1
|
Dawson DR, Bar Y, Ajwani F, Rotenberg S, Atlas B, Ricupero M, Greewood C, Parrott MD. Combining elements of the CO-OP Approach ™ with education to promote healthy eating among older adults: A pilot study. Front Rehabilit Sci 2022; 3:971300. [PMCID: PMC9634402 DOI: 10.3389/fresc.2022.971300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Accepted: 09/27/2022] [Indexed: 11/06/2022]
Abstract
This paper describes an exploratory study developing the Baycrest Brain-healthy Eating Approach (BBEA). Poor diet is a modifiable risk factor for many health problems including dementia. Mediterranean type diets, high in plant-based foods, rich in poly- and mono- unsaturated fatty acids with minimal consumption of saturated fat, red meat, and processed foods, are considered brain healthful. While several dementia prevention trials randomized controlled trials have included nutritional counselling in favor of these diets as one component of their interventions, the extent to which dietary change occurred is not known. Based on observations that a strategy training approach, the Cognitive Orientation to daily Occupational Performance (CO-OP) Approach, was beneficial for promoting lifestyle changes in older adults with complaints of cognitive changes, we undertook to develop the BBEA combining elements of CO-OP with didactic nutrition education. This exploratory, descriptive study assesses the feasibility and acceptability of the BBEA. Healthy community dwelling older adults (n = 5) were recruited using convenience sampling. Participants received five, 2 h, group sessions. During these sessions participants were supported in adopting dietary practices consistent with brain healthy eating. Each participant set specific dietary goals important to them. Feasibility of the intervention was demonstrated through high levels of attendance and by the findings that at each session, all participants set personally meaningful goals and received education on selected brain healthy eating topics. Acceptability was demonstrated through participants' positive reports of their experiences and perspectives obtained via semi-structured interviews. Thus, the BBEA appears to be feasible and acceptable.
Collapse
Affiliation(s)
- Deirdre R. Dawson
- Rotman Research Institute, Baycrest Health Sciences, Toronto, ON, Canada,Department of Occupational Science / Occupational Therapy, University of Toronto, Toronto, ON, Canada,Rehabilitation Sciences Institute, University of Toronto, Toronto, ON, Canada,Correspondence: Deirdre R. Dawson
| | - Yael Bar
- Cardiovascular Prevention and Rehabilitation Program, Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada
| | - Fatim Ajwani
- Cardiovascular Prevention and Rehabilitation Program, Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada
| | - Shlomit Rotenberg
- Rotman Research Institute, Baycrest Health Sciences, Toronto, ON, Canada,Department of Occupational Science / Occupational Therapy, University of Toronto, Toronto, ON, Canada,Rehabilitation Sciences Institute, University of Toronto, Toronto, ON, Canada
| | - Barbara Atlas
- Rotman Research Institute, Baycrest Health Sciences, Toronto, ON, Canada
| | - Maria Ricupero
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Carol Greewood
- Rotman Research Institute, Baycrest Health Sciences, Toronto, ON, Canada,Department of Nutritional Sciences, University of Toronto, Toronto, ON, Canada
| | | |
Collapse
|
2
|
Koblinsky ND, Anderson ND, Ajwani F, Parrott MD, Dawson D, Marzolini S, Oh P, MacIntosh B, Middleton L, Ferland G, Greenwood CE. Feasibility and preliminary efficacy of the LEAD trial: a cluster randomized controlled lifestyle intervention to improve hippocampal volume in older adults at-risk for dementia. Pilot Feasibility Stud 2022; 8:37. [PMID: 35139918 PMCID: PMC8826667 DOI: 10.1186/s40814-022-00977-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Accepted: 01/11/2022] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Healthy diet and exercise are associated with reduced risk of dementia in older adults. The impact of diet and exercise interventions on brain health is less consistent, especially with dietary interventions which rely on varying approaches. Our objective was to evaluate the feasibility and preliminary efficacy of a 6-month intervention combining exercise with a novel dietary counseling approach to improve hippocampal volume among older adults at-risk for dementia. METHODS Participants with vascular risk factors and subjective cognitive decline or early mild cognitive impairment were cluster randomized in groups of 3-4 to the diet intervention (DIET) or control education (ED) group. All participants engaged in 1 h of supervised exercise per week and additional exercise at home. DIET involved 1 h per week of group-based dietary counseling comprising education, goal setting, and strategy training. ED involved 1 h per week of group-based brain health education classes. Our primary outcome was change in hippocampal volume from baseline to 6 months. Secondary outcomes included changes in cognitive function, blood biomarkers, diet, and fitness. Recruitment challenges and early discontinuation of the trial due to COVID-19 necessitated a revised focus on feasibility and preliminary efficacy. RESULTS Of 190 older adults contacted, 14 (7%) were eligible and enrolled, constituting 21% of our recruitment target. All participants completed the intervention and attended 90% of exercise and DIET/ED sessions on average. All 6-month assessments prior to COVID-19 were completed but disruptions to in-person testing resulted in incomplete data collection. No serious adverse events occurred and all participants expressed positive feedback about the study. Preliminary findings did not identify any significant changes in hippocampal volume; however, substantial improvements in diet and HbA1c were observed with DIET compared to ED (d = 1.75 and 1.07, respectively). CONCLUSIONS High adherence and retention rates were observed among participants and preliminary findings illustrate improvements in diet quality and HbA1c. These results indicate that a larger trial is feasible if difficulties surrounding recruitment can be mitigated. TRIAL REGISTRATION ClinicalTrials.gov identifier: NCT03056508 .
