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Mediterranean diet, Alzheimer disease, and vascular mediation.
Arch Neurol. 2006 Dec; 63(12):1709-17.AN

Abstract

OBJECTIVES

To examine the association between the Mediterranean diet (MeDi) and Alzheimer disease (AD) in a different AD population and to investigate possible mediation by vascular pathways. Design, Setting, Patients, and

MAIN OUTCOME MEASURES

A case-control study nested within a community-based cohort in New York, NY. Adherence to the MeDi (0- to 9-point scale with higher scores indicating higher adherence) was the main predictor of AD status (194 patients with AD vs 1790 nondemented subjects) in logistic regression models that were adjusted for cohort, age, sex, ethnicity, education, apolipoprotein E genotype, caloric intake, smoking, medical comorbidity index, and body mass index (calculated as weight in kilograms divided by height in meters squared). We investigated whether there was attenuation of the association between MeDi and AD when vascular variables (stroke, diabetes mellitus, hypertension, heart disease, lipid levels) were simultaneously introduced in the models (which would constitute evidence of mediation).

RESULTS

Higher adherence to the MeDi was associated with lower risk for AD (odds ratio, 0.76; 95% confidence interval, 0.67-0.87; P<.001). Compared with subjects in the lowest MeDi tertile, subjects in the middle MeDi tertile had an odds ratio of 0.47 (95% confidence interval, 0.29-0.76) and those at the highest tertile an odds ratio of 0.32 (95% confidence interval, 0.17-0.59) for AD (P for trend <.001). Introduction of the vascular variables in the model did not change the magnitude of the association.

CONCLUSIONS

We note once more that higher adherence to the MeDi is associated with a reduced risk for AD. The association does not seem to be mediated by vascular comorbidity. This could be the result of either other biological mechanisms (oxidative or inflammatory) being implicated or measurement error of the vascular variables.

Links

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Authors+Show Affiliations

Scarmeas N
Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Columbia University Medical Center, New York, NY 10032, USA. ns257@columbia.edu
Stern Y
No affiliation info available
Mayeux R
No affiliation info available
Luchsinger JA
No affiliation info available

MeSH

Age FactorsAgedAged, 80 and overAlzheimer DiseaseApolipoproteins EBody Mass IndexCase-Control StudiesCohort StudiesComorbidityDiet, MediterraneanEducationEnergy IntakeEthnicityFemaleGenotypeHumansLogistic ModelsMaleModels, StatisticalNew York CityOdds RatioSex FactorsSmokingVascular Diseases

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

17030648

Citation

Scarmeas, Nikolaos, et al. "Mediterranean Diet, Alzheimer Disease, and Vascular Mediation." Archives of Neurology, vol. 63, no. 12, 2006, pp. 1709-17.
Scarmeas N, Stern Y, Mayeux R, et al. Mediterranean diet, Alzheimer disease, and vascular mediation. Arch Neurol. 2006;63(12):1709-17.
Scarmeas, N., Stern, Y., Mayeux, R., & Luchsinger, J. A. (2006). Mediterranean diet, Alzheimer disease, and vascular mediation. Archives of Neurology, 63(12), 1709-17.
Scarmeas N, et al. Mediterranean Diet, Alzheimer Disease, and Vascular Mediation. Arch Neurol. 2006;63(12):1709-17. PubMed PMID: 17030648.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Mediterranean diet, Alzheimer disease, and vascular mediation. AU - Scarmeas,Nikolaos, AU - Stern,Yaakov, AU - Mayeux,Richard, AU - Luchsinger,Jose A, Y1 - 2006/10/09/ PY - 2006/10/13/pubmed PY - 2007/1/24/medline PY - 2006/10/13/entrez SP - 1709 EP - 17 JF - Archives of neurology JO - Arch Neurol VL - 63 IS - 12 N2 - OBJECTIVES: To examine the association between the Mediterranean diet (MeDi) and Alzheimer disease (AD) in a different AD population and to investigate possible mediation by vascular pathways. Design, Setting, Patients, and MAIN OUTCOME MEASURES: A case-control study nested within a community-based cohort in New York, NY. Adherence to the MeDi (0- to 9-point scale with higher scores indicating higher adherence) was the main predictor of AD status (194 patients with AD vs 1790 nondemented subjects) in logistic regression models that were adjusted for cohort, age, sex, ethnicity, education, apolipoprotein E genotype, caloric intake, smoking, medical comorbidity index, and body mass index (calculated as weight in kilograms divided by height in meters squared). We investigated whether there was attenuation of the association between MeDi and AD when vascular variables (stroke, diabetes mellitus, hypertension, heart disease, lipid levels) were simultaneously introduced in the models (which would constitute evidence of mediation). RESULTS: Higher adherence to the MeDi was associated with lower risk for AD (odds ratio, 0.76; 95% confidence interval, 0.67-0.87; P<.001). Compared with subjects in the lowest MeDi tertile, subjects in the middle MeDi tertile had an odds ratio of 0.47 (95% confidence interval, 0.29-0.76) and those at the highest tertile an odds ratio of 0.32 (95% confidence interval, 0.17-0.59) for AD (P for trend <.001). Introduction of the vascular variables in the model did not change the magnitude of the association. CONCLUSIONS: We note once more that higher adherence to the MeDi is associated with a reduced risk for AD. The association does not seem to be mediated by vascular comorbidity. This could be the result of either other biological mechanisms (oxidative or inflammatory) being implicated or measurement error of the vascular variables. SN - 0003-9942 UR - https://www.unboundmedicine.com/medline/citation/17030648/Mediterranean_diet_Alzheimer_disease_and_vascular_mediation_ DB - PRIME DP - Unbound Medicine ER -