Lifestyle and the risk of dementia in Japanese-american men

J Am Geriatr Soc. 2012 Jan;60(1):118-23. doi: 10.1111/j.1532-5415.2011.03768.x. Epub 2011 Dec 28.


Objectives: To determine whether adhering to a healthy lifestyle in midlife may reduce the risk of dementia.

Design: Case-control study nested in a prospective cohort.

Setting: The Honolulu-Asia Aging Study, Oahu, Hawaii.

Participants: Three thousand four hundred sixty-eight Japanese-American men (mean age 52 in 1965-1968) examined for dementia 25 years later.

Measurements: Men at low risk were defined as those with the following midlife characteristics: nonsmoking, body mass index (BMI) less than 25.0 kg/m(2) , physically active, and having a healthy diet (based on alcohol, dairy, meat, fish, fruits, vegetables, cereals, and ratio of monounsaturated to saturated fat). Logistic regression was used to calculate odds ratios (ORs) and 95% confidence intervals (CIs) for developing overall dementia, Alzheimer's disease (AD), and vascular dementia (VaD), adjusting for potential confounders.

Results: Dementia was diagnosed in 6.4% of men (52.5% with AD, 35.0% with VaD). Examining the risk factors individually, BMI was most strongly associated with greater risk of overall dementia (OR = 1.87, 95% CI = 1.26-2.77; BMI > 25.0 vs <22.6 kg/m(2) ). All of the individual risk factors except diet score were significantly associated with VaD, whereas none were significantly associated with AD alone. Men with all four low-risk characteristics (7.2% of the cohort) had the lowest OR for overall dementia (OR = 0.36, 95% CI = 0.15-0.84). There were no significant associations between the combined low-risk characteristics and the risk of AD alone.

Conclusion: Among Japanese-American men, having a healthy lifestyle in midlife is associated with a lower risk of dementia in late life.

Publication types

  • Comparative Study
  • Research Support, N.I.H., Extramural
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Asian*
  • Attitude to Health / ethnology*
  • Dementia / ethnology*
  • Dementia / etiology
  • Humans
  • Life Style / ethnology*
  • Male
  • Prevalence
  • Prospective Studies
  • Risk Assessment / methods*
  • Risk Factors
  • United States / epidemiology