美国拉什大学医学中心Klodian Dhana团队研究了健康生活方式与有无阿尔茨海默氏症痴呆的预期寿命的相关性。这一研究成果于2022年4月13日发表在《英国医学杂志》上。

为了确定生活方式因素对伴或不伴阿尔茨海默氏症痴呆预期寿命的影响，研究组在美国一项基于人口的队列研究（芝加哥健康与老龄化项目）中进行了一项前瞻性队列研究，共招募了2449名65岁及以上的男性和女性。

健康生活方式评分基于五个可修改的生活方式因素制定：对大脑健康的饮食（地中海DASH饮食干预对队列分布上40%的神经变性延迟思维MIND评分）、晚年认知活动（上40%的综合评分）、中等或剧烈的体力活动（≥150分钟/周）、不吸烟、轻度至中度饮酒（女性1-15克/天，男性1-30克/天）。主要结局为女性和男性伴或不伴阿尔茨海默病痴呆的预期寿命。

有4-5个健康因素的65岁女性预期寿命为24.2年，比没有或只有一个健康因素的65岁女性（21.1年）多活3.1年。在65岁时的总预期寿命中，有4-5个健康因素的女性剩余寿命中患阿尔茨海默氏症占10.8%（2.6年），而没有或只有一个健康因素的女性剩余寿命中占19.3%（4.1年）。有4-5个健康因素的65岁女性的无阿尔茨海默氏症痴呆的预期寿命为21.5年，没有或只有一个健康因素的65岁女性为17.0年。

有4-5个健康因素的65岁男性总预期寿命为23.1年，比没有或只有一个健康因素的65岁男性（预期寿命17.4年）多活5.7年。在65岁时的总预期寿命中，有4-5个健康因素的男性剩余寿命中患阿尔茨海默氏症占6.1%（1.4年），而没有或只有一个健康因素的男性剩余寿命中患阿尔茨海默氏症占12.0%（2.1年）。有4-5个健康因素的65岁男性的无阿尔茨海默氏症痴呆的预期寿命为21.7年，没有或只有一个健康因素的65岁男性为15.3年。

研究结果表明，健康的生活方式与男性和女性的预期寿命更长有关，而且他们在剩余的岁月中有很大一部分不会患阿尔茨海默氏症。预期寿命估计可能有助于卫生专业人员、政策制定者和利益相关者来规划未来的医疗服务、成本和需求。

附：英文原文

Title: Healthy lifestyle and life expectancy with and without Alzheimer’s dementia: population based cohort study

Author: Klodian Dhana, Oscar H Franco, Ethan M Ritz, Christopher N Ford, Pankaja Desai, Kristin R Krueger, Thomas M Holland, Anisa Dhana, Xiaoran Liu, Neelum T Aggarwal, Denis A Evans, Kumar B Rajan

Issue&Volume: 2022/04/13

Abstract:

Objective To determine the impact of lifestyle factors on life expectancy lived with and without Alzheimer’s dementia.

Design Prospective cohort study.

Setting The Chicago Health and Aging Project, a population based cohort study in the United States.

Participants 2449 men and women aged 65 years and older.

Main exposure A healthy lifestyle score was developed based on five modifiable lifestyle factors: a diet for brain health (Mediterranean-DASH Diet Intervention for Neurodegenerative Delay—MIND diet score in upper 40% of cohort distribution), late life cognitive activities (composite score in upper 40%), moderate or vigorous physical activity (≥150 min/week), no smoking, and light to moderate alcohol consumption (women 1-15 g/day; men 1-30 g/day).

Main outcome Life expectancy with and without Alzheimer’s dementia in women and men.

Results Women aged 65 with four or five healthy factors had a life expectancy of 24.2 years (95% confidence interval 22.8 to 25.5) and lived 3.1 years longer than women aged 65 with zero or one healthy factor (life expectancy 21.1 years, 19.5 to 22.4). Of the total life expectancy at age 65, women with four or five healthy factors spent 10.8% (2.6 years, 2.0 to 3.3) of their remaining years with Alzheimer’s dementia, whereas women with zero or one healthy factor spent 19.3% (4.1 years, 3.2 to 5.1) with the disease. Life expectancy for women aged 65 without Alzheimer’s dementia and four or five healthy factors was 21.5 years (20.0 to 22.7), and for those with zero or one healthy factor it was 17.0 years (15.5 to 18.3). Men aged 65 with four or five healthy factors had a total life expectancy of 23.1 years (21.4 to 25.6), which is 5.7 years longer than men aged 65 with zero or one healthy factor (life expectancy 17.4 years, 15.8 to 20.1). Of the total life expectancy at age 65, men with four or five healthy factors spent 6.1% (1.4 years, 0.3 to 2.0) of their remaining years with Alzheimer’s dementia, and those with zero or one healthy factor spent 12.0% (2.1 years, 0.2 to 3.0) with the disease. Life expectancy for men aged 65 without Alzheimer’s dementia and four or five healthy factors was 21.7 years (19.7 to 24.9), and for those with zero or one healthy factor life expectancy was 15.3 years (13.4 to 19.1).

Conclusion A healthy lifestyle was associated with a longer life expectancy among men and women, and they lived a larger proportion of their remaining years without Alzheimer’s dementia. The life expectancy estimates might help health professionals, policy makers, and stakeholders to plan future healthcare services, costs, and needs.

DOI: 10.1136/bmj-2021-068390

Source: https://www.bmj.com/content/377/bmj-2021-068390