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Walking 8,000 steps 1-2 days a week linked to major health benefits

Current research suggests that walking 8,000 brisk steps or more per day may be the sweet spot for receiving the health benefits walking provides.
People who have trouble finding time to walk each day of the week will be encouraged by a new study that demonstrates walking just one to two days is still associated with a significant reduction in all-cause and cardiovascular mortality.
The study’s authors found that each additional day walked confers greater benefits.

Briskly walking 8,000 or more steps each day of the week is associated with a significant decrease in all-cause and cardiovascular mortality. A new study finds, however, that people taking just 8,000 steps one or two days a week are also less likely to die over a 10-year follow-up period.

The study published in JAMA Network Open found that over a decade of follow-up, people 20 years or older who took 8,000 or more steps on one or two days a week were 14.9{bf0515afdcaddba073662ceb89fbb62b6b1bf123143c0e06b788e1946e8c353f} less likely to die compared to people who were sedentary.

The risk of death dropped as the number of days involved increased. For example, exercising from three to seven days a week was associated with a 16.5{bf0515afdcaddba073662ceb89fbb62b6b1bf123143c0e06b788e1946e8c353f} reduction in all-cause and cardiovascular deaths.

The same pattern held true for people meeting step goals of 6,000 to 10,000 steps.

Previous research found that mortality risk decreases up to 10,000 steps per day for people younger than 60 and 8,000 for people older than 60.

The study’s findings pertain to both “weekend warriors,” people who confine their exercise to non-work days, and to people who steal a few hours to walk during the week.

The study cites recent data showing the average American takes just 4,800 steps a day, too few to provide much of a health benefit.

“Brisk walking” is defined as walking three miles an hour. If you can speak song lyrics but not sing them, you are walking briskly.

The current study compared data from the U.S. 2005 and 2006 National Health and Nutrition Examination Survey with the National Death Index up to the year 2019. It incorporated accelerometer data from 3,101 participants 20 years or older and was a nationally representative sample. It included a similar number of women and men, and 50.9{bf0515afdcaddba073662ceb89fbb62b6b1bf123143c0e06b788e1946e8c353f} were White, 21.5{bf0515afdcaddba073662ceb89fbb62b6b1bf123143c0e06b788e1946e8c353f} Black, 23.7{bf0515afdcaddba073662ceb89fbb62b6b1bf123143c0e06b788e1946e8c353f} Hispanic, and 3.9{bf0515afdcaddba073662ceb89fbb62b6b1bf123143c0e06b788e1946e8c353f} other race and ethnicity.

The participants most likely to walk 8,000 or more steps every day were more likely to be young, male, Hispanic, insured, and married. They were also typically never-smokers and were less likely to be obese or have comorbidities.

For many people, walking 8,000 steps each day requires a significant commitment of time. 8,000 steps are about four miles, which, walking at three miles per hour, comes to a total of about an hour and 20 minutes every day. Steps can be taken simultaneously or in shorter periods of brisk walking.

The study was led by Dr. Kosuke Inoue of Kyoto University in Japan, collaborating with researchers from UCLA in California. Dr. Inoue explained why the study was undertaken:

“We started this study to answer the question one of my patients asked during an outpatient clinic: ‘It is hard for me to keep sufficient steps every day. Is it okay to focus on walking only during the weekend?’”

Steps studies often consider the value of a week’s worth of various step goals, and Dr. Inoue saw a lack of evidence regarding the possible benefits of walking just a few days a week.

“Given that a lack of time is one of the major barriers to exercise in modern society,” said Dr. Inoue, “our findings provide useful information to recommend walking even for a couple of days per week to reduce mortality risk.”

“This is one of the first studies to use direct measures of daily steps using a wearable accelerometer over a 10-year followup period,” said Dr. Paul Arciero, a professor in the Health and Human Physiological Sciences Department at Skidmore College, who was not involved in the study.

Walking is viewed as a simple, low impact means of making a person’s life less sedentary. A sedentary lifestyle has been linked to an increased risk of all-cause and cardiovascular mortality.

