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Dietary patterns and cognitive decline in an Australian study of ageing

Abstract

The aim of this paper was to investigate the association of three well-recognised dietary patterns with cognitive change over a 3-year period. Five hundred and twenty-seven healthy participants from the Australian Imaging, Biomarkers and Lifestyle study of ageing completed the Cancer Council of Victoria food frequency questionnaire at baseline and underwent a comprehensive neuropsychological assessment at baseline, 18 and 36 months follow-up. Individual neuropsychological test scores were used to construct composite scores for six cognitive domains and a global cognitive score. Based on self-reported consumption, scores for three dietary patterns, (1) Australian-style Mediterranean diet (AusMeDi), (2) western diet and (3) prudent diet were generated for each individual. Linear mixed model analyses were conducted to examine the relationship between diet scores and cognitive change in each cognitive domain and for the global score. Higher baseline adherence to the AusMeDi was associated with better performance in the executive function cognitive domain after 36 months in apolipoprotein E (APOE) ɛ4 allele carriers (P<0.01). Higher baseline western diet adherence was associated with greater cognitive decline after 36 months in the visuospatial cognitive domain in APOE ɛ4 allele non-carriers (P<0.01). All other results were not significant. Our findings in this well-characterised Australian cohort indicate that adherence to a healthy diet is important to reduce risk for cognitive decline, with the converse being true for the western diet. Executive function and visuospatial functioning appear to be particularly susceptible to the influence of diet.

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References

  1. Carter CL, Resnick EM, Mallampalli M, Kalbarczyk A . Sex and gender differences in Alzheimer's disease: recommendations for future research. J Womens Health (Larchmt) 2012; 21: 1018–1023.

    Article  Google Scholar 

  2. Kant AK . Indexes of overall diet quality: a review. J Am Diet Assoc 1996; 96: 785–791.

    Article  CAS  Google Scholar 

  3. Feart C, Samieri C, Rondeau V, Amieva H, Portet F, Dartigues JF et al. Adherence to a Mediterranean diet, cognitive decline, and risk of dementia. JAMA 2009; 302: 638–648.

    Article  CAS  Google Scholar 

  4. Scarmeas N, Stern Y, Tang MX, Mayeux R, Luchsinger JA . Mediterranean diet and risk for Alzheimer's disease. Ann Neurol 2006; 59: 912–921.

    Article  Google Scholar 

  5. Scarmeas N, Stern Y, Mayeux R, Luchsinger JA . Mediterranean diet, Alzheimer disease, and vascular mediation. Arch Neurol 2006; 63: 1709–1717.

    Article  Google Scholar 

  6. Scarmeas N, Luchsinger JA, Mayeux R, Stern Y . Mediterranean diet and Alzheimer disease mortality. Neurology 2007; 69: 1084–1093.

    Article  Google Scholar 

  7. Tangney CC, Kwasny MJ, Li H, Wilson RS, Evans DA, Morris MC . Adherence to a Mediterranean-type dietary pattern and cognitive decline in a community population. Am J Clin Nutr 2011; 93: 601–607.

    Article  CAS  Google Scholar 

  8. Samieri C, Jutand MA, Feart C, Capuron L, Letenneur L, Barberger-Gateau P . Dietary patterns derived by hybrid clustering method in older people: association with cognition, mood, and self-rated health. J Am Diet Assoc 2008; 108: 1461–1471.

    Article  Google Scholar 

  9. Akbaraly TN, Singh-Manoux A, Marmot MG, Brunner EJ . Education attenuates the association between dietary patterns and cognition. Dement Geriatr Cogn Disord 2009; 27: 147–154.

    Article  Google Scholar 

  10. Kesse-Guyot E, Andreeva VA, Lassale C, Ferry M, Jeandel C, Hercberg S et al. Mediterranean diet and cognitive function: a French study. Am J Clin Nutr 2013; 97: 369–376.

