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Chen X, Walton K, Brodaty H, Chalton K. Polyphenols and Diets as Current and Potential Nutrition Senotherapeutics in Alzheimer's Disease: Findings from Clinical Trials. J Alzheimers Dis 2024:JAD231222. [PMID: 38875032 DOI: 10.3233/jad-231222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/16/2024]
Abstract
Cellular senescence, a hallmark of aging, plays an important role in age-related conditions among older adults. Targeting senescent cells and its phenotype may provide a promising strategy to delay the onset or progression of Alzheimer's disease (AD). In this review article, we investigated efficacy and safety of nutrition senotherapy in AD, with a focus on the role of polyphenols as current and potential nutrition senotherapeutic agents, as well as relevant dietary patterns. Promising results with neuroprotective effects of senotherapeutic agents such as quercetin, resveratrol, Epigallocatechin-gallate, curcumin and fisetin were reported from preclinical studies. However, in-human trials remain limited, and findings were inconclusive. In future, nutrition senotherapeutic agents should be studied both individually and within dietary patterns, through the perspective of cellular senescence and AD. Further studies are warranted to investigate bioavailability, dosing regimen, long term effects of nutrition senotherapy and provide better understanding of the underlying mechanisms. Collaboration between researchers needs to be established, and methodological limitations of current studies should be addressed.
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Affiliation(s)
- Xi Chen
- School of Medical, Indigenous and Health Sciences, Faculty of Science, Medicine and Health, University of Wollongong, NSW, Australia
- Centre for Healthy Brain Ageing (CHeBA), School of Psychiatry, University of New South Wales, NSW, Australia
| | - Karen Walton
- School of Medical, Indigenous and Health Sciences, Faculty of Science, Medicine and Health, University of Wollongong, NSW, Australia
| | - Henry Brodaty
- Centre for Healthy Brain Ageing (CHeBA), School of Psychiatry, University of New South Wales, NSW, Australia
| | - Karen Chalton
- School of Medical, Indigenous and Health Sciences, Faculty of Science, Medicine and Health, University of Wollongong, NSW, Australia
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Ruiz-Rizzo AL, Finke K, Damoiseaux JS, Bartels C, Buerger K, Cosma NC, Dechent P, Dobisch L, Ewers M, Fliessbach K, Frommann I, Glanz W, Goerss D, Hetzer S, Incesoy EI, Janowitz D, Kilimann I, Laske C, van Lent DM, Munk MHJ, Peters O, Priller J, Ramirez A, Rostamzadeh A, Roy N, Scheffler K, Schneider A, Spottke A, Spruth EJ, Teipel S, Wagner M, Wiltfang J, Yakupov R, Jessen F, Duezel E, Perneczky R, Rauchmann BS. Fornix fractional anisotropy mediates the association between Mediterranean diet adherence and memory four years later in older adults without dementia. Neurobiol Aging 2024; 136:99-110. [PMID: 38340637 DOI: 10.1016/j.neurobiolaging.2024.01.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Revised: 01/24/2024] [Accepted: 01/26/2024] [Indexed: 02/12/2024]
Abstract
Here, we investigated whether fractional anisotropy (FA) of hippocampus-relevant white-matter tracts mediates the association between baseline Mediterranean diet adherence (MeDiAd) and verbal episodic memory over four years. Participants were healthy older adults with and without subjective cognitive decline and patients with amnestic mild cognitive impairment from the DELCODE cohort study (n = 376; age: 71.47 ± 6.09 years; 48.7 % female). MeDiAd and diffusion data were obtained at baseline. Verbal episodic memory was assessed at baseline and four yearly follow-ups. The associations between baseline MeDiAd and white matter, and verbal episodic memory's mean and rate of change over four years were tested with latent growth curve modeling. Baseline MeDiAd was associated with verbal episodic memory four years later (95 % confidence interval, CI [0.01, 0.32]) but not with its rate of change over this period. Baseline Fornix FA mediated - and, thus, explained - that association (95 % CI [0.002, 0.09]). Fornix FA may be an appropriate response biomarker of Mediterranean diet interventions on verbal memory in older adults.
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Affiliation(s)
- Adriana L Ruiz-Rizzo
- Department of Neurology, Jena University Hospital, Jena, Germany; Department of Psychology, General and Experimental Psychology Unit, LMU Munich, Munich, Germany.
| | - Kathrin Finke
- Department of Neurology, Jena University Hospital, Jena, Germany; Department of Psychology, General and Experimental Psychology Unit, LMU Munich, Munich, Germany
| | - Jessica S Damoiseaux
- Department of Psychology, Wayne State University, Detroit, MI, USA; Institute of Gerontology, Wayne State University, Detroit, MI, USA
| | - Claudia Bartels
- Department of Psychiatry and Psychotherapy, University Medical Center Goettingen, University of Goettingen, Goettingen, Germany
| | - Katharina Buerger
- German Center for Neurodegenerative Diseases (DZNE, Munich), Munich, Germany; Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich, Munich, Germany
| | - Nicoleta Carmen Cosma
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin-Institute of Psychiatry and Psychotherapy, Germany
| | - Peter Dechent
- MR-Research in Neurosciences, Department of Cognitive Neurology, Georg-August-University Goettingen, Germany
| | - Laura Dobisch
- German Center for Neurodegenerative Diseases (DZNE), Magdeburg, Germany
| | - Michael Ewers
- German Center for Neurodegenerative Diseases (DZNE, Munich), Munich, Germany; Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich, Munich, Germany
| | - Klaus Fliessbach
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany; University of Bonn Medical Center, Dept. of Neurodegenerative Disease and Geriatric Psychiatry/Psychiatry, Bonn, Germany
| | - Ingo Frommann
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany; University of Bonn Medical Center, Dept. of Neurodegenerative Disease and Geriatric Psychiatry/Psychiatry, Bonn, Germany
| | - Wenzel Glanz
- German Center for Neurodegenerative Diseases (DZNE), Magdeburg, Germany
| | - Doreen Goerss
- German Center for Neurodegenerative Diseases (DZNE), Rostock, Germany; Department of Psychosomatic Medicine, Rostock University Medical Center, Rostock, Germany
| | - Stefan Hetzer
- Bernstein Center for Computational Neuroscience, Charité - Universitätsmedizin, Berlin, Germany
| | - Enise I Incesoy
- German Center for Neurodegenerative Diseases (DZNE), Magdeburg, Germany; Institute of Cognitive Neurology and Dementia Research (IKND), Otto-von-Guericke University, Magdeburg, Germany; Department for Psychiatry and Psychotherapy, University Clinic Magdeburg, Germany
| | - Daniel Janowitz
- German Center for Neurodegenerative Diseases (DZNE, Munich), Munich, Germany