“Further, a sedentary lifestyle drastically increases the risk of cardiometabolic disease such as abdominal obesity, hypertension (high blood pressure), type 2 diabetes, stroke, heart disease, and certain inflammatory conditions and cancers,” said Dr. Arciero.

According to Harvard Medical School, taking one’s steps has additional, less-obvious benefits. Walking offsets the effect of weight-promoting genes, reduces breast cancer risk, and boosts one’s immune system. It can also lessen arthritis-based joint pain, and even a 15-minute walk can curb a craving for chocolate, both generally and in response to stress.

The study’s findings should provide valuable information for clinicians and health professionals, said Dr. Inoue. He suggested a reader’s takeaway should be that for people who have difficulties engaging in regular exercise, “achieving recommended daily steps only a couple of days per week can have meaningful health benefits.”

Describing the study’s conclusions as “encouraging,” Dr. Arciero suggested the study may help people who don’t have enough time to walk 8,000 steps a day overcome feelings that walking less is pointless.

“We now have scientific evidence that proves this mindset is not true, and even a couple of days is beneficial!” said Dr. Arciero.

He said the study underscores the value of increasing one’s daily step count:

“Always a good reminder that any amount of walking, even one to two days per week, is still better than no walking.”

Heart Healthy Lifestyle Linked to Longer Life Without Diabetes, Cancer

Researchers say people who follow the Life Essential 8 recommendations tend to have healthier cardiovascular systems and live longer.
The eight recommended lifestyle elements include a healthy diet, regular exercise, weight management, and low cholesterol and blood sugar levels.
Researchers say adopting these daily habits can help reduce the risk of type 2 diabetes, cancer, and dementia.

Adults who live a heart-healthy lifestyle and have scores on the higher end of the American Heart Association’s Life Essential 8 cardiovascular heart chart tend to live longer with optimal health.

That’s according to a pair of studies presented at the association’s Epidemiology, Prevention, Lifestyle & Cardiometabolic Health Scientific Sessions 2023.

Both studies are based on the American Heart Association Life Essential 8 and participants were scored based on whether they implemented the points in their lives.

The Essential 8 are:

Eat better
Be more active
Quit tobacco
Get healthy sleep
Manage weight
Control cholesterol
Manage blood sugar
Manage blood pressure

The American Heart Association defined scores as:

Less than 50 – poor cardiovascular health
51 to 80 – intermediate cardiovascular health
81 – high cardiovascular health

The studies haven’t been published yet in a peer-reviewed journal.

The first study looked at the levels of the American Heart Association Life Essential 8 and its correlation with life expectancy and living free of chronic disease.

The scientists reviewed the health data of 136,599 adults in the United Kingdom who did not have cardiovascular disease, type 2 diabetes, cancer, or dementia at the start of the study.

The researchers compared life expectancy between the groups. They reported that adults who scored in the high cardiovascular health category at age 50 lived longer than those in the poor heart category. On average, men lived about 5 years longer and women lived about 6 years longer.

People with excellent cardiovascular health also live longer without chronic disease. Disease-free life expectancy accounted for nearly 76{bf0515afdcaddba073662ceb89fbb62b6b1bf123143c0e06b788e1946e8c353f} of total life expectancy for men and more than 83{bf0515afdcaddba073662ceb89fbb62b6b1bf123143c0e06b788e1946e8c353f} for women with ideal cardiovascular health.

In contrast, disease-free life expectancy was about 65{bf0515afdcaddba073662ceb89fbb62b6b1bf123143c0e06b788e1946e8c353f} of men and about 69{bf0515afdcaddba073662ceb89fbb62b6b1bf123143c0e06b788e1946e8c353f} of women with poor cardiovascular health.

“The ideal would be to follow healthy habits from the start,” said Dr. Alexandra Lajoie, a non-invasive cardiologist at Providence Saint John’s Health Center in California.

