A less healthy lifestyle increases the risk of dementia

The less healthy your lifestyle, the more you are at risk of developing dementia in later life, a new systematic review has shown. Researchers analysed the results of 18 studies with over 44,000 participants | BMJ Open | via National Institute for Health research


Having two or more ‘modifiable risk factors’, including smoking, high blood pressure, poor diet, inactivity, obesity and excessive alcohol consumption, puts adults at greater risk of developing dementia.

The included studies followed up people without signs of cognitive decline to see who developed dementia of any cause.

A third of the studies could be combined in a meta analysis and these showed a 20% increase in the risk of dementia for one risk factor, which rose to 65% for two risk factors. The presence of three risk factors doubled the risk of dementia.

There was also a reduction in risk conveyed by having fewer risk factors and this, despite any direct evidence from intervention trials, holds out hope that interventions which either reduce or remove risk will lead to a reduction in the incidence of dementia diagnoses.

These results are consistent with our growing knowledge of the links between unhealthy lifestyles and dementia and are highly relevant to the promotion of healthy ageing behaviours in mid-life and beyond,  providing a compelling call to action in terms of public health and ageing.

Further detail at National Institute for Health Research

Full reference: Peters R, Booth A, Rockwood K et al. Combining modifiable risk factors and risk of dementia: a systematic review and meta-analysis. | BMJ Open | 2019 | 9:e022846.

10000 steps a day is a myth, reports JAMA study

Abbasi J. For Mortality, Busting the Myth of 10 000 Steps per Day|  JAMA |2019322(6):492–493. doi:10.1001/jama.2019.10042

JAMA has published the findings of an observational study that followed more than 6 000 women with an average age of 72 years wore accelerometers during their waking hours. Researchers collected data from the devices on step volume and intensity over 4 to 7 days. The women were divided into 4 groups from low to high, based on how much they walked. The researchers then tracked how many women died in each group over an average of 4 years of follow-up.

For many older people, reaching the target of 10 000 steps every day can feel daunting, and this may discourage them from walking more.

Equally, there may be no scientific basis for the widely used number. Its likely origin: the brand name of a Japanese pedometer sold in 1960s called Manpo-kei, or “10 000 steps meter.”


What the study showed:

  • On average the majority of the participants took 4400 daily steps,
  • Women who averaged approximately 4400 daily steps had lower mortality rates than those who took about 2700 steps a day.

  • There were additional declines in mortality among women who hoofed it more—but only up to about 7500 daily steps, beyond which the death rates leveled out.

  • Walking faster or slower didn’t appear to affect mortality rates when the number of steps was factored in.

  • The study’s lead author, I-Min Lee, of Brigham and Women’s Hospital and Harvard Medical School in Boston, the results likely apply to all individuals who are not very active, including men and younger women.
  • Lee told JAMA:

    “Step more—even a modest number of steps is associated with lower mortality.” And, she added, “all steps count,” not just those taken during exercise. If you already get 10 000 steps or more per day, don’t lower your goal. “There is no harm, and there may be additional benefits for outcomes not studied,” Lee said, like quality of life, physical function, and cognition. “We are continuing to follow the women in our study and hope to report on other outcomes in the future.” I-Min Lee

    (Source: JAMA)

The full article is available to read from JAMA; Athens login required

Alternatively, the Library  is able to provide a copy of this article

Is video gaming positively associated with higher body mass?

Are children, teenagers and adults who spend a lot of time playing video games more obese? This meta-analysis study looked into this question, and found that the cliché to be true – but only for adults | Social Science & Medicine | published online 9 June 2019 | story via ScienceDaily

A new study comprising a total of 20 relevant studies with more than 38,000 participants has revealed a small correlation between video game playing and excess weight or body mass. However, the link was only established for adults but not for children and teenagers. This authors identified a significant indirect effect which shows that people who spend more time playing video games also spend less time exercising and therefore weigh more or have more body mass which helps explain this correlation.




High body mass and obesity are frequently linked to the use of sedentary media, like television (TV) or non-active video games. Empirical evidence regarding video gaming, however, has been mixed, and theoretical considerations explaining a relationship between general screen time and body mass may not generalize to non-active video gaming.