| | - Ingo Kilimann
- German Center for Neurodegenerative Diseases (DZNE), Rostock, Germany; Department of Psychosomatic Medicine, Rostock University Medical Center, Rostock, Germany
| | - Christoph Laske
- German Center for Neurodegenerative Diseases (DZNE), Tübingen, Germany; Section for Dementia Research, Hertie Institute for Clinical Brain Research and Department of Psychiatry and Psychotherapy, University of Tübingen, Tübingen, Germany
| | - Debora Melo van Lent
- Glenn Biggs Institute for Alzheimer's & Neurodegenerative Diseases, UT Health San Antonio, San Antonio, TX, USA; Department of Neurology, Boston University School of Medicine, Boston, MA, USA; The Framingham Heart Study, Framingham, MA, USA
| | - Matthias H J Munk
- German Center for Neurodegenerative Diseases (DZNE), Tübingen, Germany; Department of Psychiatry and Psychotherapy, University of Tübingen, Tübingen, Germany
| | - Oliver Peters
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin-Institute of Psychiatry and Psychotherapy, Germany; German Center for Neurodegenerative Diseases (DZNE), Berlin, Germany
| | - Josef Priller
- German Center for Neurodegenerative Diseases (DZNE), Berlin, Germany; Department of Psychiatry and Psychotherapy, Charité, Berlin, Germany; School of Medicine, Technical University of Munich; Department of Psychiatry and Psychotherapy, Munich, Germany; University of Edinburgh and UK DRI, Edinburgh, UK
| | - Alfredo Ramirez
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany; University of Bonn Medical Center, Dept. of Neurodegenerative Disease and Geriatric Psychiatry/Psychiatry, Bonn, Germany; Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), University of Cologne, Cologne, Germany; Division of Neurogenetics and Molecular Psychiatry, Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany; Department of Psychiatry & Glenn Biggs Institute for Alzheimer's and Neurodegenerative Diseases, San Antonio, TX, USA
| | - Ayda Rostamzadeh
- Department of Psychiatry, University of Cologne, Medical Faculty, Cologne, Germany
| | - Nina Roy
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
| | - Klaus Scheffler
- Department for Biomedical Magnetic Resonance, University of Tübingen, Tübingen, Germany
| | - Anja Schneider
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany; University of Bonn Medical Center, Dept. of Neurodegenerative Disease and Geriatric Psychiatry/Psychiatry, Bonn, Germany
| | - Annika Spottke
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany; Department of Neurology, University of Bonn, Bonn, Germany
| | - Eike Jakob Spruth
- German Center for Neurodegenerative Diseases (DZNE), Berlin, Germany; Department of Psychiatry and Psychotherapy, Charité, Berlin, Germany
| | - Stefan Teipel
- German Center for Neurodegenerative Diseases (DZNE), Rostock, Germany; Department of Psychosomatic Medicine, Rostock University Medical Center, Rostock, Germany
| | - Michael Wagner
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany; University of Bonn Medical Center, Dept. of Neurodegenerative Disease and Geriatric Psychiatry/Psychiatry, Bonn, Germany
| | - Jens Wiltfang
- Department of Psychiatry and Psychotherapy, University Medical Center Goettingen, University of Goettingen, Goettingen, Germany; Neurosciences and Signaling Group, Institute of Biomedicine (iBiMED), Department of Medical Sciences, University of Aveiro, Aveiro, Portugal
| | - Renat Yakupov
- German Center for Neurodegenerative Diseases (DZNE), Magdeburg, Germany
| | - Frank Jessen
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany; Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), University of Cologne, Cologne, Germany; Department of Psychiatry, University of Cologne, Medical Faculty, Cologne, Germany
| | - Emrah Duezel
- German Center for Neurodegenerative Diseases (DZNE), Magdeburg, Germany; Institute of Cognitive Neurology and Dementia Research (IKND), Otto-von-Guericke University, Magdeburg, Germany; Department of Psychiatry and Psychotherapy, Otto-von-Guericke University, Magdeburg, Germany; Department of Neurology, Otto-von-Guericke University, Magdeburg, Germany
| | - Robert Perneczky
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Germany; German Center for Neurodegenerative Diseases (DZNE), Munich, Germany; Ageing Epidemiology (AGE) Research Unit, School of Public Health, Imperial College, London, UK; Munich Cluster for Systems Neurology (SyNergy), Munich, Germany; Sheffield Institute for Translational Neuroscience (SITraN), University of Sheffield, Sheffield, UK
| | - Boris-Stephan Rauchmann
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Germany; German Center for Neurodegenerative Diseases (DZNE), Munich, Germany; Sheffield Institute for Translational Neuroscience (SITraN), University of Sheffield, Sheffield, UK; Institute of Neuroradiology, University Hospital, LMU Munich, Germany
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Randolph JJ, Lacritz LH, Colvin MK, Espe-Pfeifer P, Carter KR, Arnett PA, Fox-Fuller J, Aduen PA, Cullum CM, Sperling SA. Integrating Lifestyle Factor Science into Neuropsychological Practice: A National Academy of Neuropsychology Education Paper. Arch Clin Neuropsychol 2024; 39:121-139. [PMID: 37873931 DOI: 10.1093/arclin/acad078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/26/2023] [Indexed: 10/25/2023] Open
Abstract
OBJECTIVE The primary aim of this paper is to review evidence and clinical implications related to lifestyle activities associated with promoting brain and cognitive health. Our review targets four key lifestyle factors: physical activity and exercise, social engagement, cognitively stimulating activity, and consuming Mediterranean-style diets. METHOD We conducted a critical review of the lifestyle factor literature in the four domains listed earlier. We contextualize this literature review by translating findings, when possible, into evidence-based recommendations to consider when providing neuropsychological services. RESULTS There is significant current evidence supporting the role of physical activity and exercise, social engagement, cognitively stimulating activity, and consuming Mediterranean-style diets on positive brain and cognitive health outcomes. While some null findings are present in all four areas reviewed, the weight of the evidence supports the notion that engaging in these activities may promote brain and cognitive functioning. CONCLUSIONS Clinical neuropsychologists can have confidence in recommending engagement in physical activity, social activity, and cognitively stimulating activity, and adhering to a Mediterranean-style diet to promote brain and cognitive health. We discuss limitations in existing lifestyle factor research and future directions to enhance the existing evidence base, including additional research with historically underrepresented groups and individuals with neurological conditions.