“But starting exercise, getting better sleep, and maintaining a healthy body weight improves blood pressure and blood sugar, and consequently reduces cardiovascular event risk for decades beyond age 50,” she told Healthline.

“It is never too late to improve your lifestyle,” Lajoie continued. “Heart-healthy changes at any age have been shown to improve quality of life and reduce the number of necessary prescription medications.”

Limitations to the study were that cardiovascular disease, cancer, and dementia were the only diseases included in the definition of disease-free life expectancy.

In the second study, researchers analyzed information, including Life’s Essential 8 scores, for more than 23,000 adults in the United States who took part in the National Health and Nutrition Examination Survey (NHANES) from 2005 to 2018.

These researchers used the same categories as the first study.

The scientists found that people at age 50 with scores exceeding 80 had a life expectancy of about 33 additional years. The remaining life expectancy was about 25 years for people with poor cardiovascular health.

“Quitting smoking is the best thing to improve heart health,” Lajoie said. “After that, it’s maintaining a regular exercise routine.”

People who maintain cardiovascular health have benefits throughout their older years, but further research is needed to see how changes, such as quitting smoking change their life expectancy.

“Although all of the 8 Healthy Living points are important and are intertwined with each other, diet and exercise together is a good place to start developing healthy habits,” said Dr. Aeshita Dwivedi, a cardiologist at Lenox Hill Hospital in New York. “Our genetics play a large role in our overall health, but living a healthy life can minimize the effects of our genes.”

“It is important to note that most participants were Caucasian,” noted Dwivedi. “We don’t know if the results would be different if there were more diversity. However, it is unsurprising that living a heart-healthy lifestyle would provide more health benefits.”

“Studies such as these are encouraging and can motivate people to adopt a healthier lifestyle,” Dwivedi told Healthline. “It is especially encouraging that people who scored low and then changed some habits and transitioned from low to better scores saw improvements in their health and life expectancy.”

Healthy Lifestyle Linked to Slower Memory Decline in Older Adults

The researchers uncovered that each personal wholesome habits (healthful eating plan, standard workout, energetic social get in touch with, cognitive action, non-using tobacco, and by no means drinking alcohol) was associated with a slower-than-typical drop in memory in excess of 10 decades just after accounting for other health, economic, and social aspects. The strongest result on slowing memory decrease was a balanced diet, followed by cognitive exercise and then physical work out.

Even individuals with genes connected to Alzheimer’s ailment see advantages.

In accordance to a 10 years-extended review of older grown ups in China, just lately released in The BMJ, a nutritious way of life, specially a nutritious diet plan, is joined to slower memory decrease.

The analyze uncovered that even carriers of the apolipoprotein E (APOE) gene, which is the strongest acknowledged possibility variable for

Memory continuously declines as people age, but evidence from existing studies is insufficient to assess the effect of a healthy lifestyle on memory in later life. And given the many possible causes of memory decline, a combination of healthy behaviors might be needed for an optimal effect.

To explore this further, researchers analyzed data from 29,000 adults aged at least 60 years (average age 72; 49{bf0515afdcaddba073662ceb89fbb62b6b1bf123143c0e06b788e1946e8c353f} women) with normal cognitive function who were part of the China Cognition and Aging Study.

At the start of the study in 2009, memory function was measured using the Auditory Verbal Learning test (AVLT) and participants were tested for the APOE gene (20{bf0515afdcaddba073662ceb89fbb62b6b1bf123143c0e06b788e1946e8c353f} were found to be carriers). Follow-up assessments were then conducted over the next 10 years in 2012, 2014, 2016, and 2019.

A healthy lifestyle score combining six factors was then calculated: healthy diet, regular exercise, active social contact (eg. seeing friends and family), cognitive activity (eg. writing, reading, playing mahjong), non-smoking, and never drinking alcohol.

Based on their score, ranging from 0 to 6, participants were put into favorable (4 to 6 healthy factors), average (2 to 3 healthy factors), or unfavorable (0 to 1 healthy factors) lifestyle groups and into APOE carrier and non-carrier groups.

