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Mediterranean diet, Alzheimer disease, and vascular mediation.

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.

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  • Authors+Show Affiliations

    ,

    Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Columbia University Medical Center, New York, NY 10032, USA. ns257@columbia.edu

    , ,

    Source

    Archives of neurology 63:12 2006 Dec pg 1709-17

    MeSH

    Age Factors
    Aged
    Aged, 80 and over
    Alzheimer Disease
    Apolipoproteins E
    Body Mass Index
    Case-Control Studies
    Cohort Studies
    Comorbidity
    Diet, Mediterranean
    Education
    Energy Intake
    Ethnic Groups
    Female
    Genotype
    Humans
    Logistic Models
    Male
    Models, Statistical
    New York City
    Odds Ratio
    Sex Factors
    Smoking
    Vascular 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), pp. 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_ L2 - https://jamanetwork.com/journals/jamaneurology/fullarticle/10.1001/archneur.63.12.noc60109 DB - PRIME DP - Unbound Medicine ER -