Association between Healthy Lifestyle Index and Cognitive Decline in Community-Dwelling Lebanese Older Adult

The aim of this study was to establish the association between a healthy lifestyle that includes following a healthy diet, consuming moderate alcohol amount, being physically active, maintaining a healthy BMI and never smoking and cognitive decline in community dwelling Lebanese older adults. A secondary cross-sectional data analysis was conducted on 502 community dwelling Lebanese older adults aged ≥65 years old and their informants. Cognitive decline was assessed using the validated arabic versions of the RUDAS, IQCODE and 10/66DRG. Healthy lifestyle index (HLI) was based on 5 components: diet, BMI, alcohol, physical activity and smoking with a score ranging from 0-20. The score was divided into quartiles and 3 categories created: Low adherence (Q1: 0–8), moderate adherence (Q2-Q3: 8–11) and high adherence (Q4: ≥12 points). Logistic regressions were performed to assess the relationship between HLI and prevalence of cognitive decline while adjusting for confounding factors. The final sample size included 432 participants with an average age of 72.4 years and constituted of 56.7% females. One third were cognitively declined and they were more likely to be females (p = 0.002), older in age (p = 0.002), had lower levels of education (p = 0.008), took more medications (p = 0.027), were less socially active (p = 0.02) and in general they followed a less healthy lifestyle. Participants in the highest HLI category had a significantly lower prevalence of cognitive decline as demonstrated by RUDAS (p< 0.0001) and IQCODE (p< 0.0001), but not by 10/66DRG (p = 0.069). Lastly, participants with the highest adherence to HLI had a 77% lower prevalence of cognitive decline when assessed by RUDAS (OR: 0.23, 95%CI: 0.12-0.45, p< 0.0001), but this association was not significant when assessed by IQCODE and 10/66 DRG. The results showed that a healthy lifestyle might contribute to a lower prevalence of cognitive decline in older adults. Longitudinal prospective studies should be performed to assess the effect of adherence to a healthy lifestyle on cognition at early and late-life stages. The study was funded by the Fogarty International Center, American National Institutes of Health and National Institute of Aging, grant No. 1R21AG039333-01, under the program ‘Brain Disorders in the Developing World: Research across the Lifespan (BRAIN).