After accounting for a range of other health, economic and social factors, the researchers found that each individual healthy behavior was associated with a slower-than-average decline in memory over 10 years. A healthy diet had the strongest effect on slowing memory decline, followed by cognitive activity and then physical exercise.

Compared with the group that had unfavorable lifestyles, memory decline in the favorable lifestyle group was 0.28 points slower over 10 years based on a standardized score (z score) of the AVLT, and memory decline in the average lifestyle group was 0.16 points slower. Participants with the APOE gene with favorable and average lifestyles also experienced a slower rate of memory decline than those with an unfavorable lifestyle (0.027 and 0.014 points per year slower, respectively).

What’s more, those with favorable or average lifestyles were almost 90{bf0515afdcaddba073662ceb89fbb62b6b1bf123143c0e06b788e1946e8c353f} and almost 30{bf0515afdcaddba073662ceb89fbb62b6b1bf123143c0e06b788e1946e8c353f} less likely to develop dementia or mild cognitive impairment relative to those with an unfavorable lifestyle, and the APOE group had similar results.

This is an observational study so can’t establish cause and the researchers acknowledge some limitations, such as the potential for measurement errors due to self-reporting of lifestyle factors, and the possibility of selection bias, as some participants did not return for follow-up evaluations. But this was a large study with a long follow-up period, allowing for the evaluation of individual lifestyle factors on memory function over time. And findings remained significant after further analyses, suggesting that they are robust.

As such, the researchers say their results provide strong evidence that adherence to a healthy lifestyle with a combination of positive behaviors is associated with a slower rate of memory decline, even for people who are genetically susceptible to memory decline. They suggest further research could focus on the effects of a healthy lifestyle on memory decline across the lifespan, acknowledging that memory problems can also affect younger people, not included in this study. “These results might offer important information for public health initiatives to protect older adults against memory decline,” they conclude.

“Prevention is important, given the absence of effective treatments for Alzheimer’s disease and related dementias,” say researchers in a linked editorial.

However, they point out that these results do not help to determine which among the six health behaviors included in the score (or specific combination) is the best target for dementia prevention, or when in the life course to focus prevention efforts. Further insight is also needed to determine whether the differences in memory decline observed in this study are clinically meaningful, they add.

They suggest a similar approach that led to a substantial reduction in cardiovascular disease should be taken with dementia prevention, “identifying not only the factors that matter most but also the threshold at which they matter, and the age when intervention is likely to be most effective.”

Reference: “Association between healthy lifestyle and memory decline in older adults: 10 year, population based, prospective cohort study” by Jianping Jia, Tan Zhao, Zhaojun Liu, Yumei Liang, Fangyu Li, Yan Li, Wenying Liu, Fang Li, Shengliang Shi, Chunkui Zhou, Heyun Yang, Zhengluan Liao, Yang Li, Huiying Zhao, Jintao Zhang, Kunnan Zhang, Minchen Kan, Shanshan Yang, Hao Li, Zhongling Liu, Rong Ma, Jihui Lv, Yue Wang, Xin Yan, Furu Liang, Xiaoling Yuan, Jinbiao Zhang, Serge Gauthier and Jeffrey Cummings, 25 January 2023, The BMJ.
DOI: 10.1136/bmj-2022-072691

The study was funded by the National Natural Science Foundation of China.

Heart-healthy habits linked to longer life without chronic conditions

The American Heart Association’s Life’s Essential 8 is a concept that defines cardiovascular health based on four modifiable behaviors, such as physical activity and sleep, and four modifiable biometric measures, such as weight, blood glucose, and blood lipid levels, that impact cardiovascular health.
The composite cardiovascular health score measured using the aforementioned eight metrics can help clinicians measure and monitor cardiovascular health to prevent or treat cardiovascular diseases.
A recent study showed that an optimal composite cardiovascular score based on the Life’s Essential 8 metrics was associated with longer life expectancy free of chronic conditions such as cancer and cardiovascular diseases.
An accompanying study showed that the decline in deaths due to cardiovascular disease contributed significantly to the increase in life expectancy associated with good cardiovascular health.

