Associations of healthy lifestyles with cerebrospinal fluid biomarkers of Alzheimer\u2019s disease pathology in cognitively intact older adults: the CABLE study

Xiao-He Hou,Lan Tan,Yan-Lin Bi,Qiang Dong,Ya-Hui Ma,Xue-Ning Shen,Wei Xu,Jin-Tai Yu

doi:10.1186/s13195-021-00822-7

Abstract

ObjectiveWe aimed to investigate the associations between healthy lifestyles and Alzheimer’s disease (AD) biomarkers in cerebrospinal fluid (CSF).MethodsA total of 1108 cognitively intact individuals from Chinese Alzheimer’s Biomarker and LifestylE (CABLE) study were examined to evaluate the associations of AD biomarkers with healthy lifestyle factors, including no current smoking, no harmful drinking, absence of social isolation, and regular physical activity. The participants were categorized into groups of favorable, intermediate, and unfavorable lifestyles according to the lifestyle factors. The associations between overall lifestyle and CSF biomarkers were also analyzed.ResultsAmong cognitively intact older adults, those having more social engagement had lower CSF tau (p = 0.009) and p-tau (p < 0.001) than those who had social isolation. Regular physical activity was associated with higher CSF Aβ42 (p = 0.013) and lower levels of CSF tau (p = 0.036) and p-tau (p = 0.007). However, no significant associations were found of smoking status or alcohol intake with CSF biomarkers. When the overall lifestyle of the participants was evaluated by all the four lifestyle factors, favorable lifestyle profiles were related to lower levels of CSF tau (p < 0.001) and p-tau (p < 0.001).ConclusionsThese findings suggest that healthy lifestyles had a beneficial effect on AD pathology among cognitively intact elders.

Highlights

Alzheimer’s disease (AD) is the most common cause of dementia, which becomes a great burden on patients and society [1]
We aimed to investigate the associations of common healthy lifestyles including no current smoking, no harmful drinking, absence of social isolation, and regular physical activity with cerebrospinal fluid (CSF) biomarkers of Alzheimer’s disease pathology in a large sample of 1108 cognitively intact individuals
Participants with more healthy lifestyles had lower CSF tau and p-tau levels (p < 0.01 for CSF tau and p-tau, Additional file 1: Supplementary Table 3). These results indicated that regular physical activity and social engagement could significantly influence AD biomarkers

Summary

Introduction

Alzheimer’s disease (AD) is the most common cause of dementia, which becomes a great burden on patients and society [1]. AD risk can be influenced by both genetic and environmental factors. Recent analyses have shown that modifiable lifestyle factors might influence the risk of AD [2]. It has been found that several healthy lifestyle factors are associated with lower risk of dementia [3,4,5,6,7,8]. Dementia risk can be lowered by the combination of favorable lifestyle factors [9, 10]. In 2019, WHO published a guideline for the prevention of cognitive decline and dementia, which included tobacco cessation interventions, physical activity interventions, social activity interventions, and interventions for alcohol use disorders [11]. Estimates suggest that over a third of dementia cases could be prevented if currently established modifiable risk factors were eliminated at a population level [12]

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Discussion

Conclusion