Reference data and clustering of lifestyle-based dementia risk factor scales among older Canadian adults

To establish age- and sex-stratified reference data for six validated lifestyle-based dementia risk factor scales measuring physical activity, brain-healthy eating, cognitive engagement, social connections, and mental wellbeing among Canadian adults aged 50+, and to identify patterns of lifestyle engagement across the five lifestyle domains.

A total of 1048 Canadian adults aged 50-97 (56% female) completed the CHAMPS, EPSA, FCAS, UCLA Loneliness Scale, and DASS-21 and PSS-10 to assess physical activity, brain-healthy eating, cognitive engagement, social connections, and mental wellbeing, respectively. Participants repeated the measures an average of 8.2 days later. Age- and sex-specific reference values (means, standard deviations, percentile cut-offs, and minimally detectable change) were calculated across sex and age decade (50s, 60s, 70s, 80s+). Latent class analysis was used to identify behavioural clusters in all participants.

Females reported greater cognitive engagement and healthier eating but higher perceived stress, while males reported being more physically active. Older age was associated with better eating, cognitive engagement, and lower stress and loneliness. Two lifestyle profiles emerged: (1) Well-rounded Lifestyle; and (2) Vulnerable to Psychosocial and Cognitive Disengagement. No age or sex differences were found between clusters.

This study provides the first Canadian reference data for these lifestyle scales, enabling personalized risk profiling in health promotion. Lifestyle behaviours cluster in ways that highlight the importance of addressing cognitive, social, and mental wellbeing alongside physical activity and brain-healthy eating in older adults.