Physical Activity, Diet, and Risk of Alzheimer Disease
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CONTEXT: Both higher adherence to a Mediterranean-type diet and more physical activity have been independently associated with lower Alzheimer disease (AD) risk but their combined association has not been investigated. OBJECTIVE: To investigate the combined association of diet and physical activity with AD risk. DESIGN, SETTING, AND PATIENTS: Prospective cohort study of 2 cohorts comprising 1880 community-dwelling elders without dementia living in New York, New York, with both diet and physical activity information available. Standardized neurological and neuropsychological measures were administered approximately every 1.5 years from 1992 through 2006. Adherence to a Mediterranean-type diet (scale of 0-9; trichotomized into low, middle, or high; and dichotomized into low or high) and physical activity (sum of weekly participation in various physical activities, weighted by the type of physical activity [light, moderate, vigorous]; trichotomized into no physical activity, some, or much; and dichotomized into low or high), separately and combined, were the main predictors in Cox models. Models were adjusted for cohort, age, sex, ethnicity, education, apolipoprotein E genotype, caloric intake, body mass index, smoking status, depression, leisure activities, a comorbidity index, and baseline Clinical Dementia Rating score. MAIN OUTCOME MEASURE: Time to incident AD. RESULTS: A total of 282 incident AD cases occurred during a mean (SD) of 5.4 (3.3) years of follow-up. When considered simultaneously, both Mediterranean-type diet adherence (compared with low diet score, hazard ratio [HR] for middle diet score was 0.98 [95% confidence interval {CI}, 0.72-1.33]; the HR for high diet score was 0.60 [95% CI, 0.42-0.87]; P = .008 for trend) and physical activity (compared with no physical activity, the HR for some physical activity was 0.75 [95% CI, 0.54-1.04]; the HR for much physical activity was 0.67 [95% CI, 0.47-0.95]; P = .03 for trend) were associated with lower AD risk. Compared with individuals neither adhering to the diet nor participating in physical activity (low diet score and no physical activity; absolute AD risk of 19%), those both adhering to the diet and participating in physical activity (high diet score and high physical activity) had a lower risk of AD (absolute risk, 12%; HR, 0.65 [95% CI, 0.44-0.96]; P = .03 for trend). CONCLUSION: In this study, both higher Mediterranean-type diet adherence and higher physical activity were independently associated with reduced risk for AD.
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In patients with mild to moderate cognitive decline and different dementias, folic acid had no benefit on cognition or mood.
“In patients with mild to moderate cognitive decline and different forms of dementia, there was no benefit from folic acid on measures of cognition or mood.476”
From Vascular Contributions to Cognitive Impairment and Dementia: A Statement for Healthcare Professionals From the American Heart Association/American Stroke Association (2011) · cites this paper as [476]
The Design, Setting, and Patients section describes a cohort of elders without dementia studied for diet, physical activity, and Alzheimer disease risk. The Comment discusses those associations, but neither it nor the passages found by searching for folic acid and folate supplementation reports folic acid’s effects on cognition or mood in patients with cognitive decline or dementia. (LLM, conf=0.77)
Experimental — accuracy not yet measuredA systematic review found no beneficial effect of folic acid 750 μg/d on cognition or mood in healthy older women.
“According to 1 systematic review, there was no beneficial effect of folic acid 750 μg/d on measures of cognition or mood in healthy older women.476”
From Vascular Contributions to Cognitive Impairment and Dementia: A Statement for Healthcare Professionals From the American Heart Association/American Stroke Association (2011) · cites this paper as [476]
The Design, Setting, and Patients section describes a prospective cohort study of Mediterranean-type diet, physical activity, and Alzheimer disease risk, not a systematic review of folic acid. Searches for folic acid at 750 μg/d and for supplementation effects on cognition or mood found no passage addressing the claimed result. (LLM, conf=0.76)
Experimental — accuracy not yet measuredDiet, physical activity, substance use, and sleep habits are associated with ADRD risk and resilience through downstream pathophysiological mechanisms.
“all of which are associated with ADRD risk and resilience through downstream pathophysiological mechanisms.”
From Why the cognitive ‘fountain of youth’ may be upstream: pathways to dementia risk and resilience through social connectedness (2022) · cites this paper as [68]
Social network members' attitudes, beliefs, and behaviors shape adults' diet, physical activity, substance use, and sleep habits.
“the attitudes, beliefs, and behaviors of social network members shape the diet, physical activity, substance use, and sleep habits of adults”
From Why the cognitive ‘fountain of youth’ may be upstream: pathways to dementia risk and resilience through social connectedness (2022) · cites this paper as [68]
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- Authors
- Scarmeas, N.
- Affiliations
- Columbia University Irving Medical Center (US)
- Corresponding author
- Scarmeas, Nikolaos
- ORCID
- Scarmeas, Nikolaos
- Venue
- JAMA
- Publisher
- American Medical Association (AMA)
- Published
- 2009-08-12
- Volume
- 302
- Issue
- 6
- Pages
- 627
- ISSN
- 0002-9955 (ISSN-L)
- 0098-7484
- PMC
- PMC2765045
- OpenAlex
- W2088780441
- Cited by
- 916
- References
- 52
- Citations by year
- 2026: 22 · 2025: 28 · 2024: 38 · 2023: 34 · 2022: 33 · 2021: 44 · 2020: 53 · 2019: 63 · 2018: 51 · 2017: 53 · 2016: 43 · 2015: 68 · 2014: 81 · 2013: 73 · 2012: 68
- FWCI
- 47.47
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- JAMA (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Columbia Academic Commons (Columbia University)
- Funders
- National Institute on Aging (R01AG037212, P01AG007232, R01AG028506, AG028506, P50AG008702, P01AG07232)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Nutritional Studies and Diet
- Health Sciences › Medicine › Physiology › Alzheimer's disease research and treatments
- Keywords
- Alzheimer's disease, Mediterranean diet, physical activity, dementia risk, older adults, lifestyle factors, APOE genotype, body mass index, depression, comorbidities, Clinical Dementia Rating, cognitive decline, neuropsychological assessment, community-dwelling older adults, cardiovascular risk factors, hypertension
- MeSH terms
- Aged, Aged, 80 and over, Alzheimer Disease, Apolipoproteins E, Energy Intake, Depression, Educational Status, Female, Genotype, Humans, Leisure Activities, Male, Motor Activity, New York City, Primary Prevention, Prospective Studies, Residence Characteristics, Risk Factors, Smoking, Comorbidity, Confounding Factors, Epidemiologic, Body Mass Index, Proportional Hazards Models, Risk Assessment, Diet, Mediterranean
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