September 27, 2023

I lecture a lot about aging. And the older I get, the more interested I am in aging well.

A question I get all the time is, “How can I age and not get Alzheimer’s?” Dementia, memory loss, is a biggie when it comes to living the long, sweet life we crave.

Is there a 100% sure way we can prevent it? Obviously not. Are there things you can do to reduce the risk? Sure. What are they? That’s the issue.

Let’s liken this to car accidents. When I was a kid, there were more deaths from car crashes than there are now, and there are a lot more people in the U.S. driving today. Seat belts, better cars with crumple zones, air bags, better tires, etc. And let’s not forget the other big society change — “have one for the road” was a favorite goodbye cheer in the ‘60s. These things have all made a difference. We can’t prevent automobile accidents but we decreased them significantly.

The same is true when it comes to aging. Things are different than they once were.

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Recent research published in the British Medical Journal points out that a healthy lifestyle not only gives you a longer life but reduces your risk of Alzheimer’s. That’s the kind of stuff that interests me. If I have a long life, I want it to be a robust one.

Researchers looked at data from nearly 2,500 people age 65 and older with no history of dementia. It was part of a large long-term, 27-year-long study, still going on, the Chicago Health and Aging Project — the goal of which was to see how well people aged with a particular interest in Alzheimer’s. Over the years, folks completed detailed lifestyle questionnaires.

Participants were encouraged to:

  • Spend 150 hours a week in physical activity. That means 20 minutes a day of walking, gardening and, yes, vacuuming counts, too. You don’t have to be on a treadmill to move your body.
  • Follow a Mediterranean-DASH diet — Dietary Approaches to Stop Hypertension — with a diet that’s rich in whole grains, green leafy vegetables and berries, and low in fast food, fried food and red meats.
  • Engage in cognitive activities such as reading, drawing, engaging in thought-provoking conversations, crosswords and other puzzles, nature walks, visiting museums, learning of any sort, critical thinking — basically using your mind actively rather than watching TV or movies, which is passive.
  • Forgo smoking.
  • Limit alcohol use. If consuming alcohol, do so in moderation — one to two drinks a day.

For each lifestyle factor, participants received a score of 1 if they met the criteria for healthy, and 0 if they did not. Scores from five lifestyle factors were summed to yield a final score ranging from 0 to 5, with a higher score indicating a healthier lifestyle. It’s simple math, simple evaluation.

After taking account of other potentially influential factors including age, sex, education and finances, the researchers found that, on average, the total life expectancy at age 65 in those with a healthy lifestyle was about 24 additional years for women and 23 for men.

For those with an unhealthy lifestyle, it dropped to 21 more years for women and all the way down to 17 years for men. Now here’s the clincher: When they looked to see who had Alzheimer’s, they found that roughly 10% of the women who lived a healthy life developed Alzheimer’s, while it doubled to 20% if they didn’t live well. As for men, the same thing happened — 6% of the men who lived right developed Alzheimer’s, while it doubled to 12% for those with low lifestyle scores.

So what does this mean for you? First off, if you live well, you still have a risk of Alzheimer’s, but there is a 90% chance you won’t get it if you’re a women and a 94% chance you won’t if you’re a man. Not bad, really.

My spin: Lifestyle clearly plays a role in Alzheimer’s disease. Eating right, moving your body, using your brain, not smoking and not drinking too much gives you a longer life that also is more likely to be a life free of this devastating disease. Steps you take now can pay off with big rewards in the future. Stay well.

This column provides general health information. Always consult your personal health care provider about concerns. No ongoing relationship of any sort is implied or offered by Dr. Paster to people submitting questions. Any opinions expressed by Dr. Paster in his columns are personal and are not meant to represent or reflect the views of SSM Health.