Two related studies recently presented at the American Health Association (AHA) conference suggest that optimal cardiovascular health (CVH) was associated with a longer chronic disease-free lifespan, reduced cardiovascular mortality, and increased total longevity.

These studies assessed CVH using the criteria defined by Life’s Essential 8, thus underscoring the validity and utility of cardiovascular health scores based on this construct as predictors of life expectancy and cardiovascular diseases (CVD).

Dr. Hao Ma, a biostatistical analyst at the Tulane University Obesity Research Center and an author of one of the studies, said:

“After decades of strong growth, the rise in US life expectancy has stagnated since 2010. The main reason for such a phenomenon is the poor cardiovascular health in the US population. Our study indicates that adhering to a high CVH, defined as the Life’s Essential 8 score, is related to a considerably increased life expectancy. Moreover, our findings lend support to the validity of the newly released Life’s Essentia 8 metrics in assessment and monitoring CVH in the general populations.”

In 2010, the American Heart Association (AHA) developed a prescription for health called Life’s Simple 7, consisting of seven measurable risk factors or metrics that together represented cardiovascular health. The AHA revised Life’Simple 7 to create Life’s Essential 8 in 2022 to improve the measurement and monitoring of cardiovascular health and facilitate cardiovascular disease prevention and treatment.

The eight metrics comprising the construct, Life’s Essential 8 include physical activity, diet, smoking and other forms of nicotine exposure, sleep, body mass index, blood glucose, blood lipids, and blood pressure. Each metric included in Life’s Essential 8 is measured on a continuous scale of 0-100. These individual metrics are used to calculate the composite or cumulative cardiovascular health score that also ranges from 0 to 100 points.

Although life expectancy has increased in the past few decades, it has been accompanied by an increase in the prevalence of chronic conditions, such as cardiovascular conditions and cancer. The combined effects of the metrics included in Life’s Essential 8 — such as being more active, quitting tobacco use and managing blood pressure — are associated with increased total life expectancy.

However, studies have not examined the association between the composite cardiovascular health score, calculated as defined by the updated Life’s Essential 8, and total life expectancy and disease-free life span.

Two studies recently presented at the AHA conference assessed whether ideal composite cardiovascular health scores were associated with increased life expectancy in the absence of chronic health conditions and reduced mortality due to cardiovascular diseases.

The first study examined whether the cardiovascular health score was associated with an increase in total life expectancy and life expectancy in the absence of chronic conditions.

The study analyzed data collected by the UK Biobank from more than 136,000 adults residing in the United Kingdom who, at the time of enrollment, did not have cardiovascular disease, diabetes, cancer, or dementia and had data on cardiovascular health scores.

The individuals were classified as having poor, intermediate, or ideal cardiovascular health based on the criteria defined by Life’s Essential 8. The researchers found that average life expectancy at 50 years of age was prolonged by 5.2 and 6.3 years in men and women with ideal CVH, respectively, compared with their counterparts with poor CVH.

Individuals with ideal CVH scores also had more years of life free of major chronic conditions, including diabetes, cardiovascular disease, dementia, and cancer, than those with poor CVH. Specifically, men and women with ideal CVH were expected to spend 75.9{bf0515afdcaddba073662ceb89fbb62b6b1bf123143c0e06b788e1946e8c353f} and 83.4{bf0515afdcaddba073662ceb89fbb62b6b1bf123143c0e06b788e1946e8c353f}, respectively, of their lives in good health, whereas their male and female counterparts with poor CVH were expected to spend 64.9{bf0515afdcaddba073662ceb89fbb62b6b1bf123143c0e06b788e1946e8c353f} and 69.4{bf0515afdcaddba073662ceb89fbb62b6b1bf123143c0e06b788e1946e8c353f} of their lives free of chronic disease.

