Modifiable Lifestyle Factors in Alzheimer Disease

While the field of Alzheimer disease (AD) continues to evaluate therapeutic regimens that begin decades before clinical symptoms, results from Oveisgharan et al reported in this issue of JAMA Neurology add to a growing body of evidence suggesting that modifiable lifestyle factors in childhood may provide some protection against disease. In 1996, Snowdon et al published data from the Nun Study highlighting that early-life linguistic ability was strongly associated with late-life cognitive decline and AD neuropathology. This transformative work demonstrated that in a largely homogenous sample with shared environmental risk factors, early-life cognitive ability modified risk for age-related disease. Oveisgharan et al dramatically extend those seminal findings by leveraging the rich cognitive, clinical, and neuropathological data from the Rush Memory and Aging Project, a prospective, community-based longitudinal cohort study of the greater Chicago, Illinois, area. The research strengthens the importance of early-life experience in determining later-life AD susceptibility and emphasizes the need for future inquiry into the mechanisms of such protection through a combination of model organism and human cohort studies.

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