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Affiliation(s)
- John J Randolph
- Department of Psychiatry, Geisel School of Medicine at Dartmouth, Lebanon, NH, USA
- Randolph Neuropsychology Associates, PLLC, Lebanon, NH, USA
| | - Laura H Lacritz
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA
- Department of Neurology, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Mary K Colvin
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Patricia Espe-Pfeifer
- Department of Psychiatry & Pediatrics, University of Iowa Hospitals and Clinics, Iowa City, IA, USA
| | | | - Peter A Arnett
- Psychology Department, The Pennsylvania State University, University Park, PA, USA
| | - Joshua Fox-Fuller
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
- Department of Psychological & Brain Sciences, Boston University, Boston, MA, USA
| | - Paula A Aduen
- Department of Psychiatry and Psychology, Mayo Clinic College of Medicine, Jacksonville, FL, USA
| | - C Munro Cullum
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA
- Department of Neurology, University of Texas Southwestern Medical Center, Dallas, TX, USA
- Department of Neurological Surgery, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Scott A Sperling
- Center for Neurological Restoration, Department of Neurology, Cleveland Clinic, Cleveland, Ohio, USA
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Barg G, Frndak S, Queirolo EI, Peregalli F, Kordas K. Dietary patterns and cognitive achievement among school children in socio-cultural context, a case of Montevideo, Uruguay. Eur J Nutr 2023; 62:2475-2488. [PMID: 37148356 PMCID: PMC10927011 DOI: 10.1007/s00394-023-03167-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Accepted: 04/27/2023] [Indexed: 05/08/2023]
Abstract
PURPOSE The benefits of a healthy diet on children´s cognition have been described in several studies. However, many previous studies have analyzed the effect on general cognitive domains (e.g. intelligence), used measures based almost exclusively on local examinations, and rarely consider social context. OBJECTIVE The objective of the present study was to examine the relationship between two diet patterns and contextualized cognitive performance measures of children aged 6-8 years from low-average income neighborhoods in Montevideo, Uruguay. METHODS 270 first-grade children with complete data participated in the study. Consumption of foods was determined via two averaged 24-h dietary recalls with the mother. Two dietary patterns were identified via principal component analysis: "processed (high calorie) foods" and "nutrient dense". Children´s cognitive performance, including general cognitive abilities, achievement in mathematics and reading, and discrepancy scores between predicted and actual achievement was assessed with the Woodcock-Muñoz Cognitive and Achievement scales. The association of dietary patterns and cognitive endpoints was analyzed in multilevel models, clustered by children´s school. Sociodemographic and biological variables were used as covariates. RESULTS The nutrient dense foods pattern, characterized by higher consumption of dark leafy and red-orange vegetables, eggs, beans & peas, potatoes, was associated with better performance in reading, with beta coefficient 3.28 (95% CI 0.02, 6.54). There was also an association between the nutrient dense foods factor and the Discrepancy in reading, 2.52 (0.17, 4.87). Processed (high calorie) foods pattern, characterized by higher consumption of breads, processed meats, fats and oils, sweetened beverages, and sweetened yogurt/dairy products; reduced intake of milk, pastries and pizza dinners was not associated with cognitive performance. CONCLUSIONS Nutrient dense food pattern was positively associated with children's reading achievement. A nutrient-rich diet may benefit written language acquisition at the beginning of schooling.
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Affiliation(s)
- Gabriel Barg
- Department of Neuroscience and Learning, Faculty of Health Sciences, Universidad Católica del Uruguay, Comandante Braga 2715, CP 11600, Montevideo, Uruguay.
| | - Seth Frndak
- Department of Epidemiology and Environmental Health, University at Buffalo, Buffalo, NY, USA
| | - Elena I Queirolo
- Department of Neuroscience and Learning, Faculty of Health Sciences, Universidad Católica del Uruguay, Comandante Braga 2715, CP 11600, Montevideo, Uruguay
| | - Fabiana Peregalli
- Department of Neuroscience and Learning, Faculty of Health Sciences, Universidad Católica del Uruguay, Comandante Braga 2715, CP 11600, Montevideo, Uruguay
| | - Katarzyna Kordas
- Department of Epidemiology and Environmental Health, University at Buffalo, Buffalo, NY, USA
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5
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Badji A, Youwakim J, Cooper A, Westman E, Marseglia A. Vascular cognitive impairment - Past, present, and future challenges. Ageing Res Rev 2023; 90:102042. [PMID: 37634888 DOI: 10.1016/j.arr.2023.102042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Revised: 08/22/2023] [Accepted: 08/23/2023] [Indexed: 08/29/2023]
Abstract
Vascular cognitive impairment (VCI) is a lifelong process encompassing a broad spectrum of cognitive disorders, ranging from subtle or mild deficits to prodromal and fully developed dementia, originating from cerebrovascular lesions such as large and small vessel disease. Genetic predisposition and environmental exposure to risk factors such as unhealthy lifestyles, hypertension, cardiovascular disease, and metabolic disorders will synergistically interact, yielding biochemical and structural brain changes, ultimately culminating in VCI. However, little is known about the pathological processes underlying VCI and the temporal dynamics between risk factors and disease mechanisms (biochemical and structural brain changes). This narrative review aims to provide an evidence-based summary of the link between individual vascular risk/disorders and cognitive dysfunction and the potential structural and biochemical pathophysiological processes. We also discuss some key challenges for future research on VCI. There is a need to shift from individual risk factors/disorders to comorbid vascular burden, identifying and integrating imaging and fluid biomarkers, implementing a life-course approach, considering possible neuroprotective influences of positive life exposures, and addressing biological sex at birth and gender differences. Finally, this review highlights the need for future researchers to leverage and integrate multidimensional data to advance our understanding of the mechanisms and pathophysiology of VCI.