Previous studies have shown that low socioeconomic status is associated with lower disease-free life expectancy. In the present study, researchers found that maintaining ideal cardiovascular health helped reduce the impact of low socioeconomic status on disease-free life expectancy.

The second study examined the impact of maintaining ideal cardiovascular health on potential improvements in life expectancy due to a decrease in cardiovascular deaths. The study analyzed data from 23,000 adults participating in the National Health and Nutrition Examination Survey (NHANES) between 2005 and 2018. Using a national death registry, the researchers determined that 1,359 participants died during the average follow-up period of 7.8 years.

Consistent with the first study, participants with ideal cardiovascular health had longer life expectancies than individuals with poor cardiovascular health. Specifically, the life expectancy of men and women with ideal CVH at 50 years of age was an average of 7.5 years and 8.9 years, respectively, longer than their counterparts with poor CVH.

Notably, 41.8{bf0515afdcaddba073662ceb89fbb62b6b1bf123143c0e06b788e1946e8c353f} and 44.1{bf0515afdcaddba073662ceb89fbb62b6b1bf123143c0e06b788e1946e8c353f} of the increase in life expectancy at 50 years of age in men and women with ideal CVH scores, respectively, could be attributed to a decline in deaths due to cardiovascular disease. Among ethnic groups, the CVH score was also associated with longer life expectancy in White and Black Americans, but not Mexican Americans.

Both studies also had a few limitations. Dr. Ma noted that the data on lifestyle factors such as diet and sleep patterns from the NHANES database were self-reported and hence, prone to errors. Moreover, the metrics used to measure cardiovascular health in both studies were assessed only at baseline, but not during the follow-up period.

Medical News Today also spoke with Dr. Alexandra Lajoie, a noninvasive cardiologist at Providence Saint John’s Health Center in Santa Monica, CA, who was not involved in the study.

“The results of these studies are not surprising. Research continues to show us that healthy lifestyle interventions are good for health outcomes, and often are even more important than prescription medications.”

Dr. Lajoie said it is possible to reverse some of the effects of not living a heart-healthy lifestyle earlier in life, but it’s better to consistently maintain a lifestyle that’s beneficial to one’s health.

“Of course the ideal would be to follow healthy habits from the start, but starting exercise, getting better sleep, and maintaining a healthybody weight improves blood pressure and blood sugar, and consequently reduces cardiovascular event risk, for decades beyond age 50,” she explained. “Quitting smoking is the best [thing] to improve heart health. After that it’s maintaining a regular exercise routine.

Poor sleep linked to increased heart disease risk: Study

Poor sleep is associated with up to seven years’ worth of increased heart disease risk and even premature death, according to a study.

The research, published in the journal BMC Medicine, analysed data from more than 300,000 middle-aged adults from the UK Biobank.

Researchers from the University of Sydney in collaboration with Southern Denmark University found that different disturbances to sleep are associated with different durations of compromised cardiovascular health later in life compared to healthy sleepers.

In particular, men with clinical sleep-related breathing disorders lost nearly seven years of cardiovascular disease-free life compared to those without these conditions, and women lost over seven years, they said.

The study found that even general poor sleep, such as insufficient sleep, insomnia, snoring, going to bed late, and daytime sleepiness is associated with a loss of around two years of normal heart health in men and women.

“Our research shows that, over time, regular poor sleep can lead to significantly compromised cardiovascular health in middle and old age,” said Professor Emmanuel Stamatakis from the University of Sydney, and senior author of the study.

“Sleep apnea is well known to increase the risk of cardiovascular disease and other chronic conditions, but these findings are a wake-up call that poor sleep in general can pose significant risk to heart health,” Stamatakis said in a statement.

The team came up with three sleep categories: poor, intermediate, and healthy at age 40, and compared this with their overall cardiovascular disease-free health expectancy.
By combining the study participants’ self-reported data with clinical data from their doctors in the two years preceding the study, the researchers were able to compare health outcomes for self-reported sleep patterns and clinically diagnosed conditions such as sleep-related breathing disorders.

