Association Between Dietary Habits in Midlife With Dementia Incidence Over a 20-Year Period.

Humans Female Middle Aged Male Incidence Follow-Up Studies Prospective Studies Alzheimer Disease / epidemiology Dementia, Vascular / epidemiology Risk Factors Feeding Behavior Diet, Mediterranean

Journal

Neurology
ISSN: 1526-632X
Titre abrégé: Neurology
Pays: United States
ID NLM: 0401060

Informations de publication

Date de publication:
03 01 2023
Historique:
received: 26 01 2022
accepted: 16 08 2022
pubmed: 13 10 2022
medline: 29 12 2022
entrez: 12 10 2022
Statut: ppublish

Résumé

Dementia cases are expected to triple during the next 30 years, highlighting the importance of finding modifiable risk factors for dementia. The aim of this study was to investigate whether adherence to conventional dietary recommendations or to a modified Mediterranean diet are associated with a subsequent lower risk of developing all-cause dementia, Alzheimer disease (AD), vascular dementia (VaD), or with future accumulation of AD-related β-amyloid (Aβ) pathology. Baseline examination in the prospective Swedish population-based Malmö Diet and Cancer Study took place in 1991-1996 with a follow-up for incident dementia until 2014. Nondemented individuals born 1923-1950 and living in Malmö were invited to participate. Thirty thousand four hundred forty-six were recruited (41% of all eligible). Twenty-eight thousand twenty-five had dietary data and were included in this study. Dietary habits were assessed with a 7-day food diary, detailed food frequency questionnaire, and 1-hour interview. Main outcomes were incident all-cause dementia, AD, or VaD determined by memory clinic physicians. Secondary outcome was Aβ-accumulation measured using CSF Aβ42 (n = 738). Cox proportional hazard models were used to examine associations between diet and risk of developing dementia (adjusted for demographics, comorbidities, smoking, physical activity, and alcohol). Sixty-one percent were women, and the mean (SD) age was 58.1 (7.6) years. One thousand nine hundred forty-three (6.9%) were diagnosed with dementia (median follow-up, 19.8 years). Individuals adhering to conventional dietary recommendations did not have lower risk of developing all-cause dementia (hazard ratio [HR] comparing worst with best adherence, 0.93, 95% CI 0.81-1.08), AD (HR 1.03, 0.85-1.23), or VaD (HR 0.93, 0.69-1.26). Neither did adherence to the modified Mediterranean diet lower the risk of developing all-cause dementia (HR 0.93 0.75-1.15), AD (HR 0.90, 0.68-1.19), or VaD (HR 1.00, 0.65-1.55). The results were similar when excluding participants developing dementia within 5 years or those with diabetes. No significant associations were found between diet and abnormal Aβ accumulation, conventional recommendations (OR 1.28, 0.74-2.24) or modified Mediterranean diet (OR 0.85, 0.39-1.84). In this 20-year follow-up study, neither adherence to conventional dietary recommendations nor to modified Mediterranean diet were significantly associated with subsequent reduced risk for developing all-cause dementia, AD dementia, VaD, or AD pathology.

Sections du résumé

BACKGROUND AND OBJECTIVES
Dementia cases are expected to triple during the next 30 years, highlighting the importance of finding modifiable risk factors for dementia. The aim of this study was to investigate whether adherence to conventional dietary recommendations or to a modified Mediterranean diet are associated with a subsequent lower risk of developing all-cause dementia, Alzheimer disease (AD), vascular dementia (VaD), or with future accumulation of AD-related β-amyloid (Aβ) pathology.
METHODS
Baseline examination in the prospective Swedish population-based Malmö Diet and Cancer Study took place in 1991-1996 with a follow-up for incident dementia until 2014. Nondemented individuals born 1923-1950 and living in Malmö were invited to participate. Thirty thousand four hundred forty-six were recruited (41% of all eligible). Twenty-eight thousand twenty-five had dietary data and were included in this study. Dietary habits were assessed with a 7-day food diary, detailed food frequency questionnaire, and 1-hour interview. Main outcomes were incident all-cause dementia, AD, or VaD determined by memory clinic physicians. Secondary outcome was Aβ-accumulation measured using CSF Aβ42 (n = 738). Cox proportional hazard models were used to examine associations between diet and risk of developing dementia (adjusted for demographics, comorbidities, smoking, physical activity, and alcohol).
RESULTS
Sixty-one percent were women, and the mean (SD) age was 58.1 (7.6) years. One thousand nine hundred forty-three (6.9%) were diagnosed with dementia (median follow-up, 19.8 years). Individuals adhering to conventional dietary recommendations did not have lower risk of developing all-cause dementia (hazard ratio [HR] comparing worst with best adherence, 0.93, 95% CI 0.81-1.08), AD (HR 1.03, 0.85-1.23), or VaD (HR 0.93, 0.69-1.26). Neither did adherence to the modified Mediterranean diet lower the risk of developing all-cause dementia (HR 0.93 0.75-1.15), AD (HR 0.90, 0.68-1.19), or VaD (HR 1.00, 0.65-1.55). The results were similar when excluding participants developing dementia within 5 years or those with diabetes. No significant associations were found between diet and abnormal Aβ accumulation, conventional recommendations (OR 1.28, 0.74-2.24) or modified Mediterranean diet (OR 0.85, 0.39-1.84).
DISCUSSION
In this 20-year follow-up study, neither adherence to conventional dietary recommendations nor to modified Mediterranean diet were significantly associated with subsequent reduced risk for developing all-cause dementia, AD dementia, VaD, or AD pathology.

