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Healthy lifestyle and life expectancy with and without Alzheimer’s dementia: population based cohort study
The BMJ ( IF 105.7 ) Pub Date : 2022-04-13 , DOI: 10.1136/bmj-2021-068390
Klodian Dhana 1, 2 , Oscar H Franco 3, 4 , Ethan M Ritz 1, 2 , Christopher N Ford 1, 2 , Pankaja Desai 1, 2 , Kristin R Krueger 1, 2 , Thomas M Holland 1, 2 , Anisa Dhana 1, 2 , Xiaoran Liu 1, 2 , Neelum T Aggarwal 5, 6 , Denis A Evans 1, 2 , Kumar B Rajan 1, 2
Affiliation  

Objective To determine the impact of lifestyle factors on life expectancy lived with and without Alzheimer’s dementia. Design Prospective cohort study. Setting The Chicago Health and Aging Project, a population based cohort study in the United States. Participants 2449 men and women aged 65 years and older. Main exposure A healthy lifestyle score was developed based on five modifiable lifestyle factors: a diet for brain health (Mediterranean-DASH Diet Intervention for Neurodegenerative Delay—MIND diet score in upper 40% of cohort distribution), late life cognitive activities (composite score in upper 40%), moderate or vigorous physical activity (≥150 min/week), no smoking, and light to moderate alcohol consumption (women 1-15 g/day; men 1-30 g/day). Main outcome Life expectancy with and without Alzheimer’s dementia in women and men. Results Women aged 65 with four or five healthy factors had a life expectancy of 24.2 years (95% confidence interval 22.8 to 25.5) and lived 3.1 years longer than women aged 65 with zero or one healthy factor (life expectancy 21.1 years, 19.5 to 22.4). Of the total life expectancy at age 65, women with four or five healthy factors spent 10.8% (2.6 years, 2.0 to 3.3) of their remaining years with Alzheimer’s dementia, whereas women with zero or one healthy factor spent 19.3% (4.1 years, 3.2 to 5.1) with the disease. Life expectancy for women aged 65 without Alzheimer’s dementia and four or five healthy factors was 21.5 years (20.0 to 22.7), and for those with zero or one healthy factor it was 17.0 years (15.5 to 18.3). Men aged 65 with four or five healthy factors had a total life expectancy of 23.1 years (21.4 to 25.6), which is 5.7 years longer than men aged 65 with zero or one healthy factor (life expectancy 17.4 years, 15.8 to 20.1). Of the total life expectancy at age 65, men with four or five healthy factors spent 6.1% (1.4 years, 0.3 to 2.0) of their remaining years with Alzheimer’s dementia, and those with zero or one healthy factor spent 12.0% (2.1 years, 0.2 to 3.0) with the disease. Life expectancy for men aged 65 without Alzheimer’s dementia and four or five healthy factors was 21.7 years (19.7 to 24.9), and for those with zero or one healthy factor life expectancy was 15.3 years (13.4 to 19.1). Conclusion A healthy lifestyle was associated with a longer life expectancy among men and women, and they lived a larger proportion of their remaining years without Alzheimer’s dementia. The life expectancy estimates might help health professionals, policy makers, and stakeholders to plan future healthcare services, costs, and needs. Deidentified data are available on request for qualified investigators from [www.riha.rush.edu/dataportal.html][1] [1]: http://www.riha.rush.edu/dataportal.html

中文翻译:

有和没有阿尔茨海默病痴呆的健康生活方式和预期寿命:基于人群的队列研究

目的 确定生活方式因素对阿尔茨海默病患者和非阿尔茨海默病患者预期寿命的影响。设计前瞻性队列研究。设置芝加哥健康与老龄化项目,这是一项在美国进行的基于人群的队列研究。参与者 2449 名 65 岁及以上的男性和女性。主要暴露 健康生活方式评分是根据五个可修改的生活方式因素开发的:大脑健康饮食(Mediterranean-DASH Diet Intervention for Neurodegeneration Delay-MIND 饮食评分在队列分布的上 40%)、晚年认知活动(综合评分40%)、中等或剧烈的体力活动(≥150 分钟/周)、不吸烟、轻度至中度饮酒(女性 1-15 克/天;男性 1-30 克/天)。主要结果 男女患阿尔茨海默氏症和不患阿尔茨海默氏症的预期寿命。结果 有 4 或 5 个健康因素的 65 岁女性的预期寿命为 24.2 年(95% 置信区间 22.8 至 25.5),比 65 岁有 0 或 1 个健康因素的女性(预期寿命 21.1 年,19.5 至 22.4 )。在 65 岁时的总预期寿命中,有 4 或 5 个健康因素的女性在其剩余年限中的 10.8%(2.6 年,2.0 至 3.3)患有阿尔茨海默病,而有 0 或 1 个健康因素的女性则为 19.3%(4.1 年, 3.2 至 5.1) 与疾病。没有阿尔茨海默病痴呆和四个或五个健康因素的 65 岁女性的预期寿命为 21.5 年(20.0 至 22.7),而那些健康因素为零或一个的女性的预期寿命为 17.0 年(15.5 至 18.3)。65 岁男性,有 4 或 5 个健康因素,总预期寿命为 23.1 岁(21.4 至 25.6),即 5。比 65 岁男性长 7 年,健康因素为零或一项(预期寿命 17.4 岁,15.8 至 20.1)。在 65 岁时的总预期寿命中,具有 4 或 5 个健康因素的男性在其剩余年限中的 6.1%(1.4 年,0.3 至 2.0)患有阿尔茨海默氏症,而具有 0 或 1 个健康因素的男性则为 12.0%(2.1 年, 0.2 至 3.0) 与疾病。没有阿尔茨海默氏症痴呆和四个或五个健康因素的 65 岁男性的预期寿命为 21.7 年(19.7 至 24.9),而那些具有零或一个健康因素的人的预期寿命为 15.3 年(13.4 至 19.1)。结论 健康的生活方式与男性和女性的预期寿命延长相关,并且他们在剩余的岁月中没有患阿尔茨海默病痴呆的比例更大。预期寿命估计值可能有助于卫生专业人员、政策制定者、和利益相关者规划未来的医疗保健服务、成本和需求。合格的调查人员可从 [www.riha.rush.edu/dataportal.html][1] [1] 索取去识别的数据:http://www.riha.rush.edu/dataportal.html
更新日期:2022-04-13
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