The current meta-analysis had two main goals. First, we wanted to provide an estimate of the average effect size of the relationship between sedentary video gaming and body mass. In doing so we acknowledged several context variables to gauge the stability of the average effect. Second, to provide additional evidence on processes, we tested the displacement effect of physical activity by video gaming time with the help of a meta-analytic structural equation model (MASEM).


Published and unpublished studies were identified through keyword searches in different databases and references in relevant reports were inspected for further studies. We present a random-effects, three-level meta-analysis based on 20 studies (total N = 38,097) with 32 effect sizes.


The analyses revealed a small positive relationship between non-active video game use and body mass, indicating that they shared less than 1% in variance. The studies showed significant heterogeneity,  Moderator analyses revealed that the relationship was more pronounced for adults,  as compared to adolescents, or children,  MASEM found little evidence for a displacement of physical activity through time spent on video gaming.

Caroline Marker, Timo Gnambs & Markus Appel | Exploring the myth of the chubby gamer: A meta-analysis of studies on sedentary video gaming and body mass  | Social Science & Medicine | published online 9 June 2019

See also: Do video games drive obesity? | ScienceDaily


Stressed doctors are more likely to binge drink and have sleep problems, finds study

Mahase,  E. | 2019|  Stressed doctors are more likely to binge drink and have sleep problems, finds study

New research published in the BMJ reports that a survey of more than 400 respondents thta doctors who experience stress or burnout from work have an increased likelihood of turning to drugs or alcohol. The research was conducted by experts from the Birkbeck, University of London and University College London (UCL).

More than a third or respondents (34 per cent) reported that they had used substances, such as drugs, food or alcohol to make themselves feel better. One-tenth also reported problems with sleep: while 11 per cent reported insomnia; two-thirds (35 per cent) said that this interfered with their daily functioning, they also said they thought about work when they went to bed.


Doctors who coped with stress by using substances had a higher risk of alcohol dependence, binge drinking, drinking large amounts of alcohol, and using alcohol frequently.

The research, published in BMJ Open, involved UK doctors (52% women, 49% consultants) and aimed to assess the prevalence of health problems such as insomnia, binge eating, substance misuse, and ill health and whether occupational distress increased the risk (Source: BMJ).

Read the full article in  the BMJ available to Athens users here

Or alternatively, contact the Library for a copy or access

Research shows dementia rates falling by 15% per decade over last 30 years

The risk of developing dementia is falling, thanks to lifestyle improvements such as reductions in smoking, new research has found. Researchers have said that while the overall number of cases is rising due to the population living longer, an individual’s chances of having the disease is going down | Alzheimers Research UK

International experts have presented research indicating that dementia incidence rates may be falling by up to 15% decade on decade. Analysing data from seven population-based studies in the United States and Europe, Prof Hofman and a global team of researchers set out to determine changes in the incidence of dementia between 1988 and 2015.

Of 59,230 individuals included in the research, 5,133 developed dementia. The rate of new dementia cases declined by 15% per decade, a finding that was consistent across the different studies included in the analysis.

The findings will be discussed at the Alzheimer’s Research UK Conference 2019 in Harrogate.

Full story at Alzheimer’s Research UK

See also:

In This video, lead author Albert Hofman, discusses trends in dementia incidence over the last three decades at the Alzheimer’s Research UK  Conference 2019. Prof. Hofman goes on to explain the reasoning behind these trends.


National Diet and Nutrition Survey

Public Health England & Food Standards Agency | January 2019 |National Diet and Nutrition Survey: Years 1 to 9 of the Rolling Programme (2008/2009 – 2016/2017): Time trend and income analyses

Public Health England & Food Standards Agency have published the National Diet and Nutrition Survey (NDNS RP), the survey takes place annually using a representative sample (of around 1000 people: 500 adults and 500 children) take part in the NDNS RP each year. The NDNS RP comprises an interview, a 4-day estimated diet diary, physical measurements and a blood and urine sample.


