Is There A Link Between Midlife Dietary Pattern and Later Cognitive Decline?
BACKGROUND AND PURPOSE:
It is unclear if midlife healthy dietary patterns may protect against dementia and mild cognitive impairment
Dearborn-Tomazos et al. (JAMA Network Open, 2019) investigated a US population without dementia to determine whether there is an association between dietary patterns in midlife with cognitive function in later life
Observational cohort study
Community-dwelling individuals participating in the Atherosclerosis Risk in Communities (ARIC) study (began in 1987 and study is ongoing)
Randomly selected and recruited | 45 to 64 years of age
Western (unhealthy) dietary pattern
Higher consumption of meats, fried foods and processed grains
Prudent (healthier) dietary pattern
Higher in fruits and vegetables, fish, chicken, whole grains etc.
Participants were assigned into the exposure groups based on food questionnaire
Cognitive assessment based on validated cognitive tests
Dementia based on in-person assessments, telephone interviews or hospital discharge codes and death certificates
Models were generated that adjusted for confounders such as age, education, CVD, alcohol use etc.
Primary outcomes (changes over 20 years)
Estimated 20 year change in cognitive function
Relative Risk of incident Dementia
13,588 total participants
7588 (55.8%) women | Mean age of 54.6 years at baseline
Cognitive scores at baseline were
Lower in participants with a Western diet
Higher in participants with a prudent diet
Differences related to cigarette smoking, eating excess calories, or engaging in less physical activity
Estimated 20-year change in global cognitive function did not differ by dietary pattern when adjusted for confounders
The risk of incident dementia did not differ by dietary pattern when adjusted for confounders (p for trend = 0.34)
Hazard ratios (HR) vs healthiest diet pattern score (Tertile 1)
Tertile 2: HR 0.97 (95% CI, 0.87 to 1.07)
Tertile 3: HR 0.99 (95% CI, 0.88 to 1.12)
The authors acknowledge that while long-term follow-up is a strength of this study, they could not account for all the changes that may occur related to dietary intake and food supply over 20 years
The results of this study suggest that eating a Western (unhealthy) diet in midlife, compared to a more prudent (healthier) diet, is not associated with cognitive decline nor dementia in later life
No significant differences in processing speed, word fluency, memory, or incident dementia were identified
A multimodal approach to reduce cognitive aging may be more beneficial than focusing on diet alone
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