Collapse
Affiliation(s)
- N D Koblinsky
- Rotman Research Institute, Baycrest Health Sciences, Toronto, Canada
| | - N D Anderson
- Rotman Research Institute, Baycrest Health Sciences, Toronto, Canada.
- Departments of Psychology and Psychiatry, University of Toronto, Toronto, Canada.
| | - F Ajwani
- Rotman Research Institute, Baycrest Health Sciences, Toronto, Canada
- KITE, Toronto Rehabilitation Institute - the University Health Network, Toronto, Canada
| | - M D Parrott
- PERFORM Centre, Concordia University, Montreal, Canada
| | - D Dawson
- Rotman Research Institute, Baycrest Health Sciences, Toronto, Canada
- Department of Occupational Sciences and Occupational Therapy and Rehabilitation Sciences Institute, University of Toronto, Toronto, Canada
| | - S Marzolini
- KITE, Toronto Rehabilitation Institute - the University Health Network, Toronto, Canada
| | - P Oh
- KITE, Toronto Rehabilitation Institute - the University Health Network, Toronto, Canada
| | - B MacIntosh
- Hurvitz Brain Sciences, Sunnybrook Research Institute, University of Toronto, Toronto, Canada
| | | | - G Ferland
- Montreal Heart Institute Research Centre, Montreal, Canada
- Department of Nutrition, Université de Montréal, Montreal, Canada
| | - C E Greenwood
- Rotman Research Institute, Baycrest Health Sciences, Toronto, Canada
- Department of Nutritional Sciences, University of Toronto, Toronto, Canada
| |
Collapse
|
3
|
Parrott MD, Carmichael PH, Laurin D, Greenwood CE, Anderson ND, Ferland G, Gaudreau P, Belleville S, Morais JA, Kergoat MJ, Fiocco AJ. The Association Between Dietary Pattern Adherence, Cognitive Stimulating Lifestyle, and Cognitive Function Among Older Adults From the Quebec Longitudinal Study on Nutrition and Successful Aging. J Gerontol B Psychol Sci Soc Sci 2021; 76:444-450. [PMID: 33063101 DOI: 10.1093/geronb/gbaa178] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVES This study examined the effect of dietary patterns and engagement in cognitive stimulating lifestyle (CSL) behaviors on the trajectory of global cognition, executive function (EF), and verbal episodic memory (VEM). METHODS Western and prudent dietary patterns were empirically derived using food frequency questionnaire responses from 350 community-dwelling older adults (mean age: 73.7 years) participating in the Quebec Longitudinal Study on Nutrition and Successful Aging. CSL was represented by a binary composite indicator based on education, occupational complexity, and social engagement. Global cognition, EF, and VEM were assessed prospectively. RESULTS Primary effect models revealed an association between higher Western dietary pattern score and a greater rate of decline in global cognition and EF. Higher Western dietary pattern adherence was also associated with poorer baseline VEM. Primary effect models also revealed that CSL was independently associated with baseline global cognition and EF. Effect modification models suggested an interactive effect between Western dietary pattern and CLS on global cognition only. No associations were found for prudent dietary pattern score. DISCUSSION Contributing to existing research supporting the negative impact of consuming an unhealthy diet on cognitive function, the current study suggests increased vulnerability among older adults who do not engage in a CSL. These findings can inform the development of lifestyle intervention programs that target brain health in later adulthood.