Key findings: 

  • There was little change in intake of fruit and vegetables over the 9-year period.
  • All age/sex groups had a mean fruit and vegetable intake below the 5 A Day
    recommendation over the 9-year period.
  • There was a downward linear trend in intake of fruit juice over time among consumers in all age/sex groups although there was little change in the proportions drinking it.
  • There was little change in intake of oily fish over the 9-year period while intake of red and processed meat showed a downward trend over time.
  • Over the 9 years, the proportion of children consuming sugar-sweetened soft drinks dropped by 26, 35 and 17 percentage points for those aged 1.5 to 3 years, 4 to 10 years and 11 to 18 years respectively.
  • For those children who drank sugar-sweetened soft drinks, intake also fell significantly over time. (Source: Public Health England & Food Standards Agency)

Read the full report National Diet and Nutrition Survey

Want to stick to your News Year’s exercise regime? New research may help you to do so

University of Manchester | December 2018 | Want to stick to your New Year’s exercise regime? This research can help

Collbaorative research between experts at University of Manchester, Leeds Trinity University and the National University of Galway Ireland have analysed the results of 180 randomised trials in order to further research into the most effective techniques for changing adults’ physical activity using a concept known as self-efficacy.


This is basically the perception of our own ability and its influence on our ability to succeed or accomplish a specific goal. While earlier research has indicated that  higher levels of self-efficacy are associated with higher levels of physical activity, what is less certain is which techniques have the most impact on our self-efficacy.

A key finding from the study is that the greater the number of techniques used, the more effective they may be at maintaining our self-efficacy in the longer-term. They also found that simply providing people with information on the associated health benefits of exercise did not increase self-efficacy

Lead author Dr Mei Yee Tang at The University of Manchester said: “One of the biggest influences of our behaviour is our own beliefs. If we believe we are capable of doing something, then we are more likely to devote effort to it and feel we can do it even if it may be a difficult task.”

Dr Tang added: “We were unable to find clear patterns of techniques which should be used together, or which might not work as well together, in increasing self-efficacy.

“Previous similar reviews which have looked at specific adult populations have found self-regulatory techniques such as setting physical activity goals and monitoring physical activity behaviour to be effective at increasing self-efficacy in obese adults and adults without a clinical condition.

“Yet, these techniques were associated with lower self-efficacy in older adults. In older adults, techniques such as setting graded tasks – such as slowly increasing walking distance each time – ,were found to be more effective for this population.

“Therefore, it’s important to stress that there isn’t a single ‘magic bullet’ that can increase self-efficacy for physical activity across all adults.

“On January first we should think about factors such as age and any illness or conditions if we are to support ourselves and our loved ones in achieving their physical activity related-New Year’s resolution.”

Read the press release from the University of Manchester

Full reference: Tang, M.Y.,  Smith, D.M.,  Mc Sharry, J., Hann, M.,  French, D.P., | 2018| Behavior Change Techniques Associated With Changes in Postintervention and Maintained Changes in Self-Efficacy For Physical Activity: A Systematic Review With Meta-analysis| Annals of Behavioral Medicine| kay090| https://doi.org/10.1093/abm/kay090



Self-efficacy is an important determinant of physical activity but it is unclear how best to increase self-efficacy for physical activity and to maintain these changes.


This systematic review aimed to identify which specific behavior change techniques (BCTs), BCT clusters, and number of BCTs were associated with changes in postintervention and maintained changes in self-efficacy for physical activity across all adult populations.


A systematic search yielded 180 randomized trials (204 comparisons) which reported changes in self-efficacy. BCTs were coded using the BCT Taxonomy v1. Hierarchical cluster analysis explored the clustering of BCTs. Meta-analyses and moderator analyses examined whether the presence and absence of individual BCTs in interventions were associated with effect-size changes for self-efficacy.


Small intervention effects were found for postintervention self-efficacy for physical activity. “Information about social, environmental, and emotional consequences” was associated with higher effect sizes, whereas “social support (practical)” was associated with lower effect sizes. Small and nonsignificant effects were found for maintained changes in self-efficacy for physical activity . Lack of meaningful clustering of BCTs was found. A significant positive relationship was found between number of BCTs and effect sizes for maintained changes in self-efficacy for physical activity.


There does not appear to be a single effective approach to change self-efficacy for physical activity in all adults: different approaches are required for different populations. Interventions with more BCTs seem more effective at maintaining changes in self-efficacy for physical activity.


Rotherham NHS staff  can request the article here