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Affiliation(s)
- Atef Badji
- Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden; Theme Inflammation and Aging, Karolinska University Hospital, Stockholm, Sweden
| | - Jessica Youwakim
- Department of Pharmacology and Physiology, Université de Montréal, Montreal, QC, Canada; Centre interdisciplinaire de recherche sur le cerveau et l'apprentissage (CIRCA), Montreal, QC, Canada; Groupe de Recherche sur la Signalisation Neuronal et la Circuiterie (SNC), Montreal, QC, Canada
| | - Alexandra Cooper
- Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden; Unit of Integrative Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Eric Westman
- Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden; Department of Neuroimaging, Centre for Neuroimaging Sciences, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK
| | - Anna Marseglia
- Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.
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van der Heide FCT, Mokhtar S, Khanna A, Said M, Henry RMA, Kroon AA, Dagnelie PC, Eussen SJPM, Berendschot TTJM, Schouten JSAG, Schram MT, van der Kallen CJH, van Greevenbroek MMJ, Wesselius A, Savelberg HHCM, Schaper NC, Webers CAB, Stehouwer CDA. Retinal Functional and Structural Neural Indices: Potential Biomarkers for the Monitoring of Cerebral Neurodegeneration: The Maastricht Study. J Alzheimers Dis 2023:JAD230104. [PMID: 37182886 DOI: 10.3233/jad-230104] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
BACKGROUND If retinal indices of neurodegeneration are to be biomarkers for the monitoring of cerebral neurodegeneration, it is important to establish whether potentially modifiable risk factors for dementia are associated with retinal neurodegenerative changes. OBJECTIVE To study associations of dementia risk factors with retinal sensitivity, an index of retinal neural function, and retinal nerve fiber layer (RNFL) thickness, an index of retinal neural structure. METHODS We used cross-sectional data from The Maastricht Study (up to 5,666 participants, 50.5% men, mean age 59.7), and investigated associations with regression analyses (adjusted for potential confounders). RESULTS Most risk factors under study (i.e., hyperglycemia, unhealthy diet, lower cardiorespiratory fitness, smoking, alcohol consumption, and hypertension) were significantly associated with lower retinal sensitivity and lower RNFL thickness. CONCLUSION Findings of this population-based study support the concept that retinal neural indices may be biomarkers for the monitoring of therapeutic strategies that aim to prevent early-stage cerebral neurodegeneration and, ultimately, dementia.
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Affiliation(s)
- Frank C T van der Heide
- CARIM School for Cardiovascular Diseases, Maastricht University (UM), The Netherlands
- Department of Internal Medicine, Maastricht University Medical Centre+ (MUMC+), The Netherlands
- MHeNS School of Mental Health and Neuroscience, Maastricht University (UM), The Netherlands
- University Eye Clinic Maastricht, MUMC+, TheNetherlands
| | - Sara Mokhtar
- CARIM School for Cardiovascular Diseases, Maastricht University (UM), The Netherlands
- Department of Internal Medicine, Maastricht University Medical Centre+ (MUMC+), The Netherlands
- MHeNS School of Mental Health and Neuroscience, Maastricht University (UM), The Netherlands
- University Eye Clinic Maastricht, MUMC+, TheNetherlands
| | - Anjani Khanna
- Department of Ophthalmology, Sharpsight eye hospital, New Delhi, India
| | - Mozhda Said
- CARIM School for Cardiovascular Diseases, Maastricht University (UM), The Netherlands
- Department of Internal Medicine, Maastricht University Medical Centre+ (MUMC+), The Netherlands
| | - Ronald M A Henry
- CARIM School for Cardiovascular Diseases, Maastricht University (UM), The Netherlands
- Department of Internal Medicine, Maastricht University Medical Centre+ (MUMC+), The Netherlands
- Heart and Vascular Centre, MUMC+ Maastricht, The Netherlands
| | - Abraham A Kroon
- CARIM School for Cardiovascular Diseases, Maastricht University (UM), The Netherlands
- Department of Internal Medicine, Maastricht University Medical Centre+ (MUMC+), The Netherlands
| | - Pieter C Dagnelie
- CARIM School for Cardiovascular Diseases, Maastricht University (UM), The Netherlands
- Department of Internal Medicine, Maastricht University Medical Centre+ (MUMC+), The Netherlands
| | - Simone J P M Eussen
- CARIM School for Cardiovascular Diseases, Maastricht University (UM), The Netherlands
- Department of Epidemiology, UM, The Netherlands
- CAPHRI Care and Public Health Research Institute, UM, The Netherlands
| | - Tos T J M Berendschot
- MHeNS School of Mental Health and Neuroscience, Maastricht University (UM), The Netherlands
- University Eye Clinic Maastricht, MUMC+, TheNetherlands
| | - Jan S A G Schouten
- University Eye Clinic Maastricht, MUMC+, TheNetherlands
- Department of Ophthalmology, Canisius Wilhelmina Hospital, Nijmegen, The Netherlands
| | - Miranda T Schram
- CARIM School for Cardiovascular Diseases, Maastricht University (UM), The Netherlands
- Department of Internal Medicine, Maastricht University Medical Centre+ (MUMC+), The Netherlands
- MHeNS School of Mental Health and Neuroscience, Maastricht University (UM), The Netherlands
- Heart and Vascular Centre, MUMC+ Maastricht, The Netherlands
| | - Carla J H van der Kallen
- CARIM School for Cardiovascular Diseases, Maastricht University (UM), The Netherlands
- Department of Internal Medicine, Maastricht University Medical Centre+ (MUMC+), The Netherlands
| | - Marleen M J van Greevenbroek
- CARIM School for Cardiovascular Diseases, Maastricht University (UM), The Netherlands
- Department of Internal Medicine, Maastricht University Medical Centre+ (MUMC+), The Netherlands
| | - Anke Wesselius
- Department of Genetics and Cell Biology, Complex Genetics, UM, The Netherlands
- NUTRIM School for Nutrition and Translational Research in Metabolism, UM, The Netherlands
| | - Hans H C M Savelberg
- NUTRIM School for Nutrition and Translational Research in Metabolism, UM, The Netherlands
- Department of Nutrition and Movement Sciences, UM, The Netherlands
| | - Nicolaas C Schaper
- CARIM School for Cardiovascular Diseases, Maastricht University (UM), The Netherlands
- Department of Social Medicine, MUMC+, The Netherlands
- Department of Internal Medicine, Division of Endocrinology and Metabolic Disease, Maastricht University Medical Centre+, Maastricht, The Netherlands
