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Systematic review of health behavioral risks and cognitive health in older adults

Published online by Cambridge University Press:  03 November 2009

Yunhwan Lee ,
Joung Hwan Back ,
Jinhee Kim ,
Si-Heon Kim ,
Duk L. Na ,
Hae-Kwan Cheong ,
Chang Hyung Hong  and
Youn Gu Kim
Yunhwan Lee*
Affiliation:
Department of Preventive Medicine and Public Health, Ajou University School of Medicine, Suwon, Republic of Korea Institute of Aging, Ajou University Medical Center, Suwon, Republic of Korea
Joung Hwan Back
Affiliation:
Department of Preventive Medicine and Public Health, Ajou University School of Medicine, Suwon, Republic of Korea Institute of Aging, Ajou University Medical Center, Suwon, Republic of Korea
Jinhee Kim
Affiliation:
Department of Preventive Medicine and Public Health, Ajou University School of Medicine, Suwon, Republic of Korea Institute of Aging, Ajou University Medical Center, Suwon, Republic of Korea
Si-Heon Kim
Affiliation:
Department of Preventive Medicine and Public Health, Ajou University School of Medicine, Suwon, Republic of Korea
Duk L. Na
Affiliation:
Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
Hae-Kwan Cheong
Affiliation:
Department of Social and Preventive Medicine, Sungkyunkwan University School of Medicine, Suwon, Republic of Korea
Chang Hyung Hong
Affiliation:
Department of Psychiatry and Behavioral Sciences, Ajou University School of Medicine, Suwon, Republic of Korea
Youn Gu Kim
Affiliation:
Department of Preventive Medicine and Public Health, Ajou University School of Medicine, Suwon, Republic of Korea
*
Correspondence should be addressed to: Dr. Yunhwan Lee, Department of Preventive Medicine and Public Health, Ajou University School of Medicine, San 5, Wonchun-dong, Youngtong-gu, Suwon 443-721, Republic of Korea. Phone: +82-31-219-5085; Fax: +82-31-219-5084. Email: [email protected].
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Abstract

Background: An increasing body of evidence suggests that health behaviors may protect against cognitive impairment and dementia. The purpose of this study was to summarize the current evidence on health behavioral factors predicting cognitive health through a systematic review of the published literature.

Methods: PubMed, Embase, and PsycINFO databases were searched for studies on community representative samples aged 65 and older, with prospective cohort design and multivariate analysis. The outcome – cognitive health – was defined as a continuum of cognitive function ranging from cognitive decline to impairment and dementia, and health behaviors included physical activity, smoking, alcohol drinking, body mass index, and diet and nutrition.

Results: Of 12,105 abstracts identified, 690 relevant full-texts were reviewed. The final yield amounted to 115 articles of which 37 studies were chosen that met the highest standards of quality. Leisure time physical activity, even of moderate level, showed protective effects against dementia, whereas smoking elevated the risk of Alzheimer's disease. Moderate alcohol consumption tended to be protective against cognitive decline and dementia, but nondrinkers and frequent drinkers exhibited a higher risk for dementia and cognitive impairment. Midlife obesity had an adverse effect on cognitive function in later life. Analysis showed vegetable and fish consumption to be of benefit, whereas, persons consuming a diet high in saturated fat had an increased dementia risk.

Conclusion: The review demonstrates accumulating evidence supporting health behavioral effects in reducing the risk of cognitive decline and dementia. Results indicate potential benefits of healthy lifestyles in protecting cognitive health in later life.

Keywords

cognitioncognitive declinecognitive impairmentdementiahealth behaviorshealth promotionpreventionsystematic review
Type
Review Article
Information
International Psychogeriatrics , Volume 22 , Issue 2 , March 2010 , pp. 174 - 187
Copyright
Copyright © International Psychogeriatric Association 2009

