Physical and mental activity along with a healthy diet of unprocessed food: Dementia treatment

Lifestyle features are potentially modifiable risk factors for dementia.

Two teams (Neurology 2022 Jul 27; 99:e799 and Neurology 2022 Jul 27; 99:e1056) prospectively analyzed data from the U.K. Biobank study to determine dementia risk associated with patterns of physical activity and mental activity (PA/MA) and with consumption of ultraprocessed foods (UPF).

In both studies, all participants were dementia-free at baseline.

Physical and mental activity were determined by questionnaire data, and consumption of UPF was determined by data from at least two 24-hour dietary assessments. Covariates included demographics, socioeconomic factors, alcohol/smoking status, body-mass index, area-based deprivation, medical comorbidities, and cognitive function, with the addition of sleep duration, total energy intake, and healthy diet score in the UPF study. Genetic susceptibility was determined by established genetic risk factors and self-reported family history of dementia in the PA/MA study. All-cause dementia, including Alzheimer disease (AD) and vascular dementia (VaD), was based on diagnostic codes from hospital and mortality records.

In the PA/MA study, among 501,376 participants at baseline (mean age, 56 years; 46% male) followed for a mean of 11 years, 5185 developed dementia, including 1561 with AD and 803 with VaD. Frequent vigorous and other exercise, housework-related activity, and a greater adherence to friend and family visits led to a 15% to 35% lower risk for dementia. Results were similar for AD and VaD and for both high and low genetic risk for dementia.

In the UPF study, among 72,083 participants at baseline (mean age, 62 years; 47% male) followed for a median of 10 years, 518 developed dementia, including 287 with AD and 119 with VaD. The highest quartile of UPF consumption was associated with an approximately 50% higher risk for dementia and twofold higher risk for VaD than the lowest quartile in fully adjusted models. A 10% increase in the percentage of UPFs in the diet was associated with about 25% higher risks for dementia and VaD; there also was a 14% higher risk for AD, which had borderline significance. Replacing 10% of UPFs in the diet with an equivalent proportion of unprocessed or minimally processed foods was associated with a 19% lower risk for dementia.