Mediterranean Diet and Mild Cognitive Impairment

By Nikolaos Scarmeas, Yaakov Stern, Richard P. Mayeux, Jennifer J. Manly, N. Schupf, José A. Luchsinger. Archives of Neurology, 2009

773 citations recorded by the source corpus.

Background Higher adherence to the Mediterranean diet (MeDi) may protect from Alzheimer’s disease (AD) but its association with Mild Cognitive Impairment (MCI) has not been explored. Objective To investigate the association between MeDi and MCI. Design, Setting, Patients, Outcomes In a multiethnic community study in New York, we used Cox proportional hazards to investigate the association between adherence to the MeDi (0 – 9 scale; higher scores higher adherence) and (1) incidence of MCI and (2) progression from MCI to AD. All models were adjusted for cohort, age, gender, ethnicity, education, APOE genotype, caloric intake, body mass index and time duration between baseline dietary assessment and baseline diagnosis. Results There were 1393 cognitively normal participants, 275 of whom developed MCI during 4.5 (± 2.7, 0.9–16.4) years of follow-up. Compared to subjects in the lowest MeDi adherence tertile, subjects in the middle MeDi tertile had 17 % (HR, 0.83; 95% CI, 0.62 – 1.12; p=0.24) less risk of developing MCI, while those at the highest MeDi adherence tertile had 28 % (HR, 0.72; 95% CI, 0.52 – 1.00; p=0.05) less risk of developing MCI (trend HR, 0.85; 95% CI, 0.72 – 1.00; p for trend= 0.05). There were 482 subjects with MCI, 106 of whom developed AD during 4.3 (± 2.7, 1.0 – 13.8) years of follow-up. Compared to subjects in the lowest MeDi adherence tertile, subjects in the middle MeDi adherence tertile had 45 % (HR, 0.55; 95% CI, 0.34 – 0.90; p=0.01) less risk of developing AD, while those at the highest MeDi adherence tertile had 48 % (HR, 0.52; 95% CI, 0.30 – 0.91; p=0.02) less risk of developing AD (trend HR, 0.71; 95% CI, 0.53 – 0.95; p for trend= 0.02). Conclusions Higher adherence to the MeDi is associated with a trend for reduced risk for developing MCI and with reduced risk for MCI conversion to AD.

Subfields: Physiology, Public Health, Environmental and Occupational Health

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Citations in the corpus

Association of Mediterranean diet with Mild Cognitive Impairment and Alzheimer’s disease: A Systematic Review and Meta-Analysis (2014, methodology): “Therefore, we conducted a sensitivity analysis by excluding the paper with the smaller sample size [6].”
Systematic Review: Factors Associated With Risk for and Possible Prevention of Cognitive Decline in Later Life (2010, background): “6 Inadequate evidence* Trace metals (9–11) 2 6335† 4–9 Copper (no association except in subgroup) Mediterranean diet (12, 13) 2 3285 4.”
Accruing evidence on benefits of adherence to the Mediterranean diet on health: an updated systematic review and meta-analysis. (2010, background): “Of these, 1 study presented the overall mortality as a clinical outcome (14), 3 studies presented the incidence and/or mortality from cardiovascular diseases (13, 15, 16), 1 study presented the incidence and/or mortality from neoplastic diseases (17), and 2 studies presented the incidence of neurode”
Adherence to a Mediterranean diet, cognitive decline, and risk of dementia. (2009, neutral): “A single study showed a reduced risk for Alzheimer disease and mild cognitive impairment in participants with greater Mediterranean diet adherence.(11,12) These results were obtained in a nonMediterranean older population, mainly US Hispanics and blacks ( 30% whites), which limits its generalizabili”
Physical activity, diet, and risk of Alzheimer disease. (2009, neutral): “Comorbidity index, mean (SD) 2.2 (1.5)b 2.0 (1.4)b 1.8 (1.4)b .001 Smoker 72 (14) 71 (11) 96 ( 14 ) .24”
Epidemiology of Alzheimer Disease (2012, positive): “In a follow-up analysis, the Mediterranean diet was also associated with a reduced risk of developing mild cognitive impairment and of progression from mild cognitive impairment to AD (Scarmeas et al. 2009).”