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Adherence to a Mediterranean diet, cognitive decline, and risk of dementia.

Abstract

CONTEXT

Higher adherence to a Mediterranean-type diet is linked to lower risk for mortality and chronic diseases, but its association with cognitive decline is unclear.

OBJECTIVE

To investigate the association of a Mediterranean diet with change in cognitive performance and risk for dementia in elderly French persons.

DESIGN, SETTING, AND PARTICIPANTS

Prospective cohort study of 1410 adults (> or = 65 years) from Bordeaux, France, included in the Three-City cohort in 2001-2002 and reexamined at least once over 5 years. Adherence to a Mediterranean diet (scored as 0 to 9) was computed from a food frequency questionnaire and 24-hour recall.

MAIN OUTCOME MEASURES

Cognitive performance was assessed on 4 neuropsychological tests: the Mini-Mental State Examination (MMSE), Isaacs Set Test (IST), Benton Visual Retention Test (BVRT), and Free and Cued Selective Reminding Test (FCSRT). Incident cases of dementia (n = 99) were validated by an independent expert committee of neurologists.

RESULTS

Adjusting for age, sex, education, marital status, energy intake, physical activity, depressive symptomatology, taking 5 medications/d or more, apolipoprotein E genotype, cardiovascular risk factors, and stroke, higher Mediterranean diet score was associated with fewer MMSE errors (beta = -0.006; 95% confidence interval [CI], -0.01 to -0.0003; P = .04 for 1 point of the Mediterranean diet score). Performance on the IST, BVRT, or FCSRT over time was not significantly associated with Mediterranean diet adherence. Greater adherence as a categorical variable (score 6-9) was not significantly associated with fewer MMSE errors and better FCSRT scores in the entire cohort, but among individuals who remained free from dementia over 5 years, the association for the highest compared with the lowest group was significant (adjusted for all factors, for MMSE: beta = -0.03; 95% CI, -0.05 to -0.001; P = .04; for FCSRT: beta = 0.21; 95% CI, 0.008 to 0.41; P =.04). Mediterranean diet adherence was not associated with the risk for incident dementia (fully adjusted model: hazard ratio, 1.12; 95% CI, 0.60 to 2.10; P = .72), although power to detect a difference was limited.

CONCLUSIONS

Higher adherence to a Mediterranean diet was associated with slower MMSE cognitive decline but not consistently with other cognitive tests. Higher adherence was not associated with risk for incident dementia.

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  • Authors+Show Affiliations

    ,

    Research Center INSERM U897, Université Victor Segalen Bordeaux 2, Bordeaux, France. catherine.feart@isped.u-bordeaux2.fr

    , , , , , ,

    Source

    JAMA 302:6 2009 Aug 12 pg 638-48

    MeSH

    Aged
    Aged, 80 and over
    Apolipoproteins E
    Body Mass Index
    Cognition
    Cognition Disorders
    Confounding Factors (Epidemiology)
    Dementia
    Depression
    Diet, Mediterranean
    Educational Status
    Energy Intake
    Female
    France
    Genotype
    Humans
    Male
    Marital Status
    Neuropsychological Tests
    Odds Ratio
    Primary Prevention
    Prospective Studies
    Research Design
    Residence Characteristics
    Risk Factors

    Pub Type(s)

    Journal Article
    Research Support, Non-U.S. Gov't

    Language

    eng

    PubMed ID

    19671905

    Citation

    Féart, Catherine, et al. "Adherence to a Mediterranean Diet, Cognitive Decline, and Risk of Dementia." JAMA, vol. 302, no. 6, 2009, pp. 638-48.
    Féart C, Samieri C, Rondeau V, et al. Adherence to a Mediterranean diet, cognitive decline, and risk of dementia. JAMA. 2009;302(6):638-48.
    Féart, C., Samieri, C., Rondeau, V., Amieva, H., Portet, F., Dartigues, J. F., ... Barberger-Gateau, P. (2009). Adherence to a Mediterranean diet, cognitive decline, and risk of dementia. JAMA, 302(6), pp. 638-48. doi:10.1001/jama.2009.1146.
    Féart C, et al. Adherence to a Mediterranean Diet, Cognitive Decline, and Risk of Dementia. JAMA. 2009 Aug 12;302(6):638-48. PubMed PMID: 19671905.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Adherence to a Mediterranean diet, cognitive decline, and risk of dementia. AU - Féart,Catherine, AU - Samieri,Cécilia, AU - Rondeau,Virginie, AU - Amieva,Hélène, AU - Portet,Florence, AU - Dartigues,Jean-François, AU - Scarmeas,Nikolaos, AU - Barberger-Gateau,Pascale, PY - 2009/8/13/entrez PY - 2009/8/13/pubmed PY - 2009/8/18/medline SP - 638 EP - 48 JF - JAMA JO - JAMA VL - 302 IS - 6 N2 - CONTEXT: Higher adherence to a Mediterranean-type diet is linked to lower risk for mortality and chronic diseases, but its association with cognitive decline is unclear. OBJECTIVE: To investigate the association of a Mediterranean diet with change in cognitive performance and risk for dementia in elderly French persons. DESIGN, SETTING, AND PARTICIPANTS: Prospective cohort study of 1410 adults (> or = 65 years) from Bordeaux, France, included in the Three-City cohort in 2001-2002 and reexamined at least once over 5 years. Adherence to a Mediterranean diet (scored as 0 to 9) was computed from a food frequency questionnaire and 24-hour recall. MAIN OUTCOME MEASURES: Cognitive performance was assessed on 4 neuropsychological tests: the Mini-Mental State Examination (MMSE), Isaacs Set Test (IST), Benton Visual Retention Test (BVRT), and Free and Cued Selective Reminding Test (FCSRT). Incident cases of dementia (n = 99) were validated by an independent expert committee of neurologists. RESULTS: Adjusting for age, sex, education, marital status, energy intake, physical activity, depressive symptomatology, taking 5 medications/d or more, apolipoprotein E genotype, cardiovascular risk factors, and stroke, higher Mediterranean diet score was associated with fewer MMSE errors (beta = -0.006; 95% confidence interval [CI], -0.01 to -0.0003; P = .04 for 1 point of the Mediterranean diet score). Performance on the IST, BVRT, or FCSRT over time was not significantly associated with Mediterranean diet adherence. Greater adherence as a categorical variable (score 6-9) was not significantly associated with fewer MMSE errors and better FCSRT scores in the entire cohort, but among individuals who remained free from dementia over 5 years, the association for the highest compared with the lowest group was significant (adjusted for all factors, for MMSE: beta = -0.03; 95% CI, -0.05 to -0.001; P = .04; for FCSRT: beta = 0.21; 95% CI, 0.008 to 0.41; P =.04). Mediterranean diet adherence was not associated with the risk for incident dementia (fully adjusted model: hazard ratio, 1.12; 95% CI, 0.60 to 2.10; P = .72), although power to detect a difference was limited. CONCLUSIONS: Higher adherence to a Mediterranean diet was associated with slower MMSE cognitive decline but not consistently with other cognitive tests. Higher adherence was not associated with risk for incident dementia. SN - 1538-3598 UR - https://www.unboundmedicine.com/medline/citation/19671905/Adherence_to_a_Mediterranean_diet_cognitive_decline_and_risk_of_dementia_ L2 - https://jamanetwork.com/journals/jama/fullarticle/10.1001/jama.2009.1146 DB - PRIME DP - Unbound Medicine ER -