People 60+ who had at least four of six favorable lifestyle factors -- healthy diet, exercise, social contact, cognitive activity and no smoking or drinking -- had slower memory decline than those who had no more than one healthy factor, according to Jianping Jia, MD, PhD, of Xuanwu Hospital of Capital Medical University in Beijing, and co-authors.

MedPage Today’s recent article entitled “Memory Decline Tied to Lifestyle Factors” reports that over 10 years, memory decline was 0.28 points less on the Auditory Verbal Learning Test (AVLT) in the favorable lifestyle group compared with the unfavorable group, Jia and co-authors reported in The BM.

People who carried the apolipoprotein E ε4 (APOE4) allele also had slower memory decline with a favorable lifestyle or an average lifestyle with two or three healthy factors compared with an unfavorable one. Similar results were seen for non-APOE4 carriers.

"APOE4 is the strongest known risk factor for Alzheimer's disease and related dementias, and within the context of ongoing and future targeted prevention trials, this outcome is particularly important," noted Séverine Sabia, PhD, of Université de Paris, and Archana Singh-Manoux, PhD, of University College London, in an accompanying editorial.

"These results support the notion that lifestyle change might counteract the deleterious effect of APOE4 on cognitive decline and dementia," Sabia and Singh-Manoux added.

Prior studies showed that APOE4 affects cognitive decline. However, it doesn’t negate all the benefits of a healthy lifestyle. In the U.S., healthy lifestyle scores in midlife have been associated with better cognition in later years, even among APOE4 carriers. In the FINGER trial, APOE4 carriers who participated in an intervention comprising diet, exercise, cognitive training and vascular risk management performed better than controls on annual cognitive tests.

Jia and co-authors analyzed data for about 29,000 adults who initially tested normal for cognitive function. Mean age was about 72; 48.5% in the study were women, and 20.4% were APOE4 carriers.

They measured immediate recall, short-delay and long-delay recall, and long-delay recognition. Of the six healthy lifestyle components, diet had the strongest association with memory, then cognitive activity, physical exercise and social contact.

"Although each lifestyle factor contributed differentially to slowing memory decline, our results showed that participants who maintained more healthy lifestyle factors had a significantly slower memory decline than those with fewer healthy lifestyle factors," Jia and co-authors wrote. "This information could be useful in making personal choices that can help to protect against memory decline, and our results provide further evidence that memory loss is potentially modifiable."

Cognitive decline is likely affected by several variables, Sabia and Singh-Manoux observed.

"The multifactorial risk paradigm introduced by the Framingham study has led to a substantial reduction in cardiovascular disease," they pointed out. "A similar approach should be taken with dementia prevention, identifying not only the factors that matter most but also the threshold at which they matter, and the age when intervention is likely to be most effective, as the World Health Organization underlined in its recent report on brain health."

Reference: MedPage Today (Jan. 25, 2023) “Memory Decline Tied to Lifestyle Factors”