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Association of Mediterranean-DASH Intervention for Neurodegenerative Delay and Mediterranean Diets With Alzheimer Disease Pathology.
Neurology. 2023 May 30; 100(22):e2259-e2268.Neur

Abstract

BACKGROUND AND OBJECTIVES

Diet may reduce Alzheimer dementia risk and slow cognitive decline, but the understanding of the relevant neuropathologic mechanisms remains limited. The association of dietary patterns with Alzheimer disease (AD) pathology has been suggested using neuroimaging biomarkers. This study examined the association of Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND) and Mediterranean dietary patterns with β-amyloid load, phosphorylated tau tangles, and global AD pathology in postmortem brain tissue of older adults.

METHODS

Autopsied participants of the Rush Memory and Aging Project with complete dietary information (collected through a validated food frequency questionnaire) and AD pathology data (β-amyloid load, phosphorylated tau tangles, and global AD pathology [summarized neurofibrillary tangles and neuritic and diffuse plaques]) were included in this study. Linear regression models controlled for age at death, sex, education, APOE-ε4 status, and total calories were used to investigate the dietary patterns (MIND and Mediterranean diets) and dietary components associated with AD pathology. Further effect modification was tested for APOE-ε4 status and sex.

RESULTS

Among our study participants (N = 581, age at death: 91.0 ± 6.3 years; mean age at first dietary assessment: 84.2 ± 5.8 years; 73% female; 6.8 ± 3.9 years of follow-up), dietary patterns were associated with lower global AD pathology (MIND: β = -0.022, p = 0.034, standardized β = -2.0; Mediterranean: β = -0.007, p = 0.039, standardized β = -2.3) and specifically less β-amyloid load (MIND: β = -0.068, p = 0.050, standardized β = -2.0; Mediterranean: β = -0.040, p = 0.004, standardized β = -2.9). The findings persisted when further adjusted for physical activity, smoking, and vascular disease burden. The associations were also retained when participants with mild cognitive impairment or dementia at the baseline dietary assessment were excluded. Those in the highest tertile of green leafy vegetables intake had less global AD pathology when compared with those in the lowest tertile (tertile 3 vs tertile 1: β = -0.115, p = 0.0038).

DISCUSSION

The MIND and Mediterranean diets are associated with less postmortem AD pathology, primarily β-amyloid load. Among dietary components, higher green leafy vegetable intake was associated with less AD pathology.