Identifiants

DOI: 10.1212/WNL.0000000000201336 PMID: 36224029 PMC: PMC9827131
pubmed: 36224029
pii: WNL.0000000000201336
doi: 10.1212/WNL.0000000000201336
pmc: PMC9827131
doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

e28-e37

Commentaires et corrections

Type : CommentIn
Type : ErratumIn
Type : CommentIn
Type : CommentIn
Type : CommentIn
Type : CommentIn
Type : CommentIn

Informations de copyright

Copyright © 2022 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the American Academy of Neurology.

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Auteurs

Isabelle Glans (I)

From the Clinical Memory Research Unit (I.G., K.N., A.-M.G., Erik Stomrud, S.P., O.H.), Department of Clinical Sciences Malmö, Lund University, Sweden; Memory Clinic (I.G., A.-M.G., Erik Stomrud, S.P., O.H.), Skåne University Hospital, Malmö, Sweden; Department of Clinical Sciences in Malmö(Emily Sonestedt, E.G.-P., Y.B.), Nutritional Epidemiology, Lund University, Skåne University Hospital, Malmö, Sweden; Department of Acute Internal Medicine and Geriatrics (K.N.), Linköping University, Sweden; and Department of Clinical Sciences Malmö (O.M., P.M.N.), Lund University, Skåne University Hospital, Malmö, Sweden. isabelle.glans@med.lu.se.

Emily Sonestedt (E)

From the Clinical Memory Research Unit (I.G., K.N., A.-M.G., Erik Stomrud, S.P., O.H.), Department of Clinical Sciences Malmö, Lund University, Sweden; Memory Clinic (I.G., A.-M.G., Erik Stomrud, S.P., O.H.), Skåne University Hospital, Malmö, Sweden; Department of Clinical Sciences in Malmö(Emily Sonestedt, E.G.-P., Y.B.), Nutritional Epidemiology, Lund University, Skåne University Hospital, Malmö, Sweden; Department of Acute Internal Medicine and Geriatrics (K.N.), Linköping University, Sweden; and Department of Clinical Sciences Malmö (O.M., P.M.N.), Lund University, Skåne University Hospital, Malmö, Sweden.

Katarina Nägga (K)

From the Clinical Memory Research Unit (I.G., K.N., A.-M.G., Erik Stomrud, S.P., O.H.), Department of Clinical Sciences Malmö, Lund University, Sweden; Memory Clinic (I.G., A.-M.G., Erik Stomrud, S.P., O.H.), Skåne University Hospital, Malmö, Sweden; Department of Clinical Sciences in Malmö(Emily Sonestedt, E.G.-P., Y.B.), Nutritional Epidemiology, Lund University, Skåne University Hospital, Malmö, Sweden; Department of Acute Internal Medicine and Geriatrics (K.N.), Linköping University, Sweden; and Department of Clinical Sciences Malmö (O.M., P.M.N.), Lund University, Skåne University Hospital, Malmö, Sweden.

Anna-Märta Gustavsson (AM)

From the Clinical Memory Research Unit (I.G., K.N., A.-M.G., Erik Stomrud, S.P., O.H.), Department of Clinical Sciences Malmö, Lund University, Sweden; Memory Clinic (I.G., A.-M.G., Erik Stomrud, S.P., O.H.), Skåne University Hospital, Malmö, Sweden; Department of Clinical Sciences in Malmö(Emily Sonestedt, E.G.-P., Y.B.), Nutritional Epidemiology, Lund University, Skåne University Hospital, Malmö, Sweden; Department of Acute Internal Medicine and Geriatrics (K.N.), Linköping University, Sweden; and Department of Clinical Sciences Malmö (O.M., P.M.N.), Lund University, Skåne University Hospital, Malmö, Sweden.

Esther González-Padilla (E)

From the Clinical Memory Research Unit (I.G., K.N., A.-M.G., Erik Stomrud, S.P., O.H.), Department of Clinical Sciences Malmö, Lund University, Sweden; Memory Clinic (I.G., A.-M.G., Erik Stomrud, S.P., O.H.), Skåne University Hospital, Malmö, Sweden; Department of Clinical Sciences in Malmö(Emily Sonestedt, E.G.-P., Y.B.), Nutritional Epidemiology, Lund University, Skåne University Hospital, Malmö, Sweden; Department of Acute Internal Medicine and Geriatrics (K.N.), Linköping University, Sweden; and Department of Clinical Sciences Malmö (O.M., P.M.N.), Lund University, Skåne University Hospital, Malmö, Sweden.