Collapse
Affiliation(s)
| | - Pierre-Hugues Carmichael
- Centre d'excellence sur le vieillissement de Québec, Centre de recherche du CHU de Québec, Canada.,Centre de recherche sur les soins et les services de première ligne de l'Université Laval, Canada
| | - Danielle Laurin
- Centre d'excellence sur le vieillissement de Québec, Centre de recherche du CHU de Québec, Canada.,Centre de recherche sur les soins et les services de première ligne de l'Université Laval, Canada
| | - Carol E Greenwood
- Rotman Research Institute, Baycrest Health Sciences, Toronto, Ontario, Canada.,Department of Nutritional Sciences, University of Toronto, Ontario, Canada
| | - Nicole D Anderson
- Rotman Research Institute, Baycrest Health Sciences, Toronto, Ontario, Canada.,Departments of Psychiatry and Psychology, University of Toronto, Ontario, Canada
| | - Guylaine Ferland
- Département de nutrition, Université de Montréal, Quebec, Canada.,Research Center, Montreal Heart Institute, Quebec, Canada
| | - Pierrette Gaudreau
- Centre de recherche du Centre hospitalier de l'Université de Montréal, Quebec, Canada.,Département de médecine, Université de Montréal, Quebec, Canada
| | - Sylvie Belleville
- Centre de recherche, Institut universitaire de gériatrie de Montréal, CIUSSS du Centre-sud-de-l'Île-de-Montréal, Quebec, Canada
| | - José A Morais
- School of Dietetics and Human Nutrition, McGill University, Montréal, Quebec, Canada.,Division of Geriatric Medicine, McGill University, Montréal, Quebec, Canada
| | - Marie-Jeanne Kergoat
- Département de médecine, Université de Montréal, Quebec, Canada.,Centre de recherche, Institut universitaire de gériatrie de Montréal, CIUSSS du Centre-sud-de-l'Île-de-Montréal, Quebec, Canada
| | | |
Collapse
|
4
|
D'Amico D, Parrott MD, Greenwood CE, Ferland G, Gaudreau P, Belleville S, Laurin D, Anderson ND, Kergoat MJ, Morais JA, Presse N, Fiocco AJ. Sex differences in the relationship between dietary pattern adherence and cognitive function among older adults: findings from the NuAge study. Nutr J 2020; 19:58. [PMID: 32563260 PMCID: PMC7306140 DOI: 10.1186/s12937-020-00575-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Accepted: 06/14/2020] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Consumption of a prudent dietary pattern rich in healthy nutrients is associated with enhanced cognitive performance in older adulthood, while a Western dietary pattern low in healthy nutrients is associated with poor age-related cognitive function. Sex differences exist in dietary intake among older adults; however, there is a paucity of research examining the relationship between sex-specific dietary patterns and cognitive function in later life. METHODS The current study aimed to investigate sex differences in the relationship between sex-specific dietary pattern adherence and global cognitive function at baseline and over a 3-year follow-up in 1268 community-dwelling older adults (Mage = 74 years, n = 664 women, n = 612 men) from the Quebec Longitudinal Study on Nutrition and Successful Aging (NuAge). A 78-item Food Frequency Questionnaire was used to estimate dietary intake over the previous year. Sex-specific dietary pattern scores were derived using principal component analysis. Global cognition was assessed using the Modified Mini-Mental State Examination (3MS). RESULTS Adjusted linear mixed effects models indicated that a healthy, prudent dietary pattern was not associated with baseline cognitive performance in men or women. No relationship was found between Western dietary pattern adherence and baseline cognitive function in women. Among men, adherence to an unhealthy, Western dietary pattern was associated with poorer baseline cognitive function (β = - 0.652, p = 0.02, 95% CI [- 1.22, - 0.65]). No association was found between prudent or Western dietary patterns and cognitive change over time in men or women. CONCLUSIONS These findings highlight the importance of conducting sex-based analyses in aging research and suggest that the relationship between dietary pattern adherence and cognitive function in late life may be sex-dependent.