The team categorised participants as poor, intermediate, and healthy sleepers at age 40, and compared their health outcomes at old age.

Women with poor sleep were likely to experience two years more of compromised cardiovascular health compared to healthy sleepers, while men experienced more than two years. Intermediate sleepers lost almost one year of heart disease-free life among women, and men lost slightly more.

This means that snoring and trouble falling asleep or staying asleep can be a warning sign of potential health issues in the future.

“While the average life expectancy of the UK study participants is around 80 years, people with clinically diagnosed sleep-related breathing disorders like sleep apnea lost over seven years of cardiovascular-disease free life,” said the study’s lead author Bo-Huei Huang, an epidemiologist recently graduating from the University of Sydney.

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Healthy lifestyle, diet linked to slower memory decline

Researchers followed 29,072 older adults (60 years old and over) over 10 years to investigate the link between lifestyle choices and memory loss.
They found a link between a healthy lifestyle and slower memory decline, even in the presence of the APOE Ɛ4 gene, which is associated with Alzheimer’s disease.
The researchers hope their findings will inform public health initiatives seeking to prevent memory loss in older adults.

The gradual loss of thinking abilities such as memory, reasoning, and psychomotor speed is a natural part of aging. However, studies such as the FINGER clinical trial have shown that it is possible to prevent cognitive decline through lifestyle improvements.

The impact of lifestyle factors on memory has been the subject of many studies. However, previous research typically focused on a single lifestyle factor, such as diet, physical activity, smoking, or drinking. Understanding the combined effect of multiple lifestyle factors on memory decline is important.

For this reason, Dr. Jianping Jia, Ph.D., neurologist and professor at Capital Medical University, Beijing, China, and his colleagues investigated the combined effects of six lifestyle factors on memory decline in a large study population over a 10-year period.

In an interview with Medical News Today, Dr. Jia said:

“[E]ffective strategies for protecting against memory decline may benefit a large number of older adults. Our results showed that adherence to a combination of healthy lifestyle behaviours was associated with a slower memory decline in older adults, including those genetically susceptible to memory decline.”

The results of the study appear in the BMJ.

Dr. Richard J. Caselli, professor of neurology at the Mayo Clinic, who was not involved in the study, described the study as “well done and generally supportive of findings from studies such as the FINGER study, this time in a Chinese population.”

The researchers recruited 29,072 study participants from North, South, and West China aged 60 or older with typical cognitive functions. Their mean age was 72.2 years, and 51.5{bf0515afdcaddba073662ceb89fbb62b6b1bf123143c0e06b788e1946e8c353f} were men.

Genetic testing at baseline showed that 20.43{bf0515afdcaddba073662ceb89fbb62b6b1bf123143c0e06b788e1946e8c353f} of the study participants were carriers of the APOE ε4 gene, the strongest known risk factor for Alzheimer’s disease and related dementias.

The researchers followed up with the participants at intervals over the next 10 years, in 2012, 2014, 2016, and 2019.

At baseline and each follow-up, the researchers assessed the participants’ memory using the Auditory Verbal Learning Test (AVLT), which includes measurement of immediate recall, short delay-free recall (3 min later), long delay-free recall (30 min later), and long delay recognition.

For this study, Dr. Jia and colleagues used American guidelines and the findings of previous studies to define a healthy lifestyle. They identified six factors:

a healthy diet – adherence to the recommended intake of at least 7 of 12 eligible food items (fruits, vegetables, fish, meat, dairy products, salt, oil, eggs, cereals, legumes, nuts, and tea)
regular physical exercise – at least 150 minutes of moderate-intensity activity or at least 75 minutes of vigorous-intensity activity per week
Active social contact (participation in meetings or attending parties, visiting friends or relatives, traveling, and chatting online) – at least twice per week
active cognitive activity (writing, reading, playing cards, mahjong, and other games) – at least twice per week
never smokes (participants who had smoked less than 100 cigarettes in their lifetime) or used to smoke (participants who had quit smoking at least 3 years before the study)
never drank alcohol or drank occasionally

