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Review
. 2021 Oct 10;10(20):4642.
doi: 10.3390/jcm10204642.

Alzheimer's Disease, Mild Cognitive Impairment and Mediterranean Diet. A Systematic Review and Dose-Response Meta-Analysis

Natalia García-Casares  1   2   3 , Paloma Gallego Fuentes  1 , Miguel Ángel Barbancho  1   2   3 , Rosa López-Gigosos  1   3 , Antonio García-Rodríguez  1   3 , Mario Gutiérrez-Bedmar  1   3   4
Affiliations
Review

Alzheimer's Disease, Mild Cognitive Impairment and Mediterranean Diet. A Systematic Review and Dose-Response Meta-Analysis

Natalia García-Casares et al. J Clin Med. .

Abstract

Alzheimer's Disease (AD) is a pathology with increasing prevalence in the context of a more long-lived society and it is the first cause of dementia in western countries. It is important to investigate factors that can be protective and may influence its development, in order to act on them trying to reduce AD incidence and its progression. The aim of this study was to conduct a systematic review and meta-analysis to determine the effects of a higher adherence to Mediterranean diet (MD) on Mild Cognitive Impairment (MCI) and AD. A literature search in PubMed, The Cochrane Library Plus and Scopus was conducted, selecting articles that analyzed associations between MD adherence and AD biomarkers (Volumetry assessed by MRI and betamiloide and Tau deposits by PET); cognitive performance in patients at risk or presenting MCI and AD; and incidence or progression from MCI to AD. Out of the 589 studies screened, 22 studies met eligibility criteria for the systematic review and qualitative synthesis. Finally, 11 studies were included in the meta-analysis (12,458 participants). Higher adherence to MD was associated with a significantly lower risk of MCI (RR = 0.91, 95%CI = 0.85-0.97) and lower risk of AD (RR = 0.89, 95% CI = 0.84-0.93). Our results enhance the importance of taking health-promoting lifestyle measures like following Mediterranean dietary patterns in order to reduce AD risk.

Keywords: Alzheimer’s disease; Mediterranean diet; meta-analysis; mild cognitive impairment.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure A1
Figure A1
Mediterranean diet adherence and risk of Alzheimer’s disease or mild cognitive impairment: a subgroup analysis according to study design. CI = confidence interval; AD = Alzheimer’s disease; MCI = Mild cognitive impairment; I-V = Mantel-Haenszel method (fixed-effects model); D + L = DerSimonian and Laird method (random-effects model).
Figure 1
Figure 1
Flowchart of identification and selection of studies.
Figure 2
Figure 2
Forest plot of Mediterranean diet adherence and risk of Alzheimer’s disease or mild cognitive impairment. CI = confidence interval; AD = Alzheimer’s disease; I-V = Mantel-Haenszel method (fixed-effects model); D + L = DerSimonian and Laird method (random-effects model); MCI = Mild cognitive impairment.
Figure 3
Figure 3
Funnel plot with pseudo 95% confidence limits. RR=relative risk; s.e. = standard error.
See this image and copyright information in PMC

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