P2‐151: Lifestyle behavior typologies predict incident dementia: The Cache County Study.

Diet, exercise, sociality, religious involvement, alcohol consumption and smoking have been associated with cognitive decline and dementia risk. We sought to identify several distinct behavioral classes, and examine their association with subsequent dementia risk. In a Utah population-based dementia study, a subsample of 2,491 initially non-demented participants (51% male) reported no ADL/IADL problems, no stroke or head injury within the past five years. Average age was 73.01 (SD = 5.69) years and average education 13.67 (SD = 4.10) years. Six dichotomized health-related behaviors included: Diet: high = above median on Dietary Approaches to Stop Hypertension scale; Exercise: 5+ hours/week of light activity and minimally occasional moderate/vigorous activity; Religiousness: attending church services at least weekly; Sociality: spending time with family/friends at least twice weekly; Alcohol: currently drinking alcoholic beverages 2+/week; Non-smoker: no current use (or former if < 100 cigarettes ever). We used Latent Class Analysis (LCA) of these behavioral domains to identify behavioral types. Time from baseline to incident dementia or to right-censoring was modeled with Cox proportional hazards regression as a function of behavioral class (covariates: age, gender, education, APOE status). Follow-up averaged 6.32 (SD = 5.31) years, with 278 incident dementia (200 AD) cases. Analyses were repeated for Alzheimer's disease (AD). LCA identified four distinct lifestyle classes. “Unhealthy-Religious” (UH-R; 11.5%) extremely low on sociality, exercise, alcohol, diet, and higher on religiousness, non-smoking. “Unhealthy-Non-Religious” (UH-NR; 10.5%) low on sociality, non-smoking, religiousness, diet, exercise, and higher on alcohol. “Healthy-Moderately Religious” (H-MR; 38.5%) high on sociality, moderately high on non-smoking, alcohol, religiousness, diet, exercise. “Healthy-Very Religious” (H-VR; 39.5%) extremely high on sociality, non-smoking, religiousness, moderately high on diet, exercise. Female gender predicted UH-R, H-VR classes. Higher education predicted H-VR, lower education predicted UH-NR, H-MR. Age, APOE did not predict latent class. Compared to UH-R class, UH-NR (Hazard Ratio, HR = .56, p = .038), H-MR (HR = .55, p = .002), and H-VR (HR = .57, p = .004) had significantly lower dementia risk. Results were comparable for AD, except that UH-NR was no longer significant. Generally healthy and functionally independent older adults appear to cluster into subpopulations with distinct patterns of health-related behaviors. These groups may have differential risk for subsequent dementia and AD. Conditional probabilities of exhibiting each of six health-related behaviors, for each of four behavioral classes

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