Collapse
Affiliation(s)
- Danielle D'Amico
- Department of Psychology, Ryerson University, Toronto, ON, Canada
| | | | - Carol E Greenwood
- Rotman Research Institute, Baycrest Health Sciences, North York, ON, Canada.,Department of Nutritional Sciences, University of Toronto, Toronto, ON, Canada
| | - Guylaine Ferland
- Department of Nutrition, Université de Montréal, Montréal, QC, Canada
| | - Pierrette Gaudreau
- Department of Medicine and Centre hospitalier de l'Université de Montréal (CHUM), Université de Montréal, Montréal, QC, Canada
| | - Sylvie Belleville
- Centre de Recherche de l'Institut Universitaire de Gériatrie de Montréal (CRIUGM), Montréal, QC, Canada
| | - Danielle Laurin
- Centre d'excellence sur le vieillissement de Québec, Université Laval, Québec, QC, Canada
| | - Nicole D Anderson
- Rotman Research Institute, Baycrest Health Sciences, North York, ON, Canada.,Department of Psychology, University of Toronto, Toronto, ON, Canada.,Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Marie-Jeanne Kergoat
- Centre de Recherche de l'Institut Universitaire de Gériatrie de Montréal (CRIUGM), Montréal, QC, Canada
| | - Jose A Morais
- Division of Geriatric Medicine, McGill University, Montréal, QC, Canada
| | - Nancy Presse
- Centre de Recherche de l'Institut Universitaire de Gériatrie de Montréal (CRIUGM), Montréal, QC, Canada.,Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, QC, Canada.,Research Center on Aging, CIUSSS-de-l'Estrie-CHUS, Sherbrooke, QC, Canada
| | | |
Collapse
|
5
|
Fiocco AJ, Krieger L, D'Amico D, Parrott MD, Laurin D, Gaudreau P, Greenwood C, Ferland G. A systematic review of existing peripheral biomarkers of cognitive aging: Is there enough evidence for biomarker proxies in behavioral modification interventions?: An initiative in association with the nutrition, exercise and lifestyle team of the Canadian Consortium on Neurodegeneration in Aging. Ageing Res Rev 2019; 52:72-119. [PMID: 31059801 DOI: 10.1016/j.arr.2019.04.008] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2018] [Revised: 03/09/2019] [Accepted: 04/29/2019] [Indexed: 12/15/2022]
Abstract
Peripheral biomarkers have shown significant value in predicting brain health and may serve as a useful proxy measurement in the assessment of evidence-based lifestyle behavior modification programs, including physical activity and nutrition programs, that aim to maintain cognitive function in late life. The aim of this systematic review was to elucidate which peripheral biomarkers are robustly associated with cognitive function among relatively healthy non-demented older adults. Following the standards for systematic reviews (PICO, PRIMSA), and employing MEDLINE and Scopus search engines, 222 articles were included in the review. Based on the review of biomarker proxies of cognitive health, it is recommended that a comprehensive biomarker panel, or biomarker signature, be developed as a clinical end point for behavior modification trials aimed at enhancing cognitive function in late life. The biomarker signature should take a multisystemic approach, including lipid, immune/inflammatory, and metabolic biomarkers in the biological signature index of cognitive health.
Collapse
Affiliation(s)
| | - Laura Krieger
- Department of Psychology, Ryerson University, Toronto, ON, Canada
| | - Danielle D'Amico
- Department of Psychology, Ryerson University, Toronto, ON, Canada
| | | | - Danielle Laurin
- Laval University, Centre de recherche du CHU de Québec, QC, Canada
| | | | | | | |
Collapse
|
6
|
Abstract
According to the Alzheimer Society of Canada, within the next generation, Canada will experience a more than doubling of individuals living with dementia and a potentially economically crippling 10-fold increase in costs to Canadians. Up to 50% of cases with dementia can be attributed to seven modifiable, predominantly vascular and/or lifestyle-associated, risk factors. Multi-modal dementia risk reduction strategies, targeting diet, exercise, mental stimulation, and vascular risk monitoring, are likely to be the most successful. Diet-related strategies need to focus on overall diet quality and not on individual foods or nutrients. High-quality diets that are associated with better cognitive function and lower dementia risk with aging are high in vegetables, fruits, nuts, whole grains, and fish and low in red meat, high-fat dairy products, sweets, and highly processed foods. It is the time to embed risk reduction strategies into our public health and healthcare infrastructure to proactively address the challenges posed by population aging.
