Association of mediterranean diet with mild cognitive impairment and Alzheimer's disease: a systematic review and meta-analysis.
Association of mediterranean diet with mild cognitive impairment and Alzheimer's disease: a systematic review and meta-analysis.
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地中海饮食与轻度认知障碍与阿尔茨海默氏病的关联：系统评价和荟萃分析。
DOI：
10.3233/jad-130830
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发表时间：
2014
期刊：
影响因子：
--
通讯作者：
Roberts RO
中科院分区：
文献类型：
--
作者：
Singh B;Parsaik AK;Mielke MM;Erwin PJ;Knopman DS;Petersen RC;Roberts RO
对所有研究进行系统回顾，以确定地中海饮食（Medi）与认知障碍之间是否存在关联。我们对主要数据库进行了全面检索，并手工检索了截至2012年11月的主要神经病学、精神病学和痴呆症会议的会议记录。纳入了前瞻性队列研究，这些研究检查了纵向随访至少1年的MeDi，并报告了认知结局（轻度认知障碍[MCI]或阿尔茨海默病[AD]）。使用随机效应模型，将效应量估计为风险比（HR）和95%置信区间（CI）。使用Cochran's Q检验和I2统计量评估异质性。在筛选的664项研究中，5项研究符合合格标准。对Medi的更高依从性与MCI和AD的风险降低相关。与最低MeDi评分三分位数相比，最高MeDi三分位数中的受试者的认知障碍（MCI或AD）风险降低33%（校正HR=0.67; 95% CI，0.55-0.81; P<0.0001）。在认知正常的个体中，对MeDi的更高依从性与MCI（HR=0.73; 95%CI，0.56-0.96; P=0.02）和AD（HR=0.64; 95%CI，0.46-0.89; P=0.007）的风险降低相关。分析中无显著异质性。虽然研究总数较少，但汇总结果表明，对Medi的更高依从性与发生MCI和AD的风险降低以及从MCI进展为AD的风险降低相关。进一步的前瞻性队列研究，更长的随访和随机对照试验是必要的，以巩固证据。
To conduct a systematic review of all studies to determine whether there is an association between the Mediterranean diet (MeDi) and cognitive impairment. We conducted a comprehensive search of the major databases and hand-searched proceedings of major neurology, psychiatry, and dementia conferences through November 2012. Prospective cohort studies examining the MeDi with longitudinal follow-up of at least 1 year and reporting cognitive outcomes (mild cognitive impairment [MCI] or Alzheimer’s disease [AD]) were included. The effect size was estimated as hazard-ratio (HR) with 95% confidence intervals (CIs) using the random-effects model. Heterogeneity was assessed using Cochran’s Q-test and I2-statistic. Out of the 664 studies screened, five studies met eligibility criteria. Higher adherence to the MeDi was associated with reduced risk of MCI and AD. The subjects in the highest MeDi tertile had 33% less risk (adjusted HR=0.67; 95% CI, 0.55–0.81; P<0.0001) of cognitive impairment (MCI or AD) as compared to the lowest MeDi score tertile. Among cognitively normal individuals, higher adherence to the MeDi was associated with a reduced risk of MCI (HR=0.73; 95% CI, 0.56–0.96; P=0.02) and AD (HR=0.64; 95% CI, 0.46–0.89; P=0.007). There was no significant heterogeneity in the analyses. While the overall number of studies is small, pooled results suggest that a higher adherence to the MeDi is associated with a reduced risk of developing MCI and AD, and a reduced risk of progressing from MCI to AD. Further prospective-cohort studies with longer follow-up and randomized controlled trials are warranted to consolidate the evidence.