Association of Life's Simple 7 with incident dementia and its modification by the apolipoprotein E genotype

Alzheimers Dement. 2021 Dec;17(12):1905-1913. doi: 10.1002/alz.12359. Epub 2021 May 2.


Introduction: There is limited and inconsistent reporting on the association between Life's Simple 7 (LS7) and dementia in the elderly population.

Methods: Based on the Washington Heights-Inwood Columbia Aging Project (WHICAP), LS7 scores were estimated to assess cardiovascular health status. Associations between LS7 scores and incident dementia were investigated by Cox proportional hazards models.

Results: Among 1987 subjects, 291 incident cases of dementia were identified over a median follow-up of 5.84 years. Compared with subjects in the poor cardiovascular health group (scores 0 to 5), those in intermediate (6 to 9) and optimal (10 to 14) groups had lower dementia risk, with the hazard ratio (HR; 95% confidence interval) being 0.74 (0.54 to 1.00) and 0.59 (0.38 to 0.91), respectively. These results were significant in apolipoprotein E genotype ε4 (APOE ε4) allele non-carriers but not in carriers.

Discussion: Higher LS7 scores are protective for dementia, especially among the APOE ε4 noncarriers.

Keywords: APOE ε4; Life's Simple 7; cardiovascular health; dementia; epidemiology.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Aged
  • Apolipoprotein E4 / genetics*
  • Apolipoproteins E / genetics
  • Body Mass Index
  • Cholesterol / blood
  • Dementia / epidemiology*
  • Diet, Healthy
  • Exercise
  • Female
  • Genotype*
  • Humans
  • Longitudinal Studies
  • Male
  • Risk Reduction Behavior*


  • ApoE protein, human
  • Apolipoprotein E4
  • Apolipoproteins E
  • Cholesterol