Collapse
Affiliation(s)
- Carol E Greenwood
- 1 Rotman Research Institute, Baycrest Health Sciences, Toronto, Ontario, Canada
- 2 Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | | |
Collapse
|
7
|
Meusel LAC, Anderson ND, Parrott MD, Yuen W, Tchistiakova E, MacIntosh BJ, Feldman S, Greenwood CE. Brain Function Is Linked to LDL Cholesterol in Older Adults with Cardiovascular Risk. J Am Geriatr Soc 2016; 65:e51-e55. [DOI: 10.1111/jgs.14663] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
| | - Nicole D. Anderson
- Rotman Research Institute; Baycrest Health Sciences; Toronto Ontario Canada
- Departments of Psychology and Psychiatry; University of Toronto; Toronto Ontario Canada
| | - Matthew D. Parrott
- Rotman Research Institute; Baycrest Health Sciences; Toronto Ontario Canada
- Department of Nutritional Sciences; Faculty of Medicine; University of Toronto; Toronto Ontario Canada
| | - William Yuen
- Rotman Research Institute; Baycrest Health Sciences; Toronto Ontario Canada
| | - Ekaterina Tchistiakova
- Heart and Stroke Foundation Canadian Partnership for Stroke Recovery; Sunnybrook Research Institute; Toronto Ontario Canada
- Department of Medical Biophysics; Faculty of Medicine; University of Toronto; Toronto Ontario Canada
| | - Bradley J. MacIntosh
- Heart and Stroke Foundation Canadian Partnership for Stroke Recovery; Sunnybrook Research Institute; Toronto Ontario Canada
- Department of Medical Biophysics; Faculty of Medicine; University of Toronto; Toronto Ontario Canada
| | - Sid Feldman
- Baycrest Health Sciences; Toronto Ontario Canada
- Department of Family and Community Medicine; University of Toronto; Toronto Ontario Canada
| | - Carol E. Greenwood
- Rotman Research Institute; Baycrest Health Sciences; Toronto Ontario Canada
- Department of Nutritional Sciences; Faculty of Medicine; University of Toronto; Toronto Ontario Canada
| |
Collapse
|
8
|
Parrott MD, Fiocco AJ, Carmichael PH, Anderson ND, Laurin D, Greenwood CE, Ferland G, Shatenstein B, Gaudreau P, Payette H, Belleville S, Morais JA, Kergoat MJ. P2‐421: Indicators of Cognitive Reserve Moderate the Adverse Relationship Between Poor Diet Quality and Cognitive Decline in Independent Older Adults: The Nuage Study. Alzheimers Dement 2016. [DOI: 10.1016/j.jalz.2016.06.1633] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
| | | | | | | | | | | | - Guylaine Ferland
- Institut Universitaire de Gériatrie de MontréalMontrealQC Canada
| | | | | | | | | | | | | | | |
Collapse
|
9
|
Dawson D, Parrott MD, Marzolini S, Ajwani F, Ricupero M, Atlas B. P1‐414: Promoting Adoption of Brain Healthy Eating Patterns: A Pilot Study Using Problem‐Solving Training. Alzheimers Dement 2016. [DOI: 10.1016/j.jalz.2016.06.1166] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Deirdre Dawson
- BaycrestTorontoON Canada
- University of TorontoTorontoON Canada
| | | | - Susan Marzolini
- University Health Network Toronto Rehabilitation InstituteTorontoON Canada
| | - Fatim Ajwani
- University Health Network Toronto Rehabilitation InstituteTorontoON Canada
| | - Maria Ricupero
- University Health Network Toronto Rehabilitation InstituteTorontoON Canada
| | | | | |
Collapse
|
10
|
Parrott MD. P3‐393: Development of a Brain Health Food Guide for Use in Middle‐Aged and Older Adults. Alzheimers Dement 2016. [DOI: 10.1016/j.jalz.2016.06.2059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
|
11
|
Parrott MD, Winocur G, Bazinet RP, Ma DW, Greenwood CE. Whole-food diet worsened cognitive dysfunction in an Alzheimer's disease mouse model. Neurobiol Aging 2015; 36:90-9. [DOI: 10.1016/j.neurobiolaging.2014.08.013] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2014] [Revised: 08/07/2014] [Accepted: 08/12/2014] [Indexed: 12/13/2022]
|
12
|
