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. 2018 Oct 20;10(10):1557.
doi: 10.3390/nu10101557.

Mediterranean Lifestyle in Relation to Cognitive Health: Results from the HELIAD Study

Costas A Anastasiou  1   2 , Mary Yannakoulia  3 , Meropi D Kontogianni  4 , Mary H Kosmidis  5 , Eirini Mamalaki  6 , Efthimios Dardiotis  7 , Giorgos Hadjigeorgiou  8   9 , Paraskevi Sakka  10 , Angeliki Tsapanou  11   12 , Anastasia Lykou  13 , Nikolaos Scarmeas  14   15
Affiliations

Mediterranean Lifestyle in Relation to Cognitive Health: Results from the HELIAD Study

Costas A Anastasiou et al. Nutrients. .

Abstract

Many lifestyle factors have been linked to cognitive function but little is known about their combined effect. An overall lifestyle pattern for people living in the Mediterranean basin has been proposed, including diet, but also physical activity, sleep and daily living activities with social/intellectual aspects. We aimed to examine the associations between a combination of these lifestyle factors and detailed cognitive performance. A total of 1716 participants from the Hellenic Longitudinal Investigation of Ageing and Diet (HELIAD), a population-based study of participants ≥65 years, were included in this analysis. Lifestyle factors were evaluated using standard, validated questionnaires and a Total Lifestyle Index (TLI) was constructed. Cognitive outcomes included mild cognitive impairment (MCI) diagnosis, a composite z-score (either continuous or with a threshold at the 25th percentile) and z-scores for five cognitive domains. A higher TLI was associated with 65% reduced odds for MCI in the non-demented individuals and 43% reduced odds for low global cognition when MCI participants were excluded, a risk reduction equivalent to 9 and 2.7 fewer years of ageing, respectively. Each lifestyle factor was differentially associated with domain-specific cognitive performance. Our results suggest that a TLI, more so than single lifestyle parameters, may be related to cognitive performance.

Keywords: brain health; cognition; dietary patterns; instrumental activities of daily living; lifestyle; nutrition.

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Conflict of interest statement

The authors declare no conflicts of interest. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data, in the writing of the manuscript, and in the decision to publish the results.

Figures

Figure 1
Figure 1
Results from logistic regression that evaluated the impact of lifestyle factors and TLI on the odds ratio of MCI in non-demented participants. Values are odds ratios with error bars representing 95% confidence intervals. In all models age, sex and education were entered as confounders. Statistically significant linear trends at p < 0.05 were observed for IADLex and Total Lifestyle. MedDiet: Mediterranean diet, IADLex: instrumental activities of daily living extended scale. Q: quartile (Q1 lowest, Q4 highest).
Figure 2
Figure 2
Results from logistic regression that evaluated the impact of lifestyle factors and TLI on the odds ratio of low cognitive performance in non-demented, non-MCI participants. Values are odds ratios with error bars representing 95% confidence intervals. In all models age, sex and education were entered as confounders. Statistically significant linear trend at p < 0.05 was observed for physical activity. MedDiet: Mediterranean diet, IADLex: instrumental activities of daily living extended scale. Q: quartile (Q1 lowest, Q4 highest).
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