# Healthy lifestyle and Alzheimer’s disease in individuals with hyperlipidemia: A prospective cohort study

## TL;DR

A healthier lifestyle is linked to a lower risk of Alzheimer's disease, especially in people with high cholesterol and over age 60.

## Contribution

This study identifies that healthy lifestyle patterns specifically reduce Alzheimer's risk in hyperlipidemic individuals.

## Key findings

- Unhealthy lifestyle patterns increased Alzheimer's risk in hyperlipidemic individuals.
- Healthier lifestyle tiers were associated with progressively lower Alzheimer's risk in hyperlipidemic individuals.
- The protective effect was strongest in hyperlipidemic individuals over 60 years old.

## Abstract

•Healthier lifestyle patterns were associated with progressively lower AD risk in the overall cohort.•This protective association was observed predominantly among individuals with hyperlipidemia.•The benefits were most pronounced in hyperlipidemic individuals aged >60 years.•These associations remained consistent across genetic risk strata and AD polygenic risk score.

Healthier lifestyle patterns were associated with progressively lower AD risk in the overall cohort.

This protective association was observed predominantly among individuals with hyperlipidemia.

The benefits were most pronounced in hyperlipidemic individuals aged >60 years.

These associations remained consistent across genetic risk strata and AD polygenic risk score.

Whether healthy lifestyle behaviors are associated with Alzheimer’s disease (AD) risk among individuals with hyperlipidemia remains unclear.

We analyzed 241,642 dementia-free participants from the UK Biobank. A weighted lifestyle score (0–7) was derived from seven factors and categorized into five tiers. Hyperlipidemia was defined as lipid-lowering medication use or LDL-cholesterol ≥ 4.0 mmol/L. Cox regression estimated hazard ratios (HRs) and 95% confidence intervals (CIs).

Over a median follow-up of 14.5 years, 1728 AD cases occurred, including 977 cases among 104,082 individuals with hyperlipidemia. Compared with the intermediate tier, unhealthy lifestyle was associated with elevated AD risk (HR: 1.17; 95% CI: 1.02–1.35), while healtshy and very healthy tiers were associated with progressively lower risk (HR=0.85 and 0.74, respectively). These associations were evident among individuals with hyperlipidemia, but not statistically significant among those without hyperlipidemia.

Healthy lifestyle patterns were associated with lower AD risk among individuals with hyperlipidemia, with greater risk reductions observed for healthier lifestyle tiers.