Combining healthier lifestyle behaviors was associated with substantially lower risk for Alzheimer’s disease in a study that included data from nearly 3,000 research participants.

Those who adhered to four or all of the five specified healthy behaviors were found to have a 60% lower risk of Alzheimer’s.

The behaviors were physical activity, not smoking, light-to-moderate alcohol consumption, a high-quality diet, and cognitive activities.

Funded by the National Institute on Aging, part of the National Institutes of Health, this research was published in the June 17 online issue of Neurology, the medical journal of the American Academy of Neurology.

“This observational study provides more evidence on how a combination of modifiable behaviors may mitigate Alzheimer’s disease risk,” said NIA Director Richard J. Hodes, M.D.

“The findings strengthen the association between healthy behaviors and lower risk and add to the basis for controlled clinical trials to directly test the ability of interventions to slow or prevent development of Alzheimer’s disease.”

The research team reviewed data from two NIA-funded longitudinal study populations: The Chicago Health and Aging Project and the Memory and Aging Project.

They selected participants from those studies who had data available on their diet, lifestyle factors, genetics, and clinical assessments for Alzheimer’s disease. The resulting data pool included 1,845 participants from CHAP and 920 from MAP.

The researchers scored each participant based on five healthy lifestyle factors, all of which have important health benefits:


Exercise – At least 150 minutes per week of moderate- to vigorous-intensity physical activity is recommended.

Not smoking – Established research has confirmed that even in people 60 or older who have been smoking for decades, quitting will improve health.

Light-to-moderate alcohol consumption – Limiting use of alcohol may help cognitive health.

Diet – Eating a high-quality, Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND) diet, which combines the Mediterranean diet and Dietary Approaches to Stop Hypertension (DASH) diet, is beneficial. The MIND diet focuses on plant-based foods linked to dementia prevention.

Engagement in late-life cognitive activities – Being intellectually engaged by keeping the mind active may benefit the brain.


The research team then compared the scores with outcomes of clinical diagnosis of Alzheimer’s in the CHAP and MAP participants.

Klodian Dhana, M.D., Ph.D., assistant professor at Rush University Medical Center and lead author of the paper, emphasized that the combination of healthy lifestyle factors is key.

He wrote that compared to participants with no healthy lifestyle factors or just one, the risk of Alzheimer’s was 37% lower in those with two to three and 60% lower in those with four to five healthy lifestyle factors.

“This population-based study helps paint the picture of how multiple factors are likely playing parts in Alzheimer’s disease risk,” said Dallas Anderson, Ph.D., program director in the Division of Neuroscience at NIA.

“It’s not a clear cause-and-effect result but a strong finding because of the dual data sets and combination of modifiable lifestyle factors that appear to lead to risk reduction.”

NIA is currently funding more than 230 active clinical trials on Alzheimer’s and related dementias. Of those, more than 100 are nondrug interventions, such as exercise, diet, cognitive training, sleep, or combination therapies.

People interested in participating in clinical trials can find more information on the NIA website (

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