Adherence to a healthy lifestyle and brain structural imaging markers: A cross‐sectional study among middle‐aged and older adults

Abstract

AbstractBackgroundPrevious research has linked specific modifiable lifestyle factors to age‐related cognitive decline in adults. Little is known about the potential role of an overall healthy lifestyle in brain structure. We investigated the association of adherence to a combination of healthy lifestyle factors with neurodegeneration‐related brain structural markers in middle‐aged and older adults.MethodWe conducted a cross‐sectional analysis in the PolyvasculaR Evaluation for Cognitive Impairment and vaScular Events (PRECISE) study among Chinese community‐dwelling elderly adults. Participants underwent lifestyle assessments and brain 3T MRI scanning between 2017‐2019. A healthy lifestyle score (0‐5) was constructed based on five modifiable lifestyle factors: diversified diet, physically active, non‐smoking, non‐alcohol‐drinking, and healthy body weight. Validated multimodal neuroimaging markers (across tissue volume, cortical thickness, and white matter micro‐structure, etc) were derived from MRI. Multivariable‐adjusted linear and logistic regression models were used to examine the associations.ResultA total of 2370 participants (mean age 61.3 years; 53.9% female) was included in the final analysis. Compared to participants with lower healthy lifestyle score (0‐1), those with a higher lifestyle score had larger gray matter volume (GMV; β score 2‐3 = 0.34; β score 4‐5 = 0.31; p‐trend = 0.02) and lower odds of white matter hyperintensity (WMH; Odds Ratio [OR] score 2‐3 = 0.71, 95% Confidence Interval [CI]: 0.50, 1.02; OR score 4‐5 = 0.56, 95%CI: 0.35, 0.90; p‐trend = 0.003) and lacune (OR score 2‐3 = 0.62, 95%CI: 0.36, 1.06; OR score 4‐5 = 0.42, 95%CI: 0.18, 0.98; p‐trend = 0.02). In particular, diversified diet was associated with a significant lower risk of WMH and healthy body weight was associated with a variety of brain structure measures. Similar associations were observed across major subgroup variables.ConclusionAdherence to a healthier lifestyle was associated with a lower degree of neurodegeneration‐related brain structural markers in middle‐aged and older adults. Further large‐scale and longitudinal studies are warranted to confirm the study findings.