| | - Carroll A B Webers
- MHeNS School of Mental Health and Neuroscience, Maastricht University (UM), The Netherlands
- University Eye Clinic Maastricht, MUMC+, TheNetherlands
| | - Coen D A Stehouwer
- CARIM School for Cardiovascular Diseases, Maastricht University (UM), The Netherlands
- Department of Internal Medicine, Maastricht University Medical Centre+ (MUMC+), The Netherlands
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7
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Arnoldy L, Gauci S, Young LM, Marx W, Macpherson H, Pipingas A, Civier O, White DJ. The association of dietary and nutrient patterns on neurocognitive decline: A systematic review of MRI and PET studies. Ageing Res Rev 2023; 87:101892. [PMID: 36878405 DOI: 10.1016/j.arr.2023.101892] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Revised: 02/14/2023] [Accepted: 02/27/2023] [Indexed: 03/08/2023]
Abstract
BACKGROUND As the global population ages, there has been a growing incidence of neurodegenerative diseases such as Alzheimer's. More recently, studies exploring the relationship between dietary patterns and neuroimaging outcomes have received particular attention. This systematic literature review provides a structured overview of the association between dietary and nutrient patterns on neuroimaging outcomes and cognitive markers in middle-aged to older adults. A comprehensive literature search was conducted to find relevant articles published from 1999 to date using the following databases Ovid MEDLINE, Embase, PubMed, Scopus and Web of Science. The inclusion criteria for the articles comprised studies reporting on the association between dietary patterns and neuroimaging outcomes, which includes both specific pathological hallmarks of neurodegenerative diseases such as Aβ and tau and nonspecific markers such as structural MRI and glucose metabolism. The risk of bias was evaluated using the Quality Assessment tool from the National Heart, Lung, and Blood Institute of the National Institutes of Health. The results were then organized into a summary of results table, collated based on synthesis without meta-analysis. After conducting the search, 6050 records were extracted and screened for eligibility, with 107 eligible for full-text screening and 42 articles ultimately being included in this review. The results of the systematic review indicate that there is some evidence suggesting that healthy dietary and nutrient patterns were associated with neuroimaging measures, indicative of a protective influence on neurodegeneration and brain ageing. Conversely, unhealthy dietary and nutrient patterns showed evidence pointing to decreased brain volumes, poorer cognition and increased Aβ deposition. Future research should focus on sensitive neuroimaging acquisition and analysis methods, to study early neurodegenerative changes and identify critical periods for interventions and prevention. SYSTEMATIC REVIEW REGISTRATION PROSPERO registration no, CRD42020194444).
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Affiliation(s)
- Lizanne Arnoldy
- Centre of Human Psychopharmacology, Centre for Mental Health and Brain Sciences, Swinburne University, Melbourne Australia.
| | - Sarah Gauci
- Centre of Human Psychopharmacology, Centre for Mental Health and Brain Sciences, Swinburne University, Melbourne Australia; IMPACT - the Institute for Mental and Physical Health and Clinical Translation, Food & Mood Centre, School of Medicine, Deakin University, Geelong, Australia
| | - Lauren M Young
- Centre of Human Psychopharmacology, Centre for Mental Health and Brain Sciences, Swinburne University, Melbourne Australia; IMPACT - the Institute for Mental and Physical Health and Clinical Translation, Food & Mood Centre, School of Medicine, Deakin University, Geelong, Australia
| | - Wolfgang Marx
- IMPACT - the Institute for Mental and Physical Health and Clinical Translation, Food & Mood Centre, School of Medicine, Deakin University, Geelong, Australia
| | - Helen Macpherson
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC, Australia
| | - Andrew Pipingas
- Centre of Human Psychopharmacology, Centre for Mental Health and Brain Sciences, Swinburne University, Melbourne Australia
| | - Oren Civier
- Swinburne Neuroimaging, Swinburne University, Melbourne, Australia
| | - David J White
- Centre of Human Psychopharmacology, Centre for Mental Health and Brain Sciences, Swinburne University, Melbourne Australia; Swinburne Neuroimaging, Swinburne University, Melbourne, Australia
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8
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Perus L, Mangin JF, Deverdun J, Gutierrez LA, Gourieux E, Fischer C, Van Dokkum LEH, Manesco C, Busto G, Guyonnet S, Vellas B, Gabelle A, Le Bars E. Impact of multidomain preventive strategies on functional brain connectivity in older adults with cognitive complaint: Subset from the Montpellier center of the ancillary MAPT-MRI study. Front Aging Neurosci 2023; 14:971220. [PMID: 36705622 PMCID: PMC9871772 DOI: 10.3389/fnagi.2022.971220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Accepted: 12/15/2022] [Indexed: 01/12/2023] Open
Abstract
Introduction The impact of multi-domain preventive interventions on older adults, in particular on those with higher risk to develop Alzheimer's disease (AD), could be beneficial, as it may delay cognitive decline. However, the precise mechanism of such positive impact is not fully understood and may involve brain reserve and adaptability of brain functional connectivity (FC). Methods To determine the effect of multidomain interventions (involving physical activity, cognitive training, nutritional counseling alone or in combination with omega-3 fatty acid supplementation and vs. a placebo) on the brain, longitudinal FC changes were assessed after 36 months of intervention on 100 older adults (above 70 year-old) with subjective cognitive complaints. Results No global change in FC was detected after uni or multidomain preventive interventions. However, an effect of omega-3 fatty acid supplementation dependent on cognitive decline status was underlined for frontoparietal, salience, visual and sensorimotor networks FC. These findings were independent of the cortical thickness and vascular burden. Discussion These results emphasize the importance of patient stratification, based on risk factors, for preventive interventions.
