable Health and Lifestyle Factors in Nondemented Individuals” by Susanne Röhr et al. Journal of Alzheimer’s Disease


Summary

Socioeconomic disparities in cognitive functioning only marginally attributable to modifiable health and lifestyle factors in individuals without dementia

Background: There are socioeconomic inequalities in dementia risk. The underlying roads 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 non-demented population.

Methods: The Lifestyle for BRAin health (LIBRA) score was calculated for 6,203 primary participants in the LIFE-Adult-Study. LIBRA predicts dementia in middle and early life based on 12 modifiable factors. Associations of SES (education, net equivalent income, and occupational status) and LIBRA with cognitive functioning (composite score) were examined using adjusted linear regression models. Structural equation modeling (SEM) was used to examine whether LIBRA mediates the relationship of SES and cognitive functioning.

Results: Participants were M = 57.4 ( SD = 10.6, range: 40–79) years; 50.3% are women. 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 relationship of SES and cognitive functioning (IE: =0.02, 95% CI [0.02, 0.03], p < 0.001). The share of the mediated is 12.7%.

Conclusion: Differences in cognitive functioning due to SES may be partially attributable to differences in modifiable health and lifestyle factors; but to a small extent. This suggests that lifestyle interventions can reduce socioeconomic inequalities in cognitive functioning. However, direct intervention on the social determinants of health may yield greater benefits in reducing the risk of dementia.

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