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. 2013 Apr 30;80(18):1684-92.
doi: 10.1212/WNL.0b013e3182904f69.

Adherence to a Mediterranean diet and risk of incident cognitive impairment

Georgios Tsivgoulis  1 , Suzanne Judd, Abraham J Letter, Andrei V Alexandrov, George Howard, Fadi Nahab, Frederick W Unverzagt, Claudia Moy, Virginia J Howard, Brett Kissela, Virginia G Wadley
Affiliations

Adherence to a Mediterranean diet and risk of incident cognitive impairment

Georgios Tsivgoulis et al. Neurology. .

Abstract

Objective: We sought to determine the relationship of greater adherence to Mediterranean diet (MeD) and likelihood of incident cognitive impairment (ICI) and evaluate the interaction of race and vascular risk factors.

Methods: A prospective, population-based, cohort of individuals enrolled in the Reasons for Geographic and Racial Differences in Stroke (REGARDS) Study 2003-2007, excluding participants with history of stroke, impaired cognitive status at baseline, and missing data on Food Frequency Questionnaires (FFQ), was evaluated. Adherence to a MeD (scored as 0-9) was computed from FFQ. Cognitive status was evaluated at baseline and annually during a mean follow-up period of 4.0 ± 1.5 years using Six-item-Screener.

Results: ICI was identified in 1,248 (7%) out of 17,478 individuals fulfilling the inclusion criteria. Higher adherence to MeD was associated with lower likelihood of ICI before (odds ratio [lsqb]OR[rsqb] 0.89; 95% confidence interval [lsqb]CI[rsqb] 0.79-1.00) and after adjustment for potential confounders (OR 0.87; 95% CI 0.76-1.00) including demographic characteristics, environmental factors, vascular risk factors, depressive symptoms, and self-reported health status. There was no interaction between race (p = 0.2928) and association of adherence to MeD with cognitive status. However, we identified a strong interaction of diabetes mellitus (p = 0.0134) on the relationship of adherence to MeD with ICI; high adherence to MeD was associated with a lower likelihood of ICI in nondiabetic participants (OR 0.81; 95% CI 0.70-0.94; p = 0.0066) but not in diabetic individuals (OR 1.27; 95% CI 0.95-1.71; p = 0.1063).

Conclusions: Higher adherence to MeD was associated with a lower likelihood of ICI independent of potential confounders. This association was moderated by presence of diabetes mellitus.

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Figures

Figure 1
Figure 1. Flow diagram of the study population
REGARDS = Reasons for Geographic and Racial Differences in Stroke.
Figure 2
Figure 2. Interaction plot of diabetes mellitus and Mediterranean diet (MeD) adherence on the adjusted probability of cognitive decline
See this image and copyright information in PMC

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