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Affiliation(s)
- Lisa Perus
- Memory Resources and Research Center, Department of Neurology, Gui de Chauliac Hospital, Montpellier, France,INM, Univ Montpellier, INSERM, CHU Montpellier, Montpellier, France,Institut d'Imagerie Fonctionnelle Humaine, I2FH, Department of Neuroradiology, Gui de Chauliac Hospital and University of Montpellier, Montpellier, France,CATI, US52-UAR2031, CEA, ICM, SU, CNRS, INSERM, APHP, Ile de France, France
| | - Jean-François Mangin
- CATI, US52-UAR2031, CEA, ICM, SU, CNRS, INSERM, APHP, Ile de France, France,Université Paris-Saclay, CEA, CNRS, Neurospin, UMR9027 Baobab, Gif-sur-Yvette, France
| | - Jérémy Deverdun
- Institut d'Imagerie Fonctionnelle Humaine, I2FH, Department of Neuroradiology, Gui de Chauliac Hospital and University of Montpellier, Montpellier, France
| | | | | | - Clara Fischer
- CATI, US52-UAR2031, CEA, ICM, SU, CNRS, INSERM, APHP, Ile de France, France
| | - Liesjet E. H. Van Dokkum
- Institut d'Imagerie Fonctionnelle Humaine, I2FH, Department of Neuroradiology, Gui de Chauliac Hospital and University of Montpellier, Montpellier, France
| | - Clara Manesco
- Laboratoire Charles Coulomb (L2C), University of Montpellier, CNRS, Montpellier, France
| | - Germain Busto
- Memory Resources and Research Center, Department of Neurology, Gui de Chauliac Hospital, Montpellier, France,INM, Univ Montpellier, INSERM, CHU Montpellier, Montpellier, France
| | - Sophie Guyonnet
- Inserm UMR 1295, University of Toulouse III, Toulouse, France,Gérontopôle, Department of Geriatrics, CHU Toulouse, Toulouse, France
| | - Bruno Vellas
- Inserm UMR 1295, University of Toulouse III, Toulouse, France,Gérontopôle, Department of Geriatrics, CHU Toulouse, Toulouse, France
| | - Audrey Gabelle
- Memory Resources and Research Center, Department of Neurology, Gui de Chauliac Hospital, Montpellier, France,INM, Univ Montpellier, INSERM, CHU Montpellier, Montpellier, France
| | - Emmanuelle Le Bars
- Institut d'Imagerie Fonctionnelle Humaine, I2FH, Department of Neuroradiology, Gui de Chauliac Hospital and University of Montpellier, Montpellier, France,*Correspondence: Emmanuelle Le Bars ✉
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9
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Townsend RF, Logan D, O’Neill RF, Prinelli F, Woodside JV, McEvoy CT. Whole Dietary Patterns, Cognitive Decline and Cognitive Disorders: A Systematic Review of Prospective and Intervention Studies. Nutrients 2023; 15:nu15020333. [PMID: 36678204 PMCID: PMC9865080 DOI: 10.3390/nu15020333] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Revised: 12/17/2022] [Accepted: 12/21/2022] [Indexed: 01/12/2023] Open
Abstract
Dementia prevalence is a global public health concern. Adherence towards a healthy dietary pattern (DP) may reduce the risk of cognitive decline and dementia. This narrative systematic review aimed to synthesise prospective and intervention study data to evaluate the impact of a-posteriori and a-priori derived DPs on cognitive ageing, from cognitive decline to incident dementia. Ninety-three studies were included: 83 prospective studies and 10 randomised controlled trials (RCT). Most prospective studies (77%) examined a-priori DPs, with the Mediterranean diet examined most frequently. A total of 52% of prospective and 50% of RCTs reported a protective relationship between 'healthy' DPs and global cognitive decline. Overall, 59% of prospective studies reported positive associations between healthy DPs and risk of cognitive disorder. Incident cognitive disorder was examined by only one intervention study (subgroup analysis) which reported a beneficial effect of a low-fat diet on risk of probable dementia in women. Unhealthy DPs were examined less frequently (n = 17; 21%), with 41% of these studies reporting associations between adherence and poorer cognitive outcomes. Overall, there were mixed results for healthy and unhealthy DPs on cognition, likely due to between-study heterogeneity. Standardisation of diet exposure and cognitive outcome measurement would help to reduce this. Future research would benefit from investigating effects of culturally appropriate DPs on individual cognitive domains and incident cognitive disorders in diverse and high-risk populations.
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Affiliation(s)
| | - Danielle Logan
- Centre for Public Health, Queen’s University Belfast, Belfast BT12 6BA, UK
| | - Roisin F. O’Neill
- Centre for Public Health, Queen’s University Belfast, Belfast BT12 6BA, UK
| | - Federica Prinelli
- Epidemiology Unit, Institute of Biomedical Technologies, National Research Council, 93 20054 Milan, Italy
| | - Jayne V. Woodside
- Centre for Public Health, Queen’s University Belfast, Belfast BT12 6BA, UK
- Institute for Global Food Security, Queen’s University Belfast, Belfast BT9 5DL, UK
| | - Claire T. McEvoy
- Centre for Public Health, Queen’s University Belfast, Belfast BT12 6BA, UK
- Institute for Global Food Security, Queen’s University Belfast, Belfast BT9 5DL, UK
- Correspondence:
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10
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de Rooij SR. Are Brain and Cognitive Reserve Shaped by Early Life Circumstances? Front Neurosci 2022; 16:825811. [PMID: 35784851 PMCID: PMC9243389 DOI: 10.3389/fnins.2022.825811] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Accepted: 05/13/2022] [Indexed: 01/22/2023] Open
Abstract
When growing older, many people are faced with cognitive deterioration, which may even amount to a form of dementia at some point in time. Although neuropathological signs of dementia disorders can often be demonstrated in brains of patients, the degree to which clinical symptoms are present does mostly not accurately reflect the amount of neuropathology that is present. Sometimes existent pathology even goes without any obvious clinical presentation. An explanation for this phenomenon may be found in the concept of reserve capacity. Reserve capacity refers to the ability of the brain to effectively buffer changes that are associated with normal aging processes and to cope with pathological damage. A larger reserve capacity has been suggested to increase resilience against age-associated cognitive deterioration and dementia disorders. Traditionally, a division has been made between brain reserve, which is based on morphological characteristics of the brain, and cognitive reserve, which is based on functional characteristics of the brain. The present review discusses the premises that brain and cognitive reserve capacity are shaped by prenatal and early postnatal factors. Evidence is accumulating that circumstances during the first 1,000 days of life are of the utmost importance for the lifelong health of an individual. Cognitive deterioration and dementia disorders may also have their origin in early life and a potentially important pathway by which the early environment affects the risk for neurodegenerative diseases is by developmental programming of the reserve capacity of the brain. The basic idea behind developmental programming of brain and cognitive reserve is explained and an overview of studies that support this idea is presented. The review is concluded by a discussion of potential mechanisms, synthesis of the evidence and relevance and future directions in the field of developmental origins of reserve capacity.
