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Oomens, Julie E.; Vos, Stephanie J.B.; Maserejian, Nancy N.; Boada, Mercè; Didic, Mira; Engelborghs, Sebastiaan; Fladby, Tormod; Flier, Wiesje M. van der ORCID logoORCID: https://orcid.org/0000-0001-8766-6224; Frisoni, Giovanni B.; Fröhlich, Lutz; Gill, Kiran Dip; Grimmer, Timo; Hort, Jakub; Itoh, Yoshiaki; Iwatsubo, Takeshi; Klimkowicz-Mrowiec, Aleksandra; Landau, Susan M.; Lee, Dong Young; Lleó, Alberto; Martinez-Lage, Pablo; Mendonça, Alexandre de ORCID logoORCID: https://orcid.org/0000-0002-0488-1453; Meyer, Philipp T.; Parchi, Piero; Pardini, Matteo; Parnetti, Lucilla; Popp, Julius; Rami, Lorena; Reiman, Eric M.; Rinne, Juha O.; Rodrigue, Karen M.; Sánchez-Juan, Pascual; Santana, Isabel; Scarmeas, Nikolaos; Scheltens, Philip; Skoog, Ingmar; Sperling, Reisa A.; Stern, Yaakov; Villeneuve, Sylvia; Waldemar, Gunhild; Wiltfang, Jens; Zetterberg, Henrik; Alcolea, Daniel; Allegri, Ricardo F; Altomare, Daniele; Bateman, Randall J; Baiardi, Simone; Baldeiras, Ines; Blennow, Kaj; Braber, Anouk den; Buchem, Mark A. van; Byun, Min Soo; Cerman, Jiří; Chen, Kewei; Chipi, Elena; Day, Gregory S. ORCID logoORCID: https://orcid.org/0000-0001-5133-5538; Drzezga, Alexander; Ekblad, Laura L.; Förster, Stefan; Fortea, Juan; Freund-Levi, Yvonne; Frings, Lars; Guedj, Eric; Habeck, Christian G.; Handels, Ron; Hausner, Lucrezia; Hellwig, Sabine; Jiménez-Bonilla, Julio F.; Juaristi, Ane Iriondo; Kandimalla, Ramesh; Kern, Silke; Bordewick Kirsebom, Bjørn-Eivind S.; Kornhuber, Johannes; Legdeur, Nienke; Levin, Johannes ORCID logoORCID: https://orcid.org/0000-0001-5092-4306; Maier, Wolfgang; Marquié, Marta; Minatani, Shinobu; Morbelli, Silvia Daniela; Mroczko, Barbara; Ntanasi, Eva; Oliveira, Catarina Resende de; Orellana, Adelina; Peters, Oliver; Prabhakar, Sudesh; Ramakers, Inez H.; Rodríguez-Rodriguez, Eloy; Ruiz, Agustín; Rüther, Eckart; Sakhardande, Jayant; Selnes, Per; Silva, Dina; Soininen, Hilkka; Spiru, Luiza; Takeda, Akitoshi; Teunissen, Charlotte E.; Tijms, Betty M. ORCID logoORCID: https://orcid.org/0000-0002-2612-1797; Vermunt, Lisa; Wallin, Åsa K; Wiels, Wietse; Yannakoulia, Mary; Yi, Dahyun; Zettergren, Anna; Ossenkoppele, Rik; Verhey, Frans R.J.; Visser, Pieter Jelle und Jansen, Willemijn J. (2025): Associations of lifestyle factors with amyloid pathology in persons without dementia. In: Journal of Alzheimer’s Disease, Bd. 108, Nr. 3: S. 1043-1059 [PDF, 6MB]

Abstract

Background

The association between lifestyle factors and Alzheimer's disease (AD) pathophysiology remains incompletely understood.

Objective

The aim of this study was to assess the association of alcohol consumption, smoking behavior, sleep quality and physical, cognitive, and social activity with cerebral amyloid pathology.

Methods

For this cross-sectional study, we selected participants from the Amyloid Biomarker Study data pooling initiative. We used generalized estimating equations to assess associations of dichotomized lifestyle measures with amyloid pathology.

Results

We included 9171 participants with normal cognition (NC) and 2555 participants with mild cognitive impairment (MCI) from the Amyloid Biomarker Study. Of participants with NC, 58% were women, 34% were APOE ε4 carrier, and 27% had amyloid pathology. Of participants with MCI, 48% were women, 47% were APOE ε4 carrier, and 57% had amyloid pathology. In NC, cognitively active participants were less likely to have amyloid pathology (OR = 0.77, 95%CI 0.66–0.89, p < 0.001). In MCI, participants who had ever smoked or had sleep problems were less likely to have amyloid pathology (OR = 0.85, 95%CI 0.73–0.99, p = 0.029; OR = 0.62, 95%CI 0.45–0.86, p = 0.004).

Conclusions

In NC, cognitive activity was associated with a lower frequency of amyloid pathology. In MCI, favorable lifestyle behaviors were not associated with a lower frequency of amyloid pathology. The results of the current study contribute to the broader evidence base on lifestyle and AD by further characterizing the role of lifestyle behaviors in AD pathology across different clinical stages.

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