    Article  CAS  Google Scholar 

  11. Psaltopoulou T, Kyrozis A, Stathopoulos P, Trichopoulos D, Vassilopoulos D, Trichopoulou A . Diet, physical activity and cognitive impairment among elders: the EPIC-Greece cohort (European Prospective Investigation into Cancer and Nutrition). Public Health Nutr 2008; 11: 1054–1062.

    Article  CAS  Google Scholar 

  12. Vercambre MN, Grodstein F, Berr C, Kang JH . Mediterranean diet and cognitive decline in women with cardiovascular disease or risk factors. J Acad Nutr Diet 2012; 112: 816–823.

    Article  Google Scholar 

  13. Cherbuin N, Anstey KJ . The Mediterranean Diet is Not Related to Cognitive Change in a Large Prospective Investigation: The PATH Through Life Study. Am J Geriatr Psychiatry 2011; 20: 635–639.

    Article  Google Scholar 

  14. Trichopoulou A, Costacou T, Bamia C, Trichopoulos D . Adherence to a Mediterranean diet and survival in a Greek population. N Engl J Med 2003; 348: 2599–2608.

    Article  Google Scholar 

  15. Ellis KA, Bush AI, Darby D, De Fazio D, Foster J, Hudson P et al. The Australian Imaging, Biomarkers and Lifestyle (AIBL) study of aging: methodology and baseline characteristics of 1112 individuals recruited for a longitudinal study of Alzheimer's disease. Int Psychogeriatr 2009; 21: 672–687.

    Article  Google Scholar 

  16. Keogh JB, Lange K, Syrette J . Comparative analysis of two FFQ. Public Health Nutr 2010; 13: 1553–1558.

    Article  Google Scholar 

  17. Pike KE, Ellis KA, Villemagne VL, Good N, Chetelat G, Ames D et al. Cognition and beta-amyloid in preclinical Alzheimer's disease: data from the AIBL study. Neuropsychologia 2011; 49: 2384–2390.

    Article  Google Scholar 

  18. Wechsler D . A standardised memory scale for clinical use. J Psychol 1945; 19: 87–95.

    Article  Google Scholar 

  19. Delis DC, Kramer JH, Keplan E, Ober B . California Verbal Learning Test—Second Edition. Psychological Corporation: San Antonion, TX, 2000.

    Google Scholar 

  20. Meyers JE, Meyers KR . Rey Complex Figure Test and Recognition Trial. Professional Manual: Psychological Assessment Resource, Inc.; 1995.

  21. Strauss E Sherman EMS Spreen O . A Compendium of Neuropsychological Tests: Administration Norms, and Commentary. 3rd edn. Oxford University Press: New York, 2006.

    Google Scholar 

  22. Delis DC, Kaplan E, Kramer JH . Delis-Kaplan Executive Funtion System (D-KEFS). Psychological Corporation: San Antonio, TX, 2001.

    Google Scholar 

  23. Saxton J, Ratcliff G, Munro CA, Coffey EC, Becker JT, Fried L et al. Normative data on the Boston Naming Test and two equivalent 30-item short forms. Clin Neuropsychol 2000; 14: 526–534.

    Article  CAS  Google Scholar 

  24. Wechsler D . Wechsler Adult Intelligence Scale3rd edition(WAIS-III). Psychological Corporation: San Antonio, TX, 1997.

    Google Scholar 

  25. Libon DJ, Swenson RA, Barnoski EJ, Sands LP . Clock drawing as an assessment tool for dementia. Arch Clin Neuropsychol 1993; 8: 405–415.

    Article  CAS  Google Scholar 

  26. Harrington KD, Lim YY, Ellis KA, Copolov C, Darby D, Weinborn M et al. The association of Abeta amyloid and composite cognitive measures in healthy older adults and MCI. Int Psychogeriatr 2013; 25: 1667–1677.

    Article  Google Scholar 

  27. Hixson JE, Vernier DT . Restriction isotyping of human apolipoprotein E by gene amplification and cleavage with HhaI. J Lipid Res 1990; 31: 545–548.

    CAS  PubMed  Google Scholar 

  28. Gu Y, Luchsinger JA, Stern Y, Scarmeas N . Mediterranean diet, inflammatory and metabolic biomarkers, and risk of Alzheimer's disease. J Alzheimers Dis 2010; 22: 483–492.