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Affiliation(s)
- Susanne R. de Rooij
- Epidemiology and Data Science, University of Amsterdam, Amsterdam, Netherlands
- Aging and Later Life, Health Behaviors and Chronic Diseases, Amsterdam Public Health Research Institute, Amsterdam, Netherlands
- Amsterdam Reproduction and Development, Amsterdam, Netherlands
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11
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Townsend RF, Woodside JV, Prinelli F, O'Neill RF, McEvoy CT. Associations Between Dietary Patterns and Neuroimaging Markers: A Systematic Review. Front Nutr 2022; 9:806006. [PMID: 35571887 PMCID: PMC9097077 DOI: 10.3389/fnut.2022.806006] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2021] [Accepted: 03/16/2022] [Indexed: 12/13/2022] Open
Abstract
Dementia is a complex, growing challenge for population health worldwide. Dietary patterns (DPs) may offer an opportunity to beneficially influence cognitive ageing and potentially reduce an individuals’ risk of dementia through diet-related mechanisms. However, previous studies within this area have shown mixed results, which may be partly explained by the lack of sensitivity and accuracy within cognitive testing methods. Novel neuroimaging techniques provide a sensitive method to analyse brain changes preceding cognitive impairment which may have previously remained undetected. The purpose of this systematic review was to elucidate the role of DPs in relation to brain ageing processes, by summarising current prospective and intervention studies. Nine prospective studies met the inclusion criteria for the review, seven evaluated the Mediterranean diet (MeDi), one evaluated the Alternative Healthy Eating Index-2010, and one evaluated a posteriori derived DPs. No intervention studies were eligible for inclusion in this review. There was some evidence of an association between healthy DPs and neuroimaging markers including changes within these markers over time. Consequently, it is plausible that better adherence to such DPs may positively influence brain ageing and neurodegeneration. Future studies may benefit from the use of multi-modal neuroimaging techniques, to further investigate how adherence to a DP influences brain health. The review also highlights the crucial need for further intervention studies within this research area.
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Affiliation(s)
- Rebecca F Townsend
- Centre for Public Health, Queen's University Belfast, Belfast, United Kingdom
| | - Jayne V Woodside
- Centre for Public Health, Queen's University Belfast, Belfast, United Kingdom.,Institute for Global Food Security, Queen's University Belfast, Belfast, United Kingdom
| | - Federica Prinelli
- Institute of Biomedical Technologies, National Research Council, Milan, Italy
| | - Roisin F O'Neill
- Centre for Public Health, Queen's University Belfast, Belfast, United Kingdom
| | - Claire T McEvoy
- Centre for Public Health, Queen's University Belfast, Belfast, United Kingdom.,Institute for Global Food Security, Queen's University Belfast, Belfast, United Kingdom
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12
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Abstract
PURPOSE OF REVIEW Cell senescence is implicated in numerous age-related conditions. Antiageing therapies and nutritional approaches have been researched for purposes of removing senescent cells (senolytics) to treat or prevent age-related diseases, such as cognitive impairment and Alzheimer's disease. In this updated review, we examined the evidence from the last 18 months regarding nutrition senolytics, with a focus on cognitive ageing among older adults. RECENT FINDINGS Overall, 19 systematic reviews and 17 intervention studies were included. Studies failed to provide evidence of nutritional senolytic agents or senescence-associated secretory phenotype (SASP) suppressors, for oral supplements providing beneficial effects on cognitive ageing among older adults. The protective role of food sources such as berries and nuts, and dietary patterns of Mediterranean diet and Mediterranean-DASH diet Intervention for Neurodegenerative Delay diet against cognitive decline or risk of dementia have been mostly supported by recent studies. SUMMARY The present review gathered additional evidence for both oral supplements and foods/diets rich in nutritional senolytic agents or SASP suppressors on cognitive health among older adults. In pursuing antiageing strategies, the importance of whole foods and healthy diets should not be overlooked, future studies are warranted on long-term effects and cytotoxicity of nutritional senolytics.
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Affiliation(s)
- Xi Chen
- Dementia Centre for Research Collaboration
| | - Henry Brodaty
- Dementia Centre for Research Collaboration
- Centre for Healthy Brain Ageing (CHeBA), School of Psychiatry, Faculty of Medicine, University of New South Wales
| | - Fiona O'Leary
- Discipline of Nutrition and Dietetics, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
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13
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Bramorska A, Zarzycka W, Podolecka W, Kuc K, Brzezicka A. Age-Related Cognitive Decline May Be Moderated by Frequency of Specific Food Products Consumption. Nutrients 2021; 13:2504. [PMID: 34444664 PMCID: PMC8399560 DOI: 10.3390/nu13082504] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Revised: 07/18/2021] [Accepted: 07/18/2021] [Indexed: 02/06/2023] Open
Abstract
Our study aimed to evaluate whether the type of food products and the frequency of their consumption are associated with cognitive functioning in younger and older adults. The impact of diets that are high in added sugars and saturated fat on cognitive functioning, especially on memory, was at the center of our interest. Participants in the study were 204 healthy adults (aged 20-55) who performed a multitasking cognitive test and completed dietary and psychological questionnaires. Stepwise regression analysis with age and food consumption patterns as predictors, and the cognitive task performance as a dependent variable, revealed that cognitive task performance worsened with age. However, we found that the frequency of consuming different types of foods (healthy versus unhealthy dietary patterns) moderates the effects of age on cognitive functioning. Red meat and animal fat consumption were negatively correlated with cognitive performance, and this relation was dependent on the age of our participants. Conversely, white meat and fish consumption were positively related to memory. Different indices of dietary patterns (both positive and negative) were stronger predictors of cognitive performance in the older adult group. We interpret our results as evidence that diet may be a protective (or worsening) factor in age-related cognitive decline.
