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      The Role of Lifestyle Factors and Sleep Duration for Late-Onset Dementia: A Cohort Study

      research-article
      a , * , a , b
      Journal of Alzheimer's Disease
      IOS Press
      Cohort studies, dementia, diet, lifestyle, prospective studies, sleep

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          Abstract

          Background:

          The role of lifestyle factors and sleep for dementia is uncertain.

          Objective:

          To examine the associations of major lifestyle factors and sleep duration with risk of late-onset dementia.

          Methods:

          We used data from a population-based cohort of 28,775 Swedish adults who were ≥65 years of age and completed a questionnaire about lifestyle and other modifiable factors in the autumn of 1997. Dementia cases were ascertained by linkage with the Swedish National Patient Register.

          Results:

          During a mean follow-up of 12.6 years, dementia was diagnosed among 3,755 participants (mean age at diagnosis 83.2±5.1 years). There were no associations of an overall healthy diet (defined by a modified Dietary Approaches to Stop Hypertension Diet score or a Mediterranean diet score), alcohol and coffee consumption, or physical activity with dementia incidence. Compared with never smokers, dementia risk was increased in former and current smokers (hazard ratio [95% confidence interval] = 1.13 [1.04–1.23] and 1.10 [1.00–1.21], respectively). Extended time of sleep (>9 h per night) was associated with an increased risk of dementia. However, this association appeared to be related to a reverse causation effect since the association did not remain after exclusion of cases diagnosed within the first five or ten years of follow-up.

          Conclusions:

          This study found no evidence that major lifestyle factors, aside from smoking, or sleep duration influence the risk of dementia.

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          Most cited references30

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          Dementia prevention, intervention, and care

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            Mediterranean diet and risk for Alzheimer's disease.

            Previous research in Alzheimer's disease (AD) has focused on individual dietary components. There is converging evidence that composite dietary patterns such as the Mediterranean diet (MeDi) is related to lower risk for cardiovascular disease, several forms of cancer, and overall mortality. We sought to investigate the association between MeDi and risk for AD. A total of 2,258 community-based nondemented individuals in New York were prospectively evaluated every 1.5 years. Adherence to the MeDi (zero- to nine-point scale with higher scores indicating higher adherence) was the main predictor in models that were adjusted for cohort, age, sex, ethnicity, education, apolipoprotein E genotype, caloric intake, smoking, medical comorbidity index, and body mass index. There were 262 incident AD cases during the course of 4 (+/-3.0; range, 0.2-13.9) years of follow-up. Higher adherence to the MeDi was associated with lower risk for AD (hazard ratio, 0.91; 95% confidence interval, 0.83-0.98; p=0.015). Compared with subjects in the lowest MeDi tertile, subjects in the middle MeDi tertile had a hazard ratio of 0.85 (95% confidence interval, 0.63-1.16) and those at the highest tertile had a hazard ratio of 0.60 (95% confidence interval, 0.42-0.87) for AD (p for trend=0.007). We conclude that higher adherence to the MeDi is associated with a reduction in risk for AD. Ann Neurol 2006.
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              Meta-analysis of modifiable risk factors for Alzheimer's disease.

              The aetiology of Alzheimer's disease (AD) is believed to involve environmental exposure and genetic susceptibility. The aim of our present systematic review and meta-analysis was to roundly evaluate the association between AD and its modifiable risk factors.
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                Author and article information

                Journal
                J Alzheimers Dis
                J. Alzheimers Dis
                JAD
                Journal of Alzheimer's Disease
                IOS Press (Nieuwe Hemweg 6B, 1013 BG Amsterdam, The Netherlands )
                1387-2877
                1875-8908
                03 October 2018
                30 October 2018
                2018
                : 66
                : 2
                : 579-586
                Affiliations
                [a ]Unit of Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet , Sweden
                [b ]Department of Surgical Sciences, Uppsala University , Uppsala, Sweden
                Author notes
                [* ]Correspondence to: Susanna C. Larsson, Unit of Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, SE-17177 Stockholm, Sweden. E-mail: susanna.larsson@ 123456ki.se .
                Article
                JAD180529
                10.3233/JAD-180529
                6218132
                30320581
                303d4a64-937d-4980-b4e9-390aab900c02
                © 2018 – IOS Press and the authors. All rights reserved

                This is an open access article distributed under the terms of the Creative Commons Attribution Non-Commercial (CC BY-NC 4.0) License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 17 August 2018
                Categories
                Research Article

                cohort studies,dementia,diet,lifestyle,prospective studies,sleep

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