Background: Dementia is a priority health issue worldwide. Building dementia-friendly communities was discussed at the 32nd International Conference of Alzheimer's Disease International in April 2017 and followed in May by the adoption of Global Action Plan on the Public Health Response to Dementia by the 70th World Health Assembly (WHO). An unhealthy lifestyle and diet are likely to cause many diseases. Objectives: This study aims to clarify lifestyle and dietary factors associating with dementia status in the community-dwelling elderly aged 65 and older in a suburban town of Tokyo and to clarify gender differences in health behavior. Methods: Self-administered questionnaires were mailed to 2,069 elderly people in February 2004 and 1,538 responses were returned by addressees or proxies (response rate; 74.3%). Institutionalized ones were excluded. Analysis subjects were comprised of 52 people with dementia (PWD), 173 people with probable dementia (PPD) and 1,211 cognitively intact people (CIP). Mean age (sd) was 74.03 (6.55) in men and 75.56 (7.27) in women. Descriptive statistics, a chi-square, Kruskal-Wallis and Mann-Whitney U tests and Bonferroni's multiple comparisons were performed in men and women, respectively. Significance was set at 0.05 (0.017 after Bonferroni correction). Lifestyle items included smoking, alcohol drinking, cooking, breakfast eating, walking/exercise, sleep duration per day including nap, going out, daytime lying duration in bed and the number of hobbies. Dietary items included meat/poultry, soybean products, eggs, oily fish, dairy products, fruits, vegetables, salted fish, deep-/stir-fried food, miso soup/soup, pickled ume plums and pickled vegetables. Results: Significant differences were detected in most lifestyle items except smoking and breakfast eating in men and women. As for dietary items, a significant difference was found only in pickled vegetables in men, however, in women significant differences were detected in items except eggs, salted fish, heavily seasoned food and pickled ume plums. Conclusion: Significant differences in lifestyle were detected in the same items in the CIP men and women. Exercise, social and mental activities like going out and hobbies, moderate alcohol drinking and dietary items above are recommended to prevent or delay the onset of dementia by Alzheimer's Society. The results of this study showed the same implications. As for dietary items, significant differences were observed in nine out of 13 items in women, while only one item was clarified in men. Health behavior seems to be better in women.

Abstract:Yamamoto's previous study showed that the prevalence of dementia in the community-dwelling elderly of 65 years and older in City A of Tokyo was decreasing during a six-year follow-up 2001-2007, suggesting

Objectives: Dementia is a priority health issue worldwide and becoming the most expensive disease of the 21st century. The World Health Organization has unanimously adopted a global plan of action on the public health response to dementia 2017-2025 at the 70th World Health Assembly in May 2017. One of the targets included in the plan is risk reduction. An unhealthy lifestyle and diet are likely to cause many diseases. This study aims to clarify lifestyle and dietary factors associating with dementia status in the community-dwelling elderly aged 65 years and older in a suburban town of Tokyo and to clarify gender differences in health behavior. Methods: Self-administered questionnaires were mailed to 2,069 elderly people in February 2004 and 1,538 were returned by addressees or proxies (response rate 74.3%). Institutionalized ones were excluded. Analysis subjects were comprised of 52 people with dementia (PWD), 173 people with probable dementia (PPD) and 1,211 cognitively intact people (CIP). Average age(sd) was 74.03(6.55) in men and 75.56(7.27) in women. Descriptive statistics, a chi-square, Kruskal-Wallis, Mann-Whitney U and Bonferroni's multiple comparison tests were performed in men and women, respectively. Significance was set at 0.05 (0.0167 after Bonferroni correction). Lifestyle items included daytime lying hours, sleeping hours, walking/exercise, outing, pet caring, hobbies, smoking, alcohol consumption, cooking and breakfast. Diet items included meat/poultry, soy products, eggs, oily fish, dairy products, fruits, (cooked) vegetables, fried food and miso soup/soup. Results: The Kruskal-Wallis and Mann-Whitney U tests revealed significant differences in most lifestyle items except smoking in men and women. Breakfast was significant only in women. As for diet items, only fruits and fried food were significant in men: CIP>PPD and/or PWD. Women showed significant differences in every diet items: mostly CIP>PPD and CIP>PWD and only fruits showed PPD>PWD. Conclusion: Though significant differences in lifestyle were weaker in men, CIP showed healthier lifestyle. In women CIP showed better health behavior both in lifestyle and diet. Exercise, social and mental activities like outing and hobbies, moderate alcohol consumption and food items above are recommended to prevent or delay the onset of dementia by Alzheimer's Society. This study, along with Japanese women's better lifestyle, has the same implications associating with dementia risk reduction. It also suggests that Japanese diet "Washoku" (a UNESCO Intangible Cultural Heritage) which is nutritionally well-balanced contributes to better health status as Japanese women enjoy the longest longevity in the world.