Table 73Summary of evidence for association between social/economic/behavioral factors and AD or cognitive decline

ExposureChildhood exposuresEducation/occupationSocial engagementOther leisure activitiesAlcoholTobaccoPhysical activity in late adultsCognitive engagement
Studies (subjects)1 (859)Education: 11 (25196)

Occupation: 5 (6029)
Marital status: 3 (6699)
Social network: 1 (1473)
Social support: 2 (4365)
2 (7464)6 (14,646)12 (21,718)12 (25,603)None4 (7723)None
Association with AD*No associationEducation: Decreased risk

Occupation: No
Never married: Increased risk
Less social network: Increased risk
Less social support: Increased risk
Inconsistent associationDecreased riskIncreased riskProbably decreased risk-Decreased risk-
Studies (subjects)3 (6,861)Education: 14 (43201)

Occupation: 4 (7277)
Marital status/cohabitation: 7 (16565)

Social network: 5 (10926)
Social support: 5 (15459)
3 (9599)7 (15,581)14 (33685)8 (17351)1 (170)4 (6285)1 (2802)
Association with cognitive decline*No associationEducation: Inconsistent association

Occupation: Possibly decreased risk
Marital status: Inconsistent association

Social network: Inconsistent association
Social support: Inconsistent association
Probably decreased riskNo associationIncreased riskProbably decreased riskDecreased riskProbably decreased riskSlightly decreased risk
Concordance/discordance for AD and cognitive decline outcomesConcordant for no association Exposure measure variable.Education: Discordant

Occupation: Evidence inadequate
Evidence inadequate to determineEvidence inadequate to determineDiscordantConcordant for increased riskConcordant for decreased risk but exposure measures variable and imprecise; little trial data; cognitive decline measured variablyConcordant for decreased risk but exposure measures imprecise and variable; little trial data

Abbreviations: AD = Alzheimer’s disease; RCT = randomized controlled trial


Direction of risk for higher exposure (intake) and AD or cognitive decline.

From: 3, Results

Cover of Preventing Alzheimer's Disease and Cognitive Decline
Preventing Alzheimer's Disease and Cognitive Decline.
Evidence Reports/Technology Assessments, No. 193.
Williams JW, Plassman BL, Burke J, et al.

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