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References

Abbott, R. D., White, L. R., Ross, G. W., Masaki, K. H., Curb, J. D. and Petrovitch, H. (2004). Walking and dementia in physically capable elderly men. JAMA, 292, 1447–1453.CrossRefGoogle ScholarPubMed
Alzheimer's Disease International (2008). The Prevalence of Dementia Worldwide. Available at: http://www.alz.co.uk/adi/pdf/prevalence.pdf.Google Scholar
Anstey, K. J., von Sanden, C., Salim, A. and O'Kearney, R. (2007). Smoking as a risk factor for dementia and cognitive decline: a meta-analysis of prospective studies. American Journal of Epidemiology, 166, 367–378.CrossRefGoogle ScholarPubMed
Anttila, T. et al. (2004). Alcohol drinking in middle age and subsequent risk of mild cognitive impairment and dementia in old age: a prospective population based study. BMJ, 329, 539.CrossRefGoogle ScholarPubMed
Beydoun, M. A., Beydoun, H. A. and Wang, Y. (2008). Obesity and central obesity as risk factors for incident dementia and its subtypes: a systematic review and meta-analysis. Obesity Reviews, 9, 204–218.CrossRefGoogle ScholarPubMed
Brookmeyer, R., Gray, S. and Kawas, C. (1998). Projections of Alzheimer's disease in the United States and the public health impact of delaying disease onset. American Journal of Public Health, 88, 1337–1342.CrossRefGoogle ScholarPubMed
Calon, F. and Cole, G. (2007). Neuroprotective action of omega-3 polyunsaturated fatty acids against neurodegenerative diseases: evidence from animal studies. Prostaglandins, Leukotrienes and Essential Fatty Acids, 77, 287–293.CrossRefGoogle ScholarPubMed
Dai, Q., Borenstein, A. R., Wu, Y., Jackson, J. C. and Larson, E. B. (2006). Fruit and vegetable juices and Alzheimer's disease: the Kame Project. American Journal of Medicine, 119, 751–759.CrossRefGoogle ScholarPubMed
Elias, M. F., Elias, P. K., Sullivan, L. M., Wolf, P. A. and D'Agostino, R. B. (2005). Obesity, diabetes and cognitive deficit: the Framingham Heart Study. Neurobiology of Aging, 26 (Suppl. 1), 11–16.CrossRefGoogle ScholarPubMed
Elias, P. K., Elias, M. F., D'Agostino, R. B., Silbershatz, H. and Wolf, P. A. (1999). Alcohol consumption and cognitive performance in the Framingham Heart Study. American Journal of Epidemiology, 150, 580–589.CrossRefGoogle ScholarPubMed
Engelhart, M. J. et al. (2002). Dietary intake of antioxidants and risk of Alzheimer disease. JAMA, 287, 3223–3229.CrossRefGoogle ScholarPubMed
Eskelinen, M. H. et al. (2008). Fat intake at midlife and cognitive impairment later in life: a population-based CAIDE study. International Journal of Geriatric Psychiatry, 23, 741–747.CrossRefGoogle ScholarPubMed
Ferri, C. P. et al. (2005). Global prevalence of dementia: a Delphi consensus study. Lancet, 366, 2112–2117.CrossRefGoogle ScholarPubMed
Ganguli, M., Bilt, J. V., Saxton, J. A., Shen, C. and Dodge, H. H. (2005). Alcohol consumption and cognitive function in late life: a longitudinal community study. Neurology, 65, 1210–1217.CrossRefGoogle ScholarPubMed
Gorospe, E. C. and Dave, J. K. (2007). The risk of dementia with increased body mass index. Age and Ageing, 36, 23–29.CrossRefGoogle ScholarPubMed
Grodstein, F., Chen, J. and Willett, W. C. (2003). High-dose antioxidant supplements and cognitive function in community-dwelling elderly women. American Journal of Clinical Nutrition, 77, 975–984.CrossRefGoogle ScholarPubMed
Gustafson, D., Rothenberg, E., Blennow, K., Steen, B. and Skoog, I. (2003). An 18-year follow-up of overweight and risk of Alzheimer disease. Annals of Internal Medicine, 163, 1524–1528.CrossRefGoogle ScholarPubMed
Haynes, R. B., Kastner, M., Wilczynski, N. L. and Hedges Team (2005). Developing optimal search strategies for detecting clinically sound and relevant causation studies in EMBASE. BMC Medical Informatics and Decision Making, 5, 8.CrossRefGoogle ScholarPubMed
Hendrie, H. C. et al. (2006). The NIH Cognitive and Emotional Health Project: report of the Critical Evaluation Study Committee. Alzheimer's and Dementia, 2, 12–32.CrossRefGoogle ScholarPubMed
