Modifiable Lifestyle Factors in Dementia: A Systematic Review of Longitudinal Observational Cohort Studies

Luigi Yuri Di Marco, Alberto Marzo, Miguel Muñoz-Ruiz, M. Arfan Ikram, Miia Kivipelto, Daniel Ruefenacht, Annalena Venneri, Hilkka Soininen, Isabel Wanke, Yiannis A. Ventikos, Alejandro F. Frangi

Research output: Contribution to journalArticlepeer-review


Background: Numerous population-based longitudinal studies suggest an association between modifiable lifestyle factors and late-life dementia. A comprehensive description of these factors and their quantification criteria is an important preliminary step toward the elucidation of causes and mechanisms underlying the onset and progression of dementia. Objective: To present a systematic review of modifiable lifestyle factors associated with dementia risk in longitudinal observational cohort-studies. Methods: A systematic review of original articles, published in English until December 2013, listed in four electronic databases (including PubMed, MEDLINE, PsycINFO) was conducted. Results: 75 papers from 33 epidemiologic studies met the inclusion criteria. Included papers focused on dietary habits (n = 26), leisure activities (social, physical, mental) (n = 23), beverages (juice, tea, coffee, alcohol) (n = 15), smoking (n = 13), social network (n = 6), and combined lifestyle factors (n = 2). Conclusions: Broad consensus emerged on the protective role against dementia of leisure activities. Conflicting results were found for the association between dementia and putative risk factors (smoking) and protective factors (mild-to-moderate alcohol consumption, dietary antioxidants, Mediterranean diet, and living with others). However, studies varied largely in the quantification of lifestyle factors in terms of intensity, frequency and duration of exposure, and in the choice of confounders in statistical analyses. The need for standardized quantification criteria emerges, together with the current limitation in reliably tracking the past history of each patient, from childhood and young adulthood to midlife.

Original languageEnglish
Pages (from-to)119-135
Number of pages17
JournalJournal of Alzheimer's Disease
Issue number1
Publication statusPublished - 2014


  • Alzheimer's disease
  • dementia
  • longitudinal observational cohort studies
  • modifiable lifestyle factors

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Geriatrics and Gerontology
  • Clinical Psychology
  • Medicine(all)


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