Similarities and differences between Alzheimer's disease and vascular dementia from the viewpoint of nutrition.Ann N Y Acad Sci 2002; 977:155-61AN
Dietary habits were compared in patients with Alzheimer's disease (AD) and those with vascular dementia (VaD). Twenty-seven patients with AD, 15 patients with VaD, and 49 age-matched controls were enrolled. Nutritional status was assessed using a semiquantified food-frequency questionnaire. Dietary habits were very similar in male patients with AD and VaD. Both groups had significantly higher energy intake than their energy demands: +25% for AD and +35% for VaD, respectively. However, major sources of energy were different: grains and animal fats for AD versus only grains for VaD. Calculation of nutrients revealed excess intake of n-6 polyunsaturated fatty acids (PUFA) and relative deficiencies of multiple vitamins including antioxidants, vitamin C and carotene, and the vitamin B group. In contrast, dietary habits in female patients with AD differed significantly from those of male patients. Female patients consumed significantly lower amounts of fish and green vegetables. Calculation of nutrients showed absolute deficiencies of n-3 PUFA, multiple vitamins, and minerals. Our results show that AD and VaD are similar from the viewpoint of nutrition, except for the higher consumption of animal fats for AD patients, probably reflecting Westernization of dietary habits in recent years. Nutrition may be relevant to the pathogenesis of dementia through many processes. Higher intake of energy and lower intake of antioxidants may exaggerate the process of dementia through oxidative stress. Excessive amounts of n-6 PUFA or deficiency of n-3 PUFA may cause chronic inflammation, platelet aggregation, or endothelial dysfunction of microvasculature. Nutrition may be useful for preventing dementia, although gender-specific differences must be taken into account.