Adherence to a Mediterranean diet and risk of incident cognitive impairment

Georgios Tsivgoulis, Suzanne Judd, Abraham J. Letter, Andrei Alexandrov, George Howard, Fadi Nahab, Frederick W. Unverzagt, Claudia Moy, Virginia J. Howard, Brett Kissela, Virginia G. Wadley

Research output: Contribution to journalArticle

65 Citations (Scopus)

Abstract

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.

Original languageEnglish (US)
Pages (from-to)1684-1692
Number of pages9
JournalNeurology
Volume80
Issue number18
DOIs
StatePublished - Apr 30 2013

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Mediterranean Diet
Diabetes Mellitus
Stroke
Food
Cognitive Dysfunction
Health Status
Odds Ratio
Demography
Confidence Intervals
Depression

All Science Journal Classification (ASJC) codes

  • Clinical Neurology

Cite this

Adherence to a Mediterranean diet and risk of incident cognitive impairment. / Tsivgoulis, Georgios; Judd, Suzanne; Letter, Abraham J.; Alexandrov, Andrei; Howard, George; Nahab, Fadi; Unverzagt, Frederick W.; Moy, Claudia; Howard, Virginia J.; Kissela, Brett; Wadley, Virginia G.

In: Neurology, Vol. 80, No. 18, 30.04.2013, p. 1684-1692.

Research output: Contribution to journalArticle

Tsivgoulis, G, Judd, S, Letter, AJ, Alexandrov, A, Howard, G, Nahab, F, Unverzagt, FW, Moy, C, Howard, VJ, Kissela, B & Wadley, VG 2013, 'Adherence to a Mediterranean diet and risk of incident cognitive impairment', Neurology, vol. 80, no. 18, pp. 1684-1692. https://doi.org/10.1212/WNL.0b013e3182904f69
Tsivgoulis, Georgios ; Judd, Suzanne ; Letter, Abraham J. ; Alexandrov, Andrei ; Howard, George ; Nahab, Fadi ; Unverzagt, Frederick W. ; Moy, Claudia ; Howard, Virginia J. ; Kissela, Brett ; Wadley, Virginia G. / Adherence to a Mediterranean diet and risk of incident cognitive impairment. In: Neurology. 2013 ; Vol. 80, No. 18. pp. 1684-1692.
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abstract = "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.",
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AU - Tsivgoulis, Georgios

AU - Judd, Suzanne

AU - Letter, Abraham J.

AU - Alexandrov, Andrei

AU - Howard, George

AU - Nahab, Fadi

AU - Unverzagt, Frederick W.

AU - Moy, Claudia

AU - Howard, Virginia J.

AU - Kissela, Brett

AU - Wadley, Virginia G.

PY - 2013/4/30

Y1 - 2013/4/30

N2 - 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.

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