Researchers categorized participants into groups depending on their number of healthy lifestyle factors:

0-1 healthy lifestyle factors = unfavorable lifestyle (6967 participants)
2-3 healthy lifestyle factors = average lifestyle (16,549 participants)
4-6 healthy lifestyle factors = favorable lifestyle (5556 participants)

All participants’ mean memory test scores declined continuously over the decade, consistent with how memory declines with age. However, the highest memory test scores were observed in the favorable lifestyle group and the lowest in the unfavorable lifestyle group, indicating that participants with favorable lifestyles had slower memory decline than those with unfavorable lifestyles (by 0.028 points/year).

The results showed that a healthy diet had the strongest effect on memory, followed by an active cognitive activity, regular physical exercise, active social contact, never or former smoking, and never drinking.

This study did not identify the mechanisms responsible for modifying memory loss. However, the researchers hypothesized that they might include “reduced cerebrovascular risk, enhancement of cognitive reserve, inhibition of oxidative stress and inflammation, and promotion of neurotrophic factors.”

Dr. Caselli told MNT that the “findings echo heart healthy behaviors (diet, exercise, no smoking in particular), with the addition of active social and cognitive activity, [and] cardiovascular health […] in turn is important for our cognitive health, so whether directly or indirectly [beneficial to memory], these findings seem credible and consistent with other well conducted studies.”

Dorly J.H. Deeg, Ph.D., professor of epidemiology of aging at Amsterdam University Medical Center, who was not involved in the study, also praised the study for its large and varied sample population and the numerous analyses supporting the findings.

The APOE ε4 allele, present in 20.43{bf0515afdcaddba073662ceb89fbb62b6b1bf123143c0e06b788e1946e8c353f} of the study participants, is correlated with earlier and more rapidly progressive memory decline and represents a major risk factor for Alzheimer’s disease.

In this study, the researchers observed that a healthy lifestyle positively affected memory in all participants, regardless of whether they carried the APOE ε4 allele or not.

“[W]e find there are some people who are disheartened by finding they are an ε4 carrier […] The findings of this study will hopefully give such people hope that they can actively mitigate their genetically based vulnerability,” said Dr. Caselli.

In their paper, Dr. Jia and colleagues identify several study limitations, including that lifestyle factors were self-reported and thus prone to measurement errors. Furthermore, memory was evaluated using a single neuropsychological test. They also acknowledge the study design did not assess if a healthy lifestyle started affecting memory before the age of 60.

Dr. Caselli told MNT that the possibility that some participants were in the preclinical stage of Alzheimer’s disease cannot be excluded. “Though this entailed a 10-year follow-up, the preclinical phase of Alzheimer’s disease is closer to 20 years so things like social and cognitive activity may already start to decline in subtle ways before a person with preclinical stage disease develops overt symptoms and is diagnosed with MCI [mild cognitive impairment],” he said.

In comments to MNT, Dr. Deeg pointed out that the researchers “excluded a huge number of participants (30{bf0515afdcaddba073662ceb89fbb62b6b1bf123143c0e06b788e1946e8c353f} of eligible persons).” In the study paper, “[t]his is described as ‘younger than 60 years, refused to participate, etc’. As a reviewer, I would not think this is a satisfactory explanation,” she said.

Dr. Deeg told MNT that the findings of observational studies such as this one “should be replicated in randomized controlled trials.”

“Such trials have been performed – usually with only one lifestyle factor, mostly physical activity. Unfortunately, the findings are not unequivocal, and a recent JAMA article showed no effects,” she added. “So, we have some way to go to find out what intervention would work, and why – and for this, we need to know what the underlying mechanisms in the brain are.”

In an editorial linked to this study, Séverine Sabia, Ph.D., research professor at Université Paris Cité in France, and Archana Singh-Manoux, Ph.D., research professor at University College London recommend that future research focuses on “identifying not only the factors that matter most but also the threshold at which they matter, and the age when intervention is likely to be most effective.”