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Am J Clin Nutr. 2019 Jun 17. pii: nqz114. doi: 10.1093/ajcn/nqz114. [Epub ahead of print]

Mediterranean diet adherence and cognitive function in older UK adults: the European Prospective Investigation into Cancer and Nutrition-Norfolk (EPIC-Norfolk) Study.

Author information

1
Human Nutrition Research Centre, Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, United Kingdom.
2
Institute of Health and Society and Newcastle University Institute of Ageing, Newcastle University, Newcastle upon Tyne, United Kingdom.
3
Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom.
4
School of Medical Sciences and Health, Örebro University, Campus USÖ, Örebro, Sweden.
5
Clinical Gerontology Unit, School of Clinical Medicine, University of Cambridge, Cambridge, United Kingdom.
6
Department of Nutrition and Preventive Medicine, Norwich Medical School, University of East Anglia, Norwich, United Kingdom.
7
School of Sport, Exercise, and Rehabilitation Sciences, University of Birmingham, Birmingham, United Kingdom.
8
Norwich Medical School, University of East Anglia, Norwich Research Park, Norwich, United Kingdom.
9
Northumbria Healthcare NHS Foundation Trust, North Tyneside General Hospital and Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, United Kingdom.
10
Centre for Dementia Prevention, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, United Kingdom.
11
School of Life Sciences, The University of Nottingham Medical School, Queen's Medical Centre, Nottingham, United Kingdom.

Abstract

BACKGROUND:

In Mediterranean countries, adherence to a traditional Mediterranean dietary pattern (MedDiet) is associated with better cognitive function and reduced dementia risk. It is unclear if similar benefits exist in non-Mediterranean regions.

OBJECTIVES:

The aims of this study were to examine associations between MedDiet adherence and cognitive function in an older UK population and to investigate whether associations differed between individuals with high compared with low cardiovascular disease (CVD) risk.

METHODS:

We conducted an analysis in 8009 older individuals with dietary data at Health Check 1 (1993-1997) and cognitive function data at Health Check 3 (2006-2011) of the European Prospective Investigation into Cancer and Nutrition-Norfolk (EPIC-Norfolk). Associations were explored between MedDiet adherence and global and domain-specific cognitive test scores and risk of poor cognitive performance in the entire cohort, and when stratified according to CVD risk status.

RESULTS:

Higher MedDiet adherence defined by the Pyramid MedDiet score was associated with better global cognition (β ± SE = -0.012 ± 0.002; P < 0.001), verbal episodic memory (β ± SE = -0.009 ± 0.002; P < 0.001), and simple processing speed (β ± SE = -0.002 ± 0.001; P = 0.013). Lower risk of poor verbal episodic memory (OR: 0.784; 95% CI: 0.641, 0.959; P = 0.018), complex processing speed (OR: 0.739; 95% CI: 0.601, 0.907; P = 0.004), and prospective memory (OR: 0.841; 95% CI: 0.724, 0.977; P = 0.023) was also observed for the highest compared with the lowest Pyramid MedDiet tertiles. The effect of a 1-point increase in Pyramid score on global cognitive function was equivalent to 1.7 fewer years of cognitive aging. MedDiet adherence defined by the Mediterranean Diet Adherence Screener (MEDAS) score (mapped through the use of both binary and continuous scoring) showed similar, albeit less consistent, associations. In stratified analyses, associations were evident in individuals at higher CVD risk only (P < 0.05).

CONCLUSIONS:

Higher adherence to the MedDiet is associated with better cognitive function and lower risk of poor cognition in older UK adults. This evidence underpins the development of interventions to enhance MedDiet adherence, particularly in individuals at higher CVD risk, aiming to reduce the risk of age-related cognitive decline in non-Mediterranean populations.

KEYWORDS:

Mediterranean diet; cardiovascular health; cognitive decline; cognitive function; dementia risk; healthy aging

PMID:
31204785
DOI:
10.1093/ajcn/nqz114

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