Profiles of Lifestyle Health Behaviors and Postmortem Dementia-Related Neuropathology

Brittney S Lange-Maia, Maude Wagner, Christina A Rogers, Rupal I Mehta, David A Bennett, Christy Tangney, Michael E Schoeny, Shannon Halloway, Zoe Arvanitakis
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Abstract

High engagement in lifestyle health behaviors appears to be protective against cognitive decline in aging. We investigated the association between patterns of modifiable lifestyle health behaviors and common brain neuropathologies of dementia as a possible mechanism. We examined 555 decedents from the Rush Memory and Aging Project, free of dementia at their initial concurrent report of lifestyle health behaviors of interest (physical, social, and cognitive activities, and healthy diet) and who underwent a postmortem neuropathology evaluation. First, we used latent profile analysis to group participants based on baseline behavior patterns. Second, we assessed the associations of profile membership with each neurodegenerative (global Alzheimer’s Disease (AD) pathology, amyloid-beta load, density of neurofibrillary tangles, and presence of cortical Lewy bodies and TAR DNA-binding protein 43 [TDP-43] cytoplasmic inclusions) and neurovascular pathologies (presence of chronic gross or microscopic infarcts, arteriolosclerosis, atherosclerosis, and cerebral amyloid angiopathy), using separate linear or logistic regression models, adjusted for age at death, and sex (core model) vascular disease risk factors, and vascular conditions (fully-adjusted model). Participants had either consistently lower (N=224) or consistently higher (N=331) engagement across four lifestyle health behaviors. We generally found no differences in neuropathologies between higher and lower engagement groups in core or fully-adjusted models; for example, higher engagement in lifestyle health behaviors was not associated with global AD pathology after core or full adjustment (both P>0.8). In conclusion, we found no evidence of associations between patterns of lifestyle health behaviors and neuropathology. Other mechanisms may underlie protective effects of health behaviors against dementia.
生活方式健康行为与死后痴呆症相关神经病理学的概况
大量参与生活方式健康行为似乎对老年认知能力下降有保护作用。作为一种可能的机制,我们研究了可改变的生活方式健康行为模式与痴呆症常见脑神经病理学之间的关联。我们研究了拉什记忆与衰老项目中的 555 名死者,他们在最初同时报告相关生活方式健康行为(体育、社交和认知活动以及健康饮食)时没有痴呆症,并接受了死后神经病理学评估。首先,我们根据基线行为模式使用潜在特征分析对参与者进行分组。在对死亡年龄、性别(核心模型)、血管疾病风险因素和血管病症(完全调整模型)进行调整后,使用单独的线性或逻辑回归模型,对神经血管病症(是否存在慢性大面积或显微镜下梗死)和动脉硬化、动脉粥样硬化和脑淀粉样血管病进行分析。参与者对四种生活方式健康行为的参与度要么一直较低(224 人),要么一直较高(331 人)。在核心或全面调整模型中,我们普遍发现参与度较高和较低的组别在神经病理学方面没有差异;例如,在核心或全面调整后,生活方式健康行为参与度较高与总体注意力缺失症病理学无关(P>0.8)。总之,我们没有发现生活方式健康行为模式与神经病理学之间存在关联的证据。健康行为对痴呆症的保护作用可能有其他机制。
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