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Authors+Show Affiliations

Agarwal P
From the Rush Alzheimer's Disease Center (P.A., S.E.L., N.A., B.D.J., L.L.B., D.A.B., J.A.S.), Departments of Internal Medicine (P.A., B.D.J., K.D.), Clinical Nutrition (P.A.), Neurological Sciences (S.E.L., N.T.A., L.J.C., L.L.B., D.A.B., J.A.S.) and Pathology (S.A., J.A.S.); and Rush Institute of Healthy Aging (K.D.), Rush University Medical Center, Chicago, IL. puja_agarwal@rush.edu.
Leurgans SE
From the Rush Alzheimer's Disease Center (P.A., S.E.L., N.A., B.D.J., L.L.B., D.A.B., J.A.S.), Departments of Internal Medicine (P.A., B.D.J., K.D.), Clinical Nutrition (P.A.), Neurological Sciences (S.E.L., N.T.A., L.J.C., L.L.B., D.A.B., J.A.S.) and Pathology (S.A., J.A.S.); and Rush Institute of Healthy Aging (K.D.), Rush University Medical Center, Chicago, IL.
Agrawal S
From the Rush Alzheimer's Disease Center (P.A., S.E.L., N.A., B.D.J., L.L.B., D.A.B., J.A.S.), Departments of Internal Medicine (P.A., B.D.J., K.D.), Clinical Nutrition (P.A.), Neurological Sciences (S.E.L., N.T.A., L.J.C., L.L.B., D.A.B., J.A.S.) and Pathology (S.A., J.A.S.); and Rush Institute of Healthy Aging (K.D.), Rush University Medical Center, Chicago, IL.
Aggarwal NT
From the Rush Alzheimer's Disease Center (P.A., S.E.L., N.A., B.D.J., L.L.B., D.A.B., J.A.S.), Departments of Internal Medicine (P.A., B.D.J., K.D.), Clinical Nutrition (P.A.), Neurological Sciences (S.E.L., N.T.A., L.J.C., L.L.B., D.A.B., J.A.S.) and Pathology (S.A., J.A.S.); and Rush Institute of Healthy Aging (K.D.), Rush University Medical Center, Chicago, IL.
Cherian LJ
From the Rush Alzheimer's Disease Center (P.A., S.E.L., N.A., B.D.J., L.L.B., D.A.B., J.A.S.), Departments of Internal Medicine (P.A., B.D.J., K.D.), Clinical Nutrition (P.A.), Neurological Sciences (S.E.L., N.T.A., L.J.C., L.L.B., D.A.B., J.A.S.) and Pathology (S.A., J.A.S.); and Rush Institute of Healthy Aging (K.D.), Rush University Medical Center, Chicago, IL.
James BD
From the Rush Alzheimer's Disease Center (P.A., S.E.L., N.A., B.D.J., L.L.B., D.A.B., J.A.S.), Departments of Internal Medicine (P.A., B.D.J., K.D.), Clinical Nutrition (P.A.), Neurological Sciences (S.E.L., N.T.A., L.J.C., L.L.B., D.A.B., J.A.S.) and Pathology (S.A., J.A.S.); and Rush Institute of Healthy Aging (K.D.), Rush University Medical Center, Chicago, IL.
Dhana K
From the Rush Alzheimer's Disease Center (P.A., S.E.L., N.A., B.D.J., L.L.B., D.A.B., J.A.S.), Departments of Internal Medicine (P.A., B.D.J., K.D.), Clinical Nutrition (P.A.), Neurological Sciences (S.E.L., N.T.A., L.J.C., L.L.B., D.A.B., J.A.S.) and Pathology (S.A., J.A.S.); and Rush Institute of Healthy Aging (K.D.), Rush University Medical Center, Chicago, IL.
Barnes LL
From the Rush Alzheimer's Disease Center (P.A., S.E.L., N.A., B.D.J., L.L.B., D.A.B., J.A.S.), Departments of Internal Medicine (P.A., B.D.J., K.D.), Clinical Nutrition (P.A.), Neurological Sciences (S.E.L., N.T.A., L.J.C., L.L.B., D.A.B., J.A.S.) and Pathology (S.A., J.A.S.); and Rush Institute of Healthy Aging (K.D.), Rush University Medical Center, Chicago, IL.
Bennett DA
From the Rush Alzheimer's Disease Center (P.A., S.E.L., N.A., B.D.J., L.L.B., D.A.B., J.A.S.), Departments of Internal Medicine (P.A., B.D.J., K.D.), Clinical Nutrition (P.A.), Neurological Sciences (S.E.L., N.T.A., L.J.C., L.L.B., D.A.B., J.A.S.) and Pathology (S.A., J.A.S.); and Rush Institute of Healthy Aging (K.D.), Rush University Medical Center, Chicago, IL.
Schneider JA
From the Rush Alzheimer's Disease Center (P.A., S.E.L., N.A., B.D.J., L.L.B., D.A.B., J.A.S.), Departments of Internal Medicine (P.A., B.D.J., K.D.), Clinical Nutrition (P.A.), Neurological Sciences (S.E.L., N.T.A., L.J.C., L.L.B., D.A.B., J.A.S.) and Pathology (S.A., J.A.S.); and Rush Institute of Healthy Aging (K.D.), Rush University Medical Center, Chicago, IL.