Parrott MD, Shatenstein B, Ferland G, Payette H, Morais JA, Belleville S, Kergoat MJ, Gaudreau P, Greenwood CE. Relationship between diet quality and cognition depends on socioeconomic position in healthy older adults. J Nutr 2013; 143:1767-73. [PMID: 23986363 DOI: 10.3945/jn.113.181115] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Both diet quality and socioeconomic position (SEP) have been linked to age-related cognitive changes, but there is little understanding of how the socioeconomic context of dietary intake may shape its cognitive impact. We examined whether equal adherence to "prudent" and "Western" dietary patterns, identified by principal components analysis, was associated with global cognitive function [Modified Mini-Mental State Examination (3MS)] in independently living older adults with different SEPs (aged 68-84 y; n = 1099). The interaction of dietary pattern adherence with household income, educational attainment, occupational prestige, and a composite indicator of SEP combining all 3 was examined in multiple-adjusted mixed models over 3 y of follow-up in participants of the NuAge study (Quebec Longitudinal Study on Nutrition and Successful Aging). Adherence to the prudent pattern (vegetables, fruits, fish, poultry, and lower-fat dairy products) was related to higher 3MS scores at recruitment only in the upper categories of income [parameter estimate (B): 0.56; 95% CI: 0.11, 1.01], education (B: 0.44; 95% CI: 0.080, 0.80), or composite SEP (B: 0.37; 95% CI: 0.045, 0.70). High prudent pattern adherence was associated with less cognitive decline only in those with low composite SEP (B: 0.25; 95% CI: 0.0094, 0.50). Conversely, adherence to the Western pattern (meats, potatoes, processed foods, and higher-fat dairy products) was associated with more cognitive decline (B: -0.23; 95% CI: -0.43, -0.032) only in those with low educational attainment. In summary, among individuals with equivalent diet quality, the magnitude and characteristics of the diet-cognition relationship depended on their socioeconomic circumstances. These results suggest that interventions promoting retention of cognitive function through improved diet quality would provide maximum benefit to those with relatively low SEP.
Collapse
|
13
|
Parrott MD, Young KWH, Greenwood CE. Energy-containing nutritional supplements can affect usual energy intake postsupplementation in institutionalized seniors with probable Alzheimer's disease. J Am Geriatr Soc 2006; 54:1382-7. [PMID: 16970646 DOI: 10.1111/j.1532-5415.2006.00844.x] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To determine whether increases in caloric intake associated with consumption of a mid-morning nutritional supplement for 3 weeks were maintained in the week after stopping the supplement and to investigate the effects of body mass index (BMI) and cognitive and behavioral measures on this response. DESIGN Secondary analysis of a previously published randomized, crossover, nonblinded clinical trial. SETTING A fully accredited geriatric care facility affiliated with the University of Toronto. PARTICIPANTS Thirty institutionalized seniors with probable Alzheimer's disease (AD) who ate independently. MEASUREMENTS Investigator-weighed food intake, body weight, cognitive (Severe Impairment Battery; Global Deterioration Scale) and behavioral (Neuropsychiatric Inventory--Nursing Home version; London Psychogeriatric Rating Scale) assessments. RESULTS Individuals who responded successfully to supplementation as indicated by increases in daily energy intake were likely to maintain 58.8% of that increase postsupplementation, although stopping the supplement was associated with decreased habitual energy intake in low-BMI individuals who reduced their daily intakes during supplementation in response to the extra calories. Cognitive/behavioral tests were not reliable predictors of postsupplement intake. CONCLUSION Institutionalized seniors with probable AD are likely to alter their usual energy intakes to maintain changes resulting from 3 weeks of supplementation. This effect may allow for rotating supplementation schedules in nursing homes that could reduce staff burden, but only for those individuals who are most likely to respond favorably. These data indicate that nutritional supplements and diet plans should be carefully prescribed in low-BMI individuals to limit variability in total energy provided and thus prevent lower-than-normal intake.
Collapse
Affiliation(s)
- Matthew D Parrott
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, Canada.
| | | | | |
Collapse
|