Association Between the Mediterranean Diet and Cognitive Decline in a Biracial Population
Association Between the Mediterranean Diet and Cognitive Decline in a Biracial Population
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DOI：
10.1093/gerona/glu097
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发表时间：
2015-03-01
影响因子：
5.1
通讯作者：
Yaffe, Kristine
中科院分区：
文献类型：
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作者：
Koyama, Alain;Houston, Denise K.;Yaffe, Kristine
背景。大量研究结果表明，地中海饮食对心血管疾病、癌症和死亡率有保护作用。与认知能力下降风险降低相关的证据不太一致，而且由于研究人群缺乏多样性，研究受到限制。在美国的一项前瞻性队列研究（健康、衰老和身体组成研究）中，我们随访了2326名老年人（38.2%为黑人，51.3%为女性，基线年龄为70-79岁）超过8年。为了衡量地中海饮食的依从性，我们使用基线食物频率问卷计算了MedDiet评分的种族特定分位数（范围：0-55）。在整个研究过程中，使用重复的修正迷你精神状态检查分数来评估认知能力下降。我们使用线性混合模型来评估MedDiet评分与认知能力下降轨迹之间的关系。在黑人中，MedDiet得分高的参与者在修正迷你精神状态检查得分上的平均下降率明显低于MedDiet得分低的参与者（中间和底部四分位数）。在调整了年龄、性别、教育程度、体重指数、当前吸烟情况、体育活动、抑郁症、糖尿病、总能量摄入和社会经济地位等因素后，每年的平均差值为0.22分（95%置信区间：0.05-0.39;p = 0.01）。在白人受试者中，MedDiet评分与修正迷你精神状态检查评分的变化之间没有关联（p = .14）。坚持地中海饮食可能会降低黑人老年人认知能力下降的速度，但对白人老年人却没有作用。需要在不同人群中进行进一步的研究来证实这种关联，并查明可能解释这些结果的机制。
Background. Results from numerous studies suggest protective effects of the Mediterranean diet for cardiovascular disease, cancer, and mortality. Evidence for an association with a decreased risk of cognitive decline is less consistent and studies are limited by a lack of diversity in their populations.Methods. We followed 2,326 older adults (38.2% black, 51.3% female, aged 70-79 at baseline) over 8 years in a prospective cohort study in the United States (Health, Aging and Body Composition study). To measure adherence to a Mediterranean diet, we calculated race-specific tertiles of the MedDiet score (range: 0-55) using baseline food frequency questionnaires. Cognitive decline was assessed using repeated Modified Mini Mental State Examination scores over the study. We used linear mixed models to assess the association between MedDiet score and trajectory of cognitive decline.Results. Among blacks, participants with high MedDiet scores had a significantly lower mean rate of decline on the Modified Mini Mental State Examination score compared with participants with lower MedDiet scores (middle and bottom tertiles). The mean difference in points per year was 0.22 (95% confidence interval: 0.05-0.39; p = .01) after adjustment for age, sex, education, body mass index, current smoking, physical activity, depression, diabetes, total energy intake, and socioeconomic status. No association between MedDiet scores and change in Modified Mini Mental State Examination score was seen among white participants (p = .14).Conclusions. Stronger adherence to the Mediterranean diet may reduce the rate of cognitive decline among black, but not white older adults. Further studies in diverse populations are needed to confirm this association and pinpoint mechanisms that may explain these results.