Abstract

In the absence of identified etiologic treatment for dementia, the potential preventive role of nutrition may offer an interesting perspective. The objective of the thesis of C. Samieri was to study the association between nutrition and brain aging in 1,796 subjects, aged 65 y or older, from the Bordeaux sample of the Three-City study, with a particular emphasis on fatty acids. Considering the multidimensional nature of nutritional data, several complementary strategies were used. At the global diet level, dietary patterns actually observed in the population were identified by exploratory methods. Older subjects with a ‘‘healthy’’ pattern, who consumed more than 3.5 weekly servings of fish in men and more than 6 daily servings of fruits and vegetables in women, showed a better cognitive and psychological health. Adherence to the Mediterranean diet, measured according to a score-based confirmatory method, was associated with slower global cognitive decline after 5 y of follow-up. At the nutrient biomarker level, higher plasma eicosapentaenoic acid (EPA), a long-chain omega-3 fatty acid, was associated with a decreased dementia risk, and the omega-6-to-omega-3 fatty acids ratio to an increased risk, particularly in depressed subjects. EPA was also related to slower working memory decline in depressed subjects or in carriers of the e4 allele of the ApoE gene. Docosahexaenoic acid was related to slower working memory decline only in ApoE4 carriers. Overall, this work suggests a positive impact of a healthy diet rich in fruits and vegetables and fish, and notably the Mediterranean diet, on cognition in older subjects. Long-chain n-3 PUFA, in particular EPA, may be key protective nutrients against risk of dementia and cognitive decline.

Highlights

  • With the aging of populations, dementia and Alzheimer’s disease (AD) as its more frequent form, has become an important concern worldwide (Brayne, 2007)

  • The results from this thesis suggest that cognitive performances and depressive symptoms, which are two major features of brain aging, may vary according to habitual dietary habits of subjects, and may be improved in higher fish and fruits and vegetables consumers

  • We brought some evidence that higher adherence to the Mediterranean diet (MeDi) may contribute to slowing down age-related global cognitive decline

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Summary

Dietary patterns and brain aging

Actual dietary patterns as observed in a population of older subjects were identified by exploratory statistical methods (Samieri et al, 2008). Older subjects from the ‘‘healthy’’ pattern, who consumed more than 3.5 weekly servings of fish in men and more than 6 daily servings of fruits and vegetables in women, showed higher global cognitive performances as assessed by the score to the MMSE. This work suggested a potential protective role for a ‘‘healthy’’ pattern against brain aging, the cross-sectional nature of the design prevented to infer any causality in the observed associations These findings identified clusters of subjects with a particular food behaviour associated with poorer cognitive and psychological health, which may be targeted for nutrition policies in order to prevent brain aging. One could expect that a positive association between blood levels of long-chain n-3 PUFA and depressive status explained the potential association between these fatty acids and dementia risk or cognitive decline (e.g confounding effect of depression). The relationship between plasma fatty acids and dementia risk over 4 y of follow-up was studied, taking into

Raw vegetables Cooked vegetables
Depressive status
Findings
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