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#Grand Rounds

Is There A Link Between Midlife Dietary Pattern and Later Cognitive Decline?

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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

METHODS:

  • Observational cohort study
  • Study population
    • 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
  • Exposures
    • 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.
  • Study design
    • 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

RESULTS:

  • 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)

CONCLUSION:

  • 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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Learn More – Primary Sources:

Association of Dietary Patterns in Midlife and Cognitive Function in Later Life in US Adults Without Dementia

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Related ObG Topics:

Does a Healthy Lifestyle Decrease Risk of Dementia Even in Those with High Genetic Risk?
Does Fish Consumption Reduce Risk of Dementia?
Lancet Commission: Over a Third of Dementia Cases May be Preventable

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