Abstract
Nutrition is one of the modifiable risk factors for cognitive decline and Alzheimer’s disease (AD) dementia, and is therefore highly relevant in the context of prevention. However, knowledge of dietary quality in clinical populations on the spectrum of AD dementia is lacking, therefore we studied the association between dietary quality and cognitive impairment in Alzheimer’s disease (AD) dementia, mild cognitive impairment (MCI) and controls. We included 357 participants from the NUDAD project (134 AD dementia, 90 MCI, 133 controls). We assessed adherence to dietary guidelines (components: vegetables, fruit, fibers, fish, saturated fat, trans-fat, salt, and alcohol), and cognitive performance (domains: memory, language, visuospatial functioning, attention, and executive functioning). In the total population, linear regression analyses showed a lower vegetable intake is associated with poorer global cognition, visuospatial functioning, attention and executive functioning. In AD dementia, lower total adherence to dietary guidelines and higher alcohol intake were associated with poorer memory, a lower vegetable intake with poorer global cognition and executive functioning, and a higher trans-fat intake with poorer executive functioning. In conclusion, a suboptimal diet is associated with more severely impaired cognition—this association is mostly attributable to a lower vegetable intake and is most pronounced in AD dementia.
Highlights
The prevalence of Alzheimer’s disease (AD) dementia is increasing, and it is one of the largest health care challenges of our time [1]
AD dementia and mild cognitive impairment (MCI) patients were older than controls, and AD
Cognitive performance was worst in AD dementia, with MCI in between AD dementia and controls
Summary
The prevalence of Alzheimer’s disease (AD) dementia is increasing, and it is one of the largest health care challenges of our time [1]. Food groups including vegetables, fruit, or fish [3,4,5,6,7,8], and healthy dietary patterns such as the Mediterranean diet, dietary approaches to stop hypertension (DASH), or Mediterranean-DASH intervention for neurodegenerative delay (MIND) [9,10,11,12,13], have all been associated with less cognitive decline or reduced risk for mild cognitive impairment (MCI) or AD dementia. A recent study found that better adherence to the Mediterranean and MIND diets was associated with better global cognition in cognitive healthy adults, but not in MCI or AD dementia patients [14]. Most previous studies used a global cognitive screener, such as the Mini Mental State Examination (MMSE) [15], while in patients across a cognitive continuum, an extensive neuropsychological assessment provides a more sensitive outcome
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