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Journal Article

Lifestyle and the Risk of Dementia in Japanese-American Men

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/m2, 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 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.

R.P. Gelber
H. Petrovitch
K.H. Masaki
R.D. Abbott
G.Webster Ross
L.J. Launer
L.R. White
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