Associations among multidomain lifestyles, chronic diseases, and dementia in older adults: a cross-sectional analysis of a cohort study

Jing-Jing Zhang; Zhao-Xia Wu; Wei Tan; Dan Liu; Gui-Rong Cheng; Lang Xu; Fei-Fei Hu; Yan Zeng

doi:10.3389/fnagi.2023.1200671

Associations among multidomain lifestyles, chronic diseases, and dementia in older adults: a cross-sectional analysis of a cohort study

Front Aging Neurosci. 2023 Aug 4:15:1200671. doi: 10.3389/fnagi.2023.1200671. eCollection 2023.

Authors

Jing-Jing Zhang^#^{1

2

3}, Zhao-Xia Wu^#⁴, Wei Tan¹, Dan Liu^{1

2

3}, Gui-Rong Cheng^{1

2

3}, Lang Xu^{1

2

3}, Fei-Fei Hu^{1

2

3}, Yan Zeng^{1

2

3}

Affiliations

¹ Geriatric Hospital Affiliated to Wuhan University of Science and Technology, Wuhan, China.
² Brain Science and Advanced Technology Institute, Wuhan University of Science and Technology, Wuhan, China.
³ School of Public Health, Wuhan University of Science and Technology, Wuhan, China.
⁴ Wuchang Hospital Affiliated to Wuhan University of Science and Technology, Wuhan, China.

^# Contributed equally.

Abstract

Background: Unhealthy lifestyles and chronic diseases are commonly seen and treatable factors in older adults and are both associated with dementia. However, the synergistic effect of the interaction of lifestyles and chronic diseases on dementia is unknown.

Methods: We determined independent associations of multidomain lifestyles and chronic diseases (cerebrovascular disease, diabetes, and hypertension) with dementia and examined their synergistic impact on dementia among older adults. The data were drawn from the Hubei Memory and Aging Cohort Study. We created a summary score of six factors for multidomain lifestyles. Dementia was diagnosed according to the Diagnostic and Statistical Manual of Mental Disorders IV. Logistic regression and multiple correspondence analyses were used to explore the relationships among multidomain lifestyles, chronic diseases, and dementia. A sensitivity analysis was performed to minimize the interference of reverse causality and potential confounders.

Results: Independent associations with dementia were found in unhealthy (OR = 1.90, 95% CI: 1.38-2.61) and intermediate healthy lifestyles (OR, 3.29, 2.32-4.68), hypertension (OR, 1.21, 1.01-1.46), diabetes (OR, 1.30, 1.04-1.63), and cerebrovascular disease (OR, 1.39, 1.12-1.72). Interactions of diabetes (p = 0.004), hypertension (p = 0.004), and lifestyles were significant, suggesting a combined impact on dementia. Sensitivity analysis supported the strong association among multidomain lifestyles, chronic diseases, and dementia prevalence.

Conclusion: An unhealthy lifestyle was associated with a higher prevalence of dementia, regardless of whether the participants had chronic diseases; however, this association was stronger in individuals with chronic diseases. Multidomain lifestyles and chronic diseases may have an enhanced impact on dementia.

Keywords: chronic disease; community-dwelling older adults; dementia; lifestyle; synergistic effect.

Grants and funding

Financial support for the present study was received from the Science and Technology Innovation 2030 Major Projects (No. 2022ZD0211600 to YZ), the National Natural Science Foundation of China (Nos. 81870901 and 82071272 to YZ), and the Ministry of Science and Technology of China (No. 2020YFC2006000 to YZ). The financial contributors had no role in the design, analysis, or writing of this article.