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

Tommaso Filippini,Giovanna Zamboni,Caterina Garuti,Marcella Malavolti,Manuela Tondelli,Giorgia Adani,Chiara Galli,Marco Vinceti,Silvia Cilloni,Annalisa Chiari,Giulia Vinceti,Manuela Costa

doi:10.3390/nu12123682

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.

Highlights

Dementia is a syndrome, usually of a chronic or progressive nature, characterized by impairment of cognitive functions beyond what might be expected from normal ageing [1,2]
About cereals products, we found an inverse association with Early-onset dementia (EOD) risk, a positive association can be noted for subjects in the third tertile for both pasta and rice consumption
We found a positive association with EOD risk, mainly due to ice-cream, cakes, pies/pastries, and biscuits/dry cakes, while chocolate and other confectionery showed an inverse association

Summary

Introduction

Usually of a chronic or progressive nature, characterized by impairment of cognitive functions beyond what might be expected from normal ageing [1,2]. Early-onset dementia (EOD) is a heterogeneous group of cognitive disorders characterized by an onset of dementia symptoms before the age of 65 [3]. Such an age cut-point has not been established based on biological differences between younger and older subjects, but mainly on the socio-economic implications of dementia diagnosis at a younger age [3,4]. Among the dietary habits involved, a high consumption of vegetables, fruit, and fish [15,16,17], and adherence to the Mediterranean diet or other dietary patterns (e.g., the Dietary Approaches to Stop Hypertension (DASH) and the Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND) diet) have been associated with a slower cognitive decline and decreased risk of all-age dementia [12,18,19,20,21]. Data provided evidence of protective effects against the risk of developing AD, suggesting that dietary interventions may play a role in the prevention of cognitive decline [22,23]

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