Huang, T. L. et al. (2005). Benefits of fatty fish on dementia risk are stronger for those without APOE epsilon4. Neurology, 65, 1409–1414.CrossRefGoogle ScholarPubMed
Institute of Medicine (2001). Health and Behavior: The Interplay of Biological, Behavioral, and Societal Influences. Washington, DC: National Academy Press.Google Scholar
Kang, J. H., Ascherio, A. and Grodstein, F. (2005). Fruit and vegetable consumption and cognitive decline in aging women. Annals of Neurology, 57, 713–720.CrossRefGoogle ScholarPubMed
Kivipelto, M. et al. (2005). Obesity and vascular risk factors at midlife and the risk of dementia and Alzheimer disease. Archives of Neurology, 62, 1556–1560.CrossRefGoogle ScholarPubMed
Kivipelto, M. et al. (2008). Apolipoprotein E epsilon4 magnifies lifestyle risks for dementia: a population-based study. Journal of Cellular and Molecular Medicine, 12, 2762–2771.CrossRefGoogle ScholarPubMed
Laitinen, M. H. et al. (2006). Fat intake at midlife and risk of dementia and Alzheimer's disease: a population-based study. Dementia and Geriatric Cognitive Disorders, 22, 99–107.CrossRefGoogle ScholarPubMed
Larson, E. B. et al. (2006). Exercise is associated with reduced risk for incident dementia among persons 65 years of age and older. Annals of Internal Medicine, 144, 73–81.CrossRefGoogle ScholarPubMed
Laurin, D., Masaki, K. H., Foley, D. J., White, L. R. and Launer, L. J. (2004). Midlife dietary intake of antioxidants and risk of late-life incident dementia: the Honolulu-Asia Aging Study. American Journal of Epidemiology, 159, 959–967.CrossRefGoogle ScholarPubMed
Lautenschlager, N. T., Almeida, O. P. and Flicker, L. (2003). Preventing dementia: why we should focus on health promotion now. International Psychogeriatrics, 15, 111–119.CrossRefGoogle ScholarPubMed
Lee, Y., Kim, J. and Back, J. H. (2009). The influence of multiple lifestyle behaviors on cognitive function in older persons living in the community. Preventive Medicine, 48, 86–90.CrossRefGoogle ScholarPubMed
Luchsinger, J. A., Tang, M. X., Shea, S. and Mayeux, R. (2003). Antioxidant vitamin intake and risk of Alzheimer disease. Archives of Neurology, 60, 203–208.CrossRefGoogle ScholarPubMed
Luchsinger, J. A., Tang, M. X., Siddiqui, M., Shea, S. and Mayeux, R. (2004). Alcohol intake and risk of dementia. Journal of the American Geriatrics Society, 52, 540–546.CrossRefGoogle ScholarPubMed
Maxwell, C. J., Hogan, D. B. and Ebly, E. M. (2002). Serum folate levels and subsequent adverse cerebrovascular outcomes in elderly persons. Dementia and Geriatric Cognitive Disorders, 13, 225–234.CrossRefGoogle ScholarPubMed
Morris, M. C. et al. (2004). Dietary niacin and the risk of incident Alzheimer's disease and of cognitive decline. Journal of Neurology, Neurosurgery, and Psychiatry, 75, 1093–1099.CrossRefGoogle ScholarPubMed
Morris, M. C., Evans, D. A., Tangney, C. C., Bienias, J. L. and Wilson, R. S. (2005). Fish consumption and cognitive decline with age in a large community study. Archives of Neurology, 62, 1849–1853.CrossRefGoogle Scholar
Morris, M. C., Evans, D. A., Tangney, C. C., Bienias, J. L. and Wilson, R. S. (2006). Associations of vegetable and fruit consumption with age-related cognitive change. Neurology, 67, 1370–1376.CrossRefGoogle ScholarPubMed
Ngandu, T. et al. (2007). Alcohol drinking and cognitive functions: findings from the Cardiovascular Risk Factors Aging and Dementia (CAIDE) Study. Dementia and Geriatric Cognitive Disorders, 23, 140–149.CrossRefGoogle ScholarPubMed
Ott, A. et al. (1998). Smoking and risk of dementia and Alzheimer's disease in a population-based cohort study: the Rotterdam Study. Lancet, 351, 1840–1843.CrossRefGoogle Scholar
Patterson, C., Feightner, J., Garcia, A. and MacKnight, C. (2007). General risk factors for dementia: a systematic evidence review. Alzheimer's and Dementia, 3, 341–347.CrossRefGoogle ScholarPubMed