    Article  CAS  Google Scholar 

  29. Kleinbaum DG, Kupper LL, Muller KE . Variable Reduction and Factor Analysis. Applied Regression Analysis and other Multivariate Methods. PWS-KENT Publishing Company: Boston, 1988.

    Google Scholar 

  30. Kim JO, Mueller CW . Fcator Analysis: Statistical Methods and Practical Issues. Sage Publications, Thousand Oaks, CA, 1978.

    Book  Google Scholar 

  31. Breteler MM . Vascular risk factors for Alzheimer's disease: an epidemiologic perspective. Neurobiol Aging 2000; 21: 153–160.

    Article  CAS  Google Scholar 

  32. Luchsinger JA, Mayeux R . Cardiovascular risk factors and Alzheimer's disease. Curr Atheroscler Rep 2004; 6: 261–266.

    Article  Google Scholar 

  33. Cummings JL . Alzheimer's disease. N Engl J Med 2004; 351: 56–67.

    Article  CAS  Google Scholar 

  34. Waber DP, Holmes JM . Assessing children's memory productions of the Rey-Osterrieth Complex Figure. J Clin Exp Neuropsychol 1986; 8: 563–580.

    Article  CAS  Google Scholar 

  35. Calder P . Omega-3 polyunsaturated fatty acids and inflammatory processes: nutrition of pharmacology. Br J Clin Pharmacol 2012; 75: 645–662.

    Article  Google Scholar 

  36. Agostinho P, Cunha RA, Oliveira C . Neuroinflammation, oxidative stress and the pathogenesis of Alzheimer's disease. Curr Pharm Des 2010; 16: 2766–2778.

    Article  CAS  Google Scholar 

  37. Chrysohoou C, Panagiotakos DB, Pitsavos C, Das UN, Stefanadis C . Adherence to the Mediterranean diet attenuates inflammation and coagulation process in healthy adults: The ATTICA Study. J Am Coll Cardiol 2004; 44: 152–158.

    Article  Google Scholar 

  38. Fung TT, McCullough ML, Newby PK, Manson JE, Meigs JB, Rifai N et al. Diet-quality scores and plasma concentrations of markers of inflammation and endothelial dysfunction. Am J Clin Nutr 2005; 82: 163–173.

    Article  CAS  Google Scholar 

  39. Panagiotakos DB, Dimakopoulou K, Katsouyanni K, Bellander T, Grau M, Koenig W et al. Mediterranean diet and inflammatory response in myocardial infarction survivors. Int J Epidemiol 2009; 38: 856–866.

    Article  Google Scholar 

  40. Esposito K, Marfella R, Ciotola M, Di Palo C, Giugliano F, Giugliano G et al. Effect of a mediterranean-style diet on endothelial dysfunction and markers of vascular inflammation in the metabolic syndrome: a randomized trial. JAMA 2004; 292: 1440–1446.

    Article  CAS  Google Scholar 

  41. Hickling S, Hung J, Knuiman M, Divitini M, Beilby J . Are the associations between diet and C-reactive protein independent of obesity? Prev Med 2008; 47: 71–76.

    Article  CAS  Google Scholar 

  42. Fung TT, Rimm EB, Spiegelman D, Rifai N, Tofler GH, Willett WC et al. Association between dietary patterns and plasma biomarkers of obesity and cardiovascular disease risk. Am J Clin Nutr 2001; 73: 61–67.

    Article  CAS  Google Scholar 

  43. Nettleton JA, Steffen LM, Mayer-Davis EJ, Jenny NS, Jiang R, Herrington DM et al. Dietary patterns are associated with biochemical markers of inflammation and endothelial activation in the Multi-Ethnic Study of Atherosclerosis (MESA). Am J Clin Nutr 2006; 83: 1369–1379.