Yan Borne (Y)

From the Clinical Memory Research Unit (I.G., K.N., A.-M.G., Erik Stomrud, S.P., O.H.), Department of Clinical Sciences Malmö, Lund University, Sweden; Memory Clinic (I.G., A.-M.G., Erik Stomrud, S.P., O.H.), Skåne University Hospital, Malmö, Sweden; Department of Clinical Sciences in Malmö(Emily Sonestedt, E.G.-P., Y.B.), Nutritional Epidemiology, Lund University, Skåne University Hospital, Malmö, Sweden; Department of Acute Internal Medicine and Geriatrics (K.N.), Linköping University, Sweden; and Department of Clinical Sciences Malmö (O.M., P.M.N.), Lund University, Skåne University Hospital, Malmö, Sweden.

Erik Stomrud (E)

From the Clinical Memory Research Unit (I.G., K.N., A.-M.G., Erik Stomrud, S.P., O.H.), Department of Clinical Sciences Malmö, Lund University, Sweden; Memory Clinic (I.G., A.-M.G., Erik Stomrud, S.P., O.H.), Skåne University Hospital, Malmö, Sweden; Department of Clinical Sciences in Malmö(Emily Sonestedt, E.G.-P., Y.B.), Nutritional Epidemiology, Lund University, Skåne University Hospital, Malmö, Sweden; Department of Acute Internal Medicine and Geriatrics (K.N.), Linköping University, Sweden; and Department of Clinical Sciences Malmö (O.M., P.M.N.), Lund University, Skåne University Hospital, Malmö, Sweden.

Olle Melander (O)

From the Clinical Memory Research Unit (I.G., K.N., A.-M.G., Erik Stomrud, S.P., O.H.), Department of Clinical Sciences Malmö, Lund University, Sweden; Memory Clinic (I.G., A.-M.G., Erik Stomrud, S.P., O.H.), Skåne University Hospital, Malmö, Sweden; Department of Clinical Sciences in Malmö(Emily Sonestedt, E.G.-P., Y.B.), Nutritional Epidemiology, Lund University, Skåne University Hospital, Malmö, Sweden; Department of Acute Internal Medicine and Geriatrics (K.N.), Linköping University, Sweden; and Department of Clinical Sciences Malmö (O.M., P.M.N.), Lund University, Skåne University Hospital, Malmö, Sweden.

Peter M Nilsson (PM)

From the Clinical Memory Research Unit (I.G., K.N., A.-M.G., Erik Stomrud, S.P., O.H.), Department of Clinical Sciences Malmö, Lund University, Sweden; Memory Clinic (I.G., A.-M.G., Erik Stomrud, S.P., O.H.), Skåne University Hospital, Malmö, Sweden; Department of Clinical Sciences in Malmö(Emily Sonestedt, E.G.-P., Y.B.), Nutritional Epidemiology, Lund University, Skåne University Hospital, Malmö, Sweden; Department of Acute Internal Medicine and Geriatrics (K.N.), Linköping University, Sweden; and Department of Clinical Sciences Malmö (O.M., P.M.N.), Lund University, Skåne University Hospital, Malmö, Sweden.
ORCID: 0000-0002-5652-8459

Sebastian Palmqvist (S)

From the Clinical Memory Research Unit (I.G., K.N., A.-M.G., Erik Stomrud, S.P., O.H.), Department of Clinical Sciences Malmö, Lund University, Sweden; Memory Clinic (I.G., A.-M.G., Erik Stomrud, S.P., O.H.), Skåne University Hospital, Malmö, Sweden; Department of Clinical Sciences in Malmö(Emily Sonestedt, E.G.-P., Y.B.), Nutritional Epidemiology, Lund University, Skåne University Hospital, Malmö, Sweden; Department of Acute Internal Medicine and Geriatrics (K.N.), Linköping University, Sweden; and Department of Clinical Sciences Malmö (O.M., P.M.N.), Lund University, Skåne University Hospital, Malmö, Sweden.

Oskar Hansson (O)

From the Clinical Memory Research Unit (I.G., K.N., A.-M.G., Erik Stomrud, S.P., O.H.), Department of Clinical Sciences Malmö, Lund University, Sweden; Memory Clinic (I.G., A.-M.G., Erik Stomrud, S.P., O.H.), Skåne University Hospital, Malmö, Sweden; Department of Clinical Sciences in Malmö(Emily Sonestedt, E.G.-P., Y.B.), Nutritional Epidemiology, Lund University, Skåne University Hospital, Malmö, Sweden; Department of Acute Internal Medicine and Geriatrics (K.N.), Linköping University, Sweden; and Department of Clinical Sciences Malmö (O.M., P.M.N.), Lund University, Skåne University Hospital, Malmö, Sweden.

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