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Adherence to a Mediterranean diet, cognitive decline, and risk of dementia.
JAMA. 2009 Aug 12; 302(6):638-48.JAMA

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.

Authors+Show Affiliations

Research Center INSERM U897, Université Victor Segalen Bordeaux 2, Bordeaux, France. catherine.feart@isped.u-bordeaux2.frNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

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., Scarmeas, N., & Barberger-Gateau, P. (2009). Adherence to a Mediterranean diet, cognitive decline, and risk of dementia. JAMA, 302(6), 638-48. https://doi.org/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 -