    Article  CAS  Google Scholar 

  44. Esmaillzadeh A, Kimiagar M, Mehrabi Y, Azadbakht L, Hu FB, Willett WC . Dietary patterns and markers of systemic inflammation among Iranian women. J Nutr 2007; 137: 992–998.

    Article  CAS  Google Scholar 

  45. Lopez-Garcia E, Schulze MB, Fung TT, Meigs JB, Rifai N, Manson JE et al. Major dietary patterns are related to plasma concentrations of markers of inflammation and endothelial dysfunction. Am J Clin Nutr 2004; 80: 1029–1035.

    Article  CAS  Google Scholar 

  46. Nettleton JA, Matijevic N, Follis JL, Folsom AR, Boerwinkle E . Associations between dietary patterns and flow cytometry-measured biomarkers of inflammation and cellular activation in the Atherosclerosis Risk in Communities (ARIC) Carotid Artery MRI Study. Atherosclerosis 2010; 212: 260–267.

    Article  CAS  Google Scholar 

  47. Mahley RW . Apolipoprotein E cholesterol transport protein with expanding role in cell biology. Science 1988; 240: 622–630.

    Article  CAS  Google Scholar 

  48. Schipper HM . Apolipoprotein E implications for AD neurobiology, epidemiology and risk assessment. Neurobiol Aging 2011; 32: 778–790.

    Article  CAS  Google Scholar 

  49. Kariv-Inbal Z, Yacobson S, Berkecz R, Peter M, Janaky T, Lutjohann D et al. The isoform-specific pathological effects of apoE4 in vivo are prevented by a fish oil (DHA) diet and are modified by cholesterol. J Alzheimers Dis 2012; 28: 667–683.

    Article  CAS  Google Scholar 

  50. Brown BM, Peiffer JJ, Taddei K, Lui JK, Laws SM, Gupta VB et al. Physical activity and amyloid-beta plasma and brain levels: results from the Australian Imaging, Biomarkers and Lifestyle Study of Ageing. Mol Psychiatry 2012; 18: 875–881.

    Article  Google Scholar 

  51. Gardener S, Gu Y, Rainey-Smith SR, Keogh JB, Clifton PM, Mathieson SL et al. Adherence to a Mediterranean diet and Alzheimer's disease risk in an Australian population. Transl Psychiatry 2012; 2: e164.

    Article  CAS  Google Scholar 

  52. Samieri C, Okereke OI, ED E, Grodstein F . Long-term adherence to the Mediterranean diet is associated with overall cognitive status, but not cognitive decline, in women. J Nutr 2013; 143: 493–499.

    Article  CAS  Google Scholar 

  53. Samieri C, Grodstein F, Rosner BA, Kang JH, Cook NR, Manson JE et al. Mediterranean diet and cognitive function in older age. Epidemiology 2013; 24: 490–499.

    Article  Google Scholar 

  54. Alles B, Samieri C, Feart C, Jutand MA, Laurin D, Barberger-Gateau P . Dietary patterns: a novel approach to examine the link between nutrition and cognitive function in older individuals. Nutr Res Rev 2012; 25: 207–222.

    Article  CAS  Google Scholar 

  55. Hu FB . Dietary pattern analysis: a new direction in nutritional epidemiology. Curr Opin Lipidol 2002; 13: 3–9.

    Article  CAS  Google Scholar 

  56. Ireland PJ, Jolley D, Giles G, O'Dea K, Powles J, Rutishauser I, Wahlqvist ML, Williams J . Development of the Melbourne FFQ: a food frequency questionnaire for use in an Australian prospective study involving an ethnically diverse cohort. Asia Pac J Clin Nutr 1994; 3: 19–31.

    CAS  PubMed  Google Scholar 

  57. Gu Y, Nieves JW, Stern Y, Luchsinger JA, Scarmeas N . Food combination and Alzheimer disease risk: a protective diet. Arch Neurol 2010; 67: 699–706.

    Article  Google Scholar 

  58. Pryer JA, Nichols R, Elliott P, Thakrar B, Brunner E, Marmot M . Dietary patterns among a national random sample of British adults. J Epidemiol Community Health 2001; 55: 29–37.

    Article