Dietary patterns are related to cognitive functioning in elderly enriched with individuals at increased risk for Alzheimer\u2019s disease

Linda M.p Wesselman ,Luca Kleineidam ,Katharina Büerger ,Josef Priller ,Coraline D Metzger ,Anja Schneider ,Annika Spottke ,Ruth Vukovich ,Frank Jessen ,Alina Schröder ,Sietske A.m Sikkes ,Sandra Roeske ,Stefan J Teipel ,Debora Melo Van Lent ,Alfredo Ramı́rez ,Slawek Altenstein ,Manuel Fuentes ,Eike Jakob Spruth ,Steffen Wolfsgruber ,Robert Perneczky ,Verena Pross ,Martina Buchmann ,Christoph Laske ,Felix Menne ,Oliver Peters ,Ann‐Katrin Schild ,Maia Tatò ,Wenzel Glanz ,Emrah Düzel ,Wiesje M Van Der Flier ,Jens Wiltfang ,Ondine Van De Rest ,Klaus Fließbach ,Ingo Kilimann ,Daniel Janowitz ,Michael Wagner

doi:10.1007/s00394-020-02257-6

Abstract

PurposeTo investigate cross-sectional associations between dietary patterns and cognitive functioning in elderly free of dementia.MethodsData of 389 participants from the German DELCODE study (52% female, 69 ± 6 years, mean Mini Mental State Score 29 ± 1) were included. The sample was enriched with elderly at increased risk for Alzheimer’s disease (AD) by including participants with subjective cognitive decline, mild cognitive impairment (MCI) and siblings of AD patients. Mediterranean and MIND diets were derived from 148 Food Frequency Questionnaire items, and data-driven patterns by principal component analysis (PCA) of 39 food groups. Associations between dietary patterns and five cognitive domain scores were analyzed with linear regression analyses adjusted for demographics (model 1), and additionally for energy intake, BMI, other lifestyle variables and APOe4-status (model 2). For PCA-derived dietary components, final model 3 included all other dietary components.ResultsIn fully adjusted models, adherence to Mediterranean and MIND diet was associated with better memory. The ‘alcoholic beverages’ PCA component was positively associated with most cognitive domains. Exclusion of MCI subjects (n = 60) revealed that Mediterranean and MIND diet were also related to language functions; associations with the alcoholic beverages component were attenuated, but most remained significant.ConclusionIn line with data from elderly population samples, Mediterranean and MIND diet and some data-derived dietary patterns were related to memory and language function. Longitudinal data are needed to draw conclusions on the putative effect of nutrition on the rate of cognitive decline, and on the potential of dietary interventions in groups at increased risk for AD.

Highlights

The number of people living with dementia is increasing worldwide due to the aging of the population [1]
We found that higher adherence to the Mediterranean diet or the Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND) diet was associated with aspects of cognition in an elderly sample free of dementia, enriched with individuals at increased risk for Alzheimer’s disease (AD)
Higher adherence to MD and MIND was associated with better memory, and exclusion of mild cognitive impairment (MCI) subjects revealed that Mediterranean and MIND diet were related to language in the unimpaired group

Summary

Introduction

The number of people living with dementia is increasing worldwide due to the aging of the population [1]. A healthy lifestyle has been suggested to be one of the modifiable risk factors for cognitive decline and dementia, and prevention studies, increasingly focus on lifestyle and cognition [3]. Nutrition is one of the lifestyle factors that could prevent or delay cognitive decline and dementia [4, 5]. Investigating dietary patterns may be more informative for public health purposes, such as the development of foodbased dietary guidelines. It has, been suggested that relationships between food intake and cognition should be evaluated by taking into account dietary patterns, rather than the intake of single food or nutrients [12]

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