Peters, R., Peters, J., Warner, J., Beckett, N. and Bulpitt, C. (2008). Alcohol, dementia and cognitive decline in the elderly: a systematic review. Age and Ageing, 37, 505–512.CrossRefGoogle ScholarPubMed
Podewils, L. J. et al. (2005). Physical activity, APOE genotype, and dementia risk: findings from the Cardiovascular Health Cognition Study. American Journal of Epidemiology, 161, 639–651.CrossRefGoogle ScholarPubMed
Qiu, C., De Ronchi, D. and Fratiglioni, L. (2007). The epidemiology of the dementias: an update. Current Opinion in Psychiatry, 20, 380–385.CrossRefGoogle ScholarPubMed
Ravaglia, G. et al. (2005). Homocysteine and folate as risk factors for dementia and Alzheimer disease. American Journal of Clinical Nutrition, 82, 636–643.CrossRefGoogle ScholarPubMed
Ravaglia, G. et al. (2008). Plasma tocopherols and risk of cognitive impairment in an elderly Italian cohort. American Journal of Clinical Nutrition, 87, 1306–1313.CrossRefGoogle Scholar
Reitz, C., den Heijer, T., van Duijn, C., Hofman, A. and Breteler, M. M. (2007). Relation between smoking and risk of dementia and Alzheimer disease: the Rotterdam Study. Neurology, 69, 998–1005.CrossRefGoogle ScholarPubMed
Rosengren, A., Skoog, I., Gustafson, D. and Wilhelmsen, L. (2005). Body mass index, other cardiovascular risk factors, and hospitalization for dementia. Archives of Internal Medicine, 165, 321–326.CrossRefGoogle ScholarPubMed
Rovio, S. et al. (2007). Work-related physical activity and the risk of dementia and Alzheimer's disease. International Journal of Geriatric Psychiatry, 22, 874–882.CrossRefGoogle ScholarPubMed
Simons, L. A., Simons, J., McCallum, J. and Friedlander, Y. (2006). Lifestyle factors and risk of dementia: Dubbo Study of the elderly. Medical Journal of Australia, 184, 68–70.CrossRefGoogle ScholarPubMed
Singh-Manoux, A., Hillsdon, M., Brunner, E. and Marmot, M. (2005). Effects of physical activity on cognitive functioning in middle age: evidence from the Whitehall II prospective cohort study. American Journal of Public Health, 95, 2252–2258.CrossRefGoogle ScholarPubMed
Sloane, P. D. et al. (2002). The public health impact of Alzheimer's disease, 2000–2050: potential implication of treatment advances. Annual Review of Public Health, 23, 213–231.CrossRefGoogle ScholarPubMed
Swan, G. E. and Lessov-Schlaggar, C. N. (2007). The effects of tobacco smoke and nicotine on cognition and the brain. Neuropsychology Review, 17, 259–273.CrossRefGoogle ScholarPubMed
Taaffe, D. R. et al. (2008). Physical activity, physical function, and incident dementia in elderly men: the Honolulu-Asia Aging Study. Journals of Gerontology, Series A: Biological Sciences and Medical Sciences, 63, 529–535.CrossRefGoogle ScholarPubMed
Tyas, S. L. et al. (2003). Mid-life smoking and late-life dementia: the Honolulu-Asia Aging Study. Neurobiology of Aging, 24, 589–596.CrossRefGoogle ScholarPubMed
U.S. Centers for Disease Control and Prevention (1999). The Community Guide. Data Abstraction Form. Available at: http://www.thecommunityguide.org/about/abstractionform.pdf.Google Scholar
Weuve, J., Kang, J. H., Manson, J. E., Breteler, M. M. B., Ware, J. H. and Grodstein, F. (2004). Physical activity, including walking, and cognitive function in older women. JAMA, 292, 1454–1461.CrossRefGoogle ScholarPubMed
Whitmer, R. A., Gunderson, E. P., Quesenberry, C. P. Jr, Zhou, J. and Yaffe, K. (2007). Body mass index in midlife and risk of Alzheimer disease and vascular dementia. Current Alzheimer Research, 4, 103–109.CrossRefGoogle ScholarPubMed
Wilczynski, N. L., Haynes, R. B. and Hedges Team (2003). Developing optimal search strategies for detecting clinically sound causation studies in MEDLINE. American Medical Informatics Association Annual Symposium Proceedings, 719–723.Google Scholar
Yamada, M., Kasagi, F., Sasaki, H., Masunari, N., Mimori, Y. and Suzuki, G. (2003). Association between dementia and midlife risk factors: the Radiation Effects Research Foundation Adult Health Study. Journal of the American Geriatrics Society, 51, 410–414.CrossRefGoogle ScholarPubMed