Dietary Habits and Risk of Early-Onset Dementia in an Italian Case-Control Study

Abstract

Risk of early-onset dementia (EOD) might be modified by environmental factors and lifestyles, including diet. The aim of this study is to evaluate the association between dietary habits and EOD risk. We recruited 54 newly-diagnosed EOD patients in Modena (Northern Italy) and 54 caregivers as controls. We investigated dietary habits through a food frequency questionnaire, assessing both food intake and adherence to dietary patterns, namely the Greek-Mediterranean, the Dietary Approaches to Stop Hypertension (DASH), and the Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND) diets. We modeled the relation between dietary factors and risk using the restricted cubic spline regression analysis. Cereal intake showed a U-shaped relation with EOD, with risk increasing above 350 g/day. A high intake (>400 g/day) of dairy products was also associated with excess risk. Although overall fish and seafood consumption showed no association with EOD risk, we found a U-shaped relation with preserved/tinned fish, and an inverse relation with other fish. Similarly, vegetables (especially leafy) showed a strong inverse association above 100 g/day, as did citrus and dry fruits. Overall, sweet consumption was not associated with EOD risk, while dry cake and ice-cream showed a positive relation and chocolate products an inverse one. For beverages, we found no relation with EOD risk apart from a U-shaped relation for coffee consumption. Concerning dietary patterns, EOD risk linearly decreased with the increasing adherence to the MIND pattern. On the other hand, an inverse association for the Greek-Mediterranean and DASH diets emerged only at very high adherence levels. To the best of our knowledge, this is the first study that explores the association between dietary factors and EOD risk, and suggests that adherence to the MIND dietary pattern may decrease such risk.

Keywords: DASH diet; MIND diet; Mediterranean diet; dietary habits; early-onset dementia; prevention; risk.

Figure 1

Spline regression analysis of early-onset dementia (EOD) risk for increasing intake of cereals and cereal products. The black line indicates odds ratios for dementia risk; dash gray lines are 95% confidence limits; the reference line at 1.0 with black spikes indicates the distribution of participant intake.

Figure 2

Spline regression analysis of early-onset dementia (EOD) risk for increasing intake of meats and meat products. The black line indicates odds ratios for dementia risk; dash gray lines are 95% confidence limits; the reference line at 1.0 with black spikes indicates the distribution of participant intake. Note: spline analysis was not possible for offal due to a few subjects reporting consumption which is different from a null value.

Figure 3

Spline regression analysis of early-onset dementia (EOD) risk for increasing intake of milk, dairy products, and eggs. The black line indicates odds ratios for dementia risk; dash gray lines are 95% confidence limits; the reference line at 1.0 with black spikes indicates the distribution of participant intake.

Figure 4

Spline regression analysis of early-onset dementia (EOD) risk for increasing intake of fish and seafood. The black line indicates odds ratios for dementia risk; dash gray lines are 95% confidence limits; the reference line at 1.0 with black spikes indicates the distribution of participant intake.

Figure 5

Spline regression analysis of early-onset dementia (EOD) risk for increasing intake of vegetables. The black line indicates odds ratios for dementia risk; dash gray lines are 95% confidence limits; the reference line at 1.0 with black spikes indicates the distribution of participant intake.

Figure 6

Spline regression analysis of early-onset dementia (EOD) risk for increasing intake of mushrooms, legumes, and potatoes. The black line indicates odds ratios for dementia risk; dash gray lines are 95% confidence limits; the reference line at 1.0 with black spikes indicates the distribution of participant intake.

Figure 7

Spline regression analysis of early-onset dementia (EOD) risk for increasing intake of fresh and dry fruits. The black line indicates odds ratios for dementia risk; dash gray lines are 95% confidence limits; the reference line at 1.0 with black spikes indicates the distribution of participant intake.

Figure 8

Spline regression analysis of early-onset dementia (EOD) risk for increasing intake of sweets products. The black line indicates odds ratios for dementia risk; dash gray lines are 95% confidence limits; the reference line at 1.0 with black spikes indicates the distribution of participant intake.

Figure 9

Spline regression analysis of early-onset dementia (EOD) risk for increasing intake of oils and fats. The black line indicates odds ratios for dementia risk; dash gray lines are 95% confidence limits; the reference line at 1.0 with black spikes indicates the distribution of participant intake.

Figure 10

Spline regression analysis of early-onset dementia (EOD) risk for increasing intake of beverages. The black line indicates odds ratios for dementia risk; dash gray lines are 95% confidence limits; the reference line at 1.0 with black spikes indicates the distribution of participant intake. Note: Spline analysis was not possible for most of the beverages (namely tea, red, white and aperitif wines and beers, spirits and soft drinks) due to a few subjects reporting consumption which is different from a null value.

Figure 11

Spline regression analysis for dietary patterns. Greek-Mediterranean (GM) diet, Dietary Approaches to Stop Hypertension (DASH) diet, and Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND) diet. The black line indicates odds ratios for dementia risk; dash gray lines are 95% confidence limits; the reference line at 1.0 with gray bars shows the dietary-pattern score distribution.