Adherence to a Mediterranean diet and risk of incident cognitive impairment
Adherence to a Mediterranean diet and risk of incident cognitive impairment
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DOI：
10.1212/wnl.0b013e3182904f69
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发表时间：
2013-04-01
期刊：
影响因子：
9.9
通讯作者：
Wadley, Virginia G.
中科院分区：
文献类型：
--
作者：
Tsivgoulis, Georgios;Judd, Suzanne;Wadley, Virginia G.
目的：我们试图确定更多地遵守地中海饮食(Med)和发生认知损害(ICI)的可能性之间的关系，并评估种族和血管危险因素的交互作用。方法：对2003-2007年间参加卒中地理和种族差异(RECONS)研究的前瞻性、基于人群的队列个体进行评估，排除了有中风病史、基线认知状况受损和食物频率问卷(FQ)数据缺失的参与者。对MED的依从性(0-9分)是根据FFQ计算的。结果：在符合纳入标准的17,478名受试者中，有1,248名(7%)被确定为ICI。更高的依从性与较低的ICI可能性相关，在此之前(优势比[LSQB]或[RSQB]0.89；95%可信区间[LSQB][RSQB]0.79-1.00)和调整潜在混杂因素(OR 0.87；95%CI 0.76-1.00)，包括人口统计特征、环境因素、血管危险因素、抑郁症状和自我报告的健康状况。种族(p=0.2928)和对地中海的依从性与认知状态之间没有交互作用。然而，我们发现糖尿病(p=0.0134)对遵守MED与脑梗塞的关系有很强的交互作用；在非糖尿病参与者中，对MED的高依从性与较低的发生ICI的可能性相关(OR0.81；95%CI0.70-0.94；p=0.0066)，而在糖尿病患者中则不存在(OR1.27；95%CI0.95-1.71；p=0.1063)。这种联系被糖尿病的存在所缓和。
Objective: We sought to determine the relationship of greater adherence to Mediterranean diet (MeD) and likelihood of incident cognitive impairment (ICI) and evaluate the interaction of race and vascular risk factors.Methods: A prospective, population-based, cohort of individuals enrolled in the Reasons for Geographic and Racial Differences in Stroke (REGARDS) Study 2003-2007, excluding participants with history of stroke, impaired cognitive status at baseline, and missing data on Food Frequency Questionnaires (FFQ), was evaluated. Adherence to a MeD (scored as 0-9) was computed from FFQ. Cognitive status was evaluated at baseline and annually during a mean follow-up period of 4.0 +/- 1.5 years using Six-item-Screener.Results: ICI was identified in 1,248 (7%) out of 17,478 individuals fulfilling the inclusion criteria. Higher adherence to MeD was associated with lower likelihood of ICI before (odds ratio [lsqb] OR [rsqb] 0.89; 95% confidence interval [lsqb] CI[rsqb] 0.79-1.00) and after adjustment for potential confounders (OR 0.87; 95% CI 0.76-1.00) including demographic characteristics, environmental factors, vascular risk factors, depressive symptoms, and self-reported health status. There was no interaction between race (p = 0.2928) and association of adherence to MeD with cognitive status. However, we identified a strong interaction of diabetes mellitus (p = 0.0134) on the relationship of adherence to MeD with ICI; high adherence to MeD was associated with a lower likelihood of ICI in nondiabetic participants (OR 0.81; 95% CI 0.70-0.94; p = 0.0066) but not in diabetic individuals (OR 1.27; 95% CI 0.95-1.71; p = 0.1063).Conclusions: Higher adherence to MeD was associated with a lower likelihood of ICI independent of potential confounders. This association was moderated by presence of diabetes mellitus.