MeSH

HumansFemaleAgedAged, 80 and overMaleAlzheimer DiseaseDiet, MediterraneanAmyloid beta-PeptidesCognitive DysfunctionApolipoproteins E

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural

Language

eng

PubMed ID

36889921

Citation

Agarwal, Puja, et al. "Association of Mediterranean-DASH Intervention for Neurodegenerative Delay and Mediterranean Diets With Alzheimer Disease Pathology." Neurology, vol. 100, no. 22, 2023, pp. e2259-e2268.
Agarwal P, Leurgans SE, Agrawal S, et al. Association of Mediterranean-DASH Intervention for Neurodegenerative Delay and Mediterranean Diets With Alzheimer Disease Pathology. Neurology. 2023;100(22):e2259-e2268.
Agarwal, P., Leurgans, S. E., Agrawal, S., Aggarwal, N. T., Cherian, L. J., James, B. D., Dhana, K., Barnes, L. L., Bennett, D. A., & Schneider, J. A. (2023). Association of Mediterranean-DASH Intervention for Neurodegenerative Delay and Mediterranean Diets With Alzheimer Disease Pathology. Neurology, 100(22), e2259-e2268. https://doi.org/10.1212/WNL.0000000000207176
Agarwal P, et al. Association of Mediterranean-DASH Intervention for Neurodegenerative Delay and Mediterranean Diets With Alzheimer Disease Pathology. Neurology. 2023 05 30;100(22):e2259-e2268. PubMed PMID: 36889921.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Association of Mediterranean-DASH Intervention for Neurodegenerative Delay and Mediterranean Diets With Alzheimer Disease Pathology. AU - Agarwal,Puja, AU - Leurgans,Sue E, AU - Agrawal,Sonal, AU - Aggarwal,Neelum T, AU - Cherian,Laurel J, AU - James,Bryan D, AU - Dhana,Klodian, AU - Barnes,Lisa L, AU - Bennett,David A, AU - Schneider,Julie A, Y1 - 2023/03/08/ PY - 2022/09/01/received PY - 2023/01/26/accepted PY - 2023/5/31/medline PY - 2023/3/9/pubmed PY - 2023/3/8/entrez SP - e2259 EP - e2268 JF - Neurology JO - Neurology VL - 100 IS - 22 N2 - BACKGROUND AND OBJECTIVES: Diet may reduce Alzheimer dementia risk and slow cognitive decline, but the understanding of the relevant neuropathologic mechanisms remains limited. The association of dietary patterns with Alzheimer disease (AD) pathology has been suggested using neuroimaging biomarkers. This study examined the association of Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND) and Mediterranean dietary patterns with β-amyloid load, phosphorylated tau tangles, and global AD pathology in postmortem brain tissue of older adults. METHODS: Autopsied participants of the Rush Memory and Aging Project with complete dietary information (collected through a validated food frequency questionnaire) and AD pathology data (β-amyloid load, phosphorylated tau tangles, and global AD pathology [summarized neurofibrillary tangles and neuritic and diffuse plaques]) were included in this study. Linear regression models controlled for age at death, sex, education, APOE-ε4 status, and total calories were used to investigate the dietary patterns (MIND and Mediterranean diets) and dietary components associated with AD pathology. Further effect modification was tested for APOE-ε4 status and sex. RESULTS: Among our study participants (N = 581, age at death: 91.0 ± 6.3 years; mean age at first dietary assessment: 84.2 ± 5.8 years; 73% female; 6.8 ± 3.9 years of follow-up), dietary patterns were associated with lower global AD pathology (MIND: β = -0.022, p = 0.034, standardized β = -2.0; Mediterranean: β = -0.007, p = 0.039, standardized β = -2.3) and specifically less β-amyloid load (MIND: β = -0.068, p = 0.050, standardized β = -2.0; Mediterranean: β = -0.040, p = 0.004, standardized β = -2.9). The findings persisted when further adjusted for physical activity, smoking, and vascular disease burden. The associations were also retained when participants with mild cognitive impairment or dementia at the baseline dietary assessment were excluded. Those in the highest tertile of green leafy vegetables intake had less global AD pathology when compared with those in the lowest tertile (tertile 3 vs tertile 1: β = -0.115, p = 0.0038). DISCUSSION: The MIND and Mediterranean diets are associated with less postmortem AD pathology, primarily β-amyloid load. Among dietary components, higher green leafy vegetable intake was associated with less AD pathology. SN - 1526-632X UR - https://www.unboundmedicine.com/medline/citation/36889921/full_citation DB - PRIME DP - Unbound Medicine ER -
Grapherence [↓82 ↑49]

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