Poor Diet and Lower Neuropsychological Performance in a rural setting: The Bogalusa Heart Study

Abstract

AbstractBackgroundPoor diet has been associated with insidious onset dementia. The Alternate Healthy Eating Index (AHEI) can capture overall nutrient quality and individual/population eating behaviors. Higher adherence to AHEI has been associated with a lower risk of incident dementia and better cognitive function in late life. However, most evidence comes from high‐income populations from urban areas. Here, we examined the adherence to AHEI and its association with cognitive function in midlife among Black and White individuals from a community cohort in the rural, low SES area of Bogalusa, Louisiana.MethodThis cross‐sectional analysis considered 1,040 participants from the Bogalusa Heart Study (mean age 48.1 ± 61% female, 31% Black) with a complete neuropsychological (NP) assessment and food frequency questionnaires. (AHEI‐2010 score, range 0‐110). Regression models using GEE accounted for clustering effects of neighborhood factors/SES using census‐track level codes and estimated the association between quintiles (Q1‐Q5) of AHEI‐2010 and a global cognitive z‐score (GCS) and cognitive domains.ResultIndividuals in Q5 (healthiest) tended to be female (68%, p = 0.03), significantly older (49.3 ± 5, p<0.001), with higher education (³ college 56%, p<0.001), and AHEI‐2010 scores from 53.38‐79.2. Compared with participants in Q1. Those in Q5 had higher GCS [ß (95% CI):1.71 (0.85, 2.57); p<0.001] after adjusting for age, sex, race, and the ACS‐Index of concentration at the extremes (to account for neighborhood‐level SES). Similarly, those with the healthiest diet had higher NP z‐scores within the domains of executive function, attention and speed processing information, and episodic memory. However, these associations were not significant after adjusting for education. (Table 1) For episodic memory, individuals in quintile 4 had higher NP z‐scores after adjusting for education [0.36 (0.07, 0.65); p = 0.01], and the trend across quintiles was also significant in all models and after adjusting for education [p = 0.03].ConclusionAs early as midlife, Black and White individuals from rural settings with greater adherence to healthy dietary patterns have better NP performance across different neurocognitive domains. These results strengthen previous evidence suggesting that diet quality may be a potential avenue of intervention to prevent cognitive decline and aid health disparities.