Whole Dietary Patterns, Cognitive Decline and Cognitive Disorders: A Systematic Review of Prospective and Intervention Studies.
Whole Dietary Patterns, Cognitive Decline and Cognitive Disorders: A Systematic Review of Prospective and Intervention Studies.
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痴呆症的流行是一个全球性的公共卫生问题。坚持健康的饮食模式（DP）可以降低认知能力下降和痴呆的风险。本叙述性系统综述旨在综合前瞻性和干预性研究数据，以评估从认知能力下降到偶发性痴呆等认知衰老过程中先验和事后得出的DPs的影响。纳入93项研究：83项前瞻性研究和10项随机对照试验（RCT）。大多数前瞻性研究（77%）检查了先验的DPs，其中地中海饮食检查最频繁。总共52%的前瞻性随机对照试验和50%的随机对照试验报告了“健康”DPs与全球认知能力下降之间的保护关系。总体而言，59%的前瞻性研究报告了健康的DPs与认知障碍风险之间的正相关。只有一项干预研究（亚组分析）对偶发性认知障碍进行了检查，该研究报告了低脂饮食对女性患痴呆症风险的有益影响。不健康的dp被检查的频率较低（n = 17; 21%），其中41%的研究报告了依从性与较差的认知结果之间的关联。总的来说，健康和不健康的dp在认知方面的结果是混合的，可能是由于研究之间的异质性。饮食暴露和认知结果测量的标准化将有助于减少这种情况。未来的研究将受益于调查文化上适当的dp对不同和高风险人群的个体认知领域和偶发性认知障碍的影响。
Dementia prevalence is a global public health concern. Adherence towards a healthy dietary pattern (DP) may reduce the risk of cognitive decline and dementia. This narrative systematic review aimed to synthesise prospective and intervention study data to evaluate the impact of a-posteriori and a-priori derived DPs on cognitive ageing, from cognitive decline to incident dementia. Ninety-three studies were included: 83 prospective studies and 10 randomised controlled trials (RCT). Most prospective studies (77%) examined a-priori DPs, with the Mediterranean diet examined most frequently. A total of 52% of prospective and 50% of RCTs reported a protective relationship between ‘healthy’ DPs and global cognitive decline. Overall, 59% of prospective studies reported positive associations between healthy DPs and risk of cognitive disorder. Incident cognitive disorder was examined by only one intervention study (subgroup analysis) which reported a beneficial effect of a low-fat diet on risk of probable dementia in women. Unhealthy DPs were examined less frequently (n = 17; 21%), with 41% of these studies reporting associations between adherence and poorer cognitive outcomes. Overall, there were mixed results for healthy and unhealthy DPs on cognition, likely due to between-study heterogeneity. Standardisation of diet exposure and cognitive outcome measurement would help to reduce this. Future research would benefit from investigating effects of culturally appropriate DPs on individual cognitive domains and incident cognitive disorders in diverse and high-risk populations.