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Affiliation(s)
- Aleksandra Bramorska
- SWPS Institute of Psychology, University of Social Sciences and Humanities, 03-815 Warsaw, Poland; (W.Z.); (W.P.); (K.K.); (A.B.)
- Faculty of Information Technology, Polish-Japanese Academy of Information Technology, 02-008 Warsaw, Poland
| | - Wanda Zarzycka
- SWPS Institute of Psychology, University of Social Sciences and Humanities, 03-815 Warsaw, Poland; (W.Z.); (W.P.); (K.K.); (A.B.)
| | - Wiktoria Podolecka
- SWPS Institute of Psychology, University of Social Sciences and Humanities, 03-815 Warsaw, Poland; (W.Z.); (W.P.); (K.K.); (A.B.)
| | - Katarzyna Kuc
- SWPS Institute of Psychology, University of Social Sciences and Humanities, 03-815 Warsaw, Poland; (W.Z.); (W.P.); (K.K.); (A.B.)
| | - Aneta Brzezicka
- SWPS Institute of Psychology, University of Social Sciences and Humanities, 03-815 Warsaw, Poland; (W.Z.); (W.P.); (K.K.); (A.B.)
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14
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Zheng J, Zhou R, Li F, Chen L, Wu K, Huang J, Liu H, Huang Z, Xu L, Yuan Z, Mao C, Wu X. Association between dietary diversity and cognitive impairment among the oldest-old: Findings from a nationwide cohort study. Clin Nutr 2021; 40:1452-1462. [PMID: 33740515 DOI: 10.1016/j.clnu.2021.02.041] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2020] [Revised: 02/21/2021] [Accepted: 02/23/2021] [Indexed: 12/20/2022]
Abstract
BACKGROUND & AIMS Dietary diversity is widely recommended in national and international guidelines; however, whether the beneficial effects on cognitive function still apply in the oldest-old (80+) has rarely been studied. This study aimed to evaluate the associations of dietary diversity with cognitive function among the oldest-old in a large prospective cohort in China. METHODS We conducted a long-term prospective analysis on 11,970 participants aged 80+ (6581 octogenarians, 3730 nonagenarians, and 1659 centenarians). We constructed the baseline dietary diversity score (DDS) based on eight food items of a food frequency questionnaire. Mini-mental state examination (MMSE) was used to classify the participants as having cognitive impairment or not and was also used as a continuous metric. Non-linear associations of DDS with cognitive impairment was evaluated by cox models with penalized splines. We used mixed-effect models for longitudinal data with repeated measurements of MMSE (for up to seven time during the follow-up between 1998 and 2014). RESULTS We documented 4778 cognitive impairment during 46,738 person-years of follow-up. Each one unit increase in DDS was associated with a 4% lower risk of cognitive impairment (adjusted hazard ratio (HR): 0.96; 95% confidential interval (CI): 0.94-0.98). Compared to participants with DDS of 0 score, those with a DDS of 1-2, 3-4, and higher than 5 scores had a lower cognitive impairment risk, the HRs were 0.86 (0.79-0.95), 0.82 (0.74-0.91), and 0.72 (0.64-0.82) respectively, and a significant trend emerged (p < 0.001). Compared with DDS of zero score, a DDS of 1-2,3-4, ≥5 was related to slower MMSE decline (β = 0.128, 0.162, 0.301, respectively, p < 0.01). CONCLUSIONS Even after the age of 80, dietary diversity may offer a simple and straightforward mean of identifying and screening individuals at high risk for cognitive impairment. Recommendation of dietary diversity may be advocated to attenuate cognitive decline and decrease the risk of cognitive impairment in the oldest-old, especially in a low income or middle-income countries.
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Affiliation(s)
- Jiazhen Zheng
- Department of Epidemiology, School of Public Health (Guangdong Provincial Key Laboratory of Tropical Disease Research), Southern Medical University, Guangzhou, Guangdong, China
| | - Rui Zhou
- Department of Epidemiology, School of Public Health (Guangdong Provincial Key Laboratory of Tropical Disease Research), Southern Medical University, Guangzhou, Guangdong, China
| | - Furong Li
- Department of Epidemiology, School of Public Health (Guangdong Provincial Key Laboratory of Tropical Disease Research), Southern Medical University, Guangzhou, Guangdong, China
| | - Liren Chen
- Department of Regional Research, School of Social Sciences, Waseda University, Tokyo, Japan
| | - Keyi Wu
- Department of Epidemiology, School of Public Health (Guangdong Provincial Key Laboratory of Tropical Disease Research), Southern Medical University, Guangzhou, Guangdong, China
| | - Jinghan Huang
- Department of Biostatistics, School of Public Health, Boston University, Boston, USA
| | - Huamin Liu
- Department of Epidemiology, School of Public Health (Guangdong Provincial Key Laboratory of Tropical Disease Research), Southern Medical University, Guangzhou, Guangdong, China
| | - Zhiwei Huang
- Department of Epidemiology, School of Public Health (Guangdong Provincial Key Laboratory of Tropical Disease Research), Southern Medical University, Guangzhou, Guangdong, China
| | - Lin Xu
- Department of Nutrition and Food Hygiene, School of Public Health (Guangdong Provincial Key Laboratory for Food, Nutrition and Health), Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Zelin Yuan
- Department of Epidemiology, School of Public Health (Guangdong Provincial Key Laboratory of Tropical Disease Research), Southern Medical University, Guangzhou, Guangdong, China
| | - Chen Mao
- Department of Epidemiology, School of Public Health (Guangdong Provincial Key Laboratory of Tropical Disease Research), Southern Medical University, Guangzhou, Guangdong, China.
| | - Xianbo Wu
- Department of Epidemiology, School of Public Health (Guangdong Provincial Key Laboratory of Tropical Disease Research), Southern Medical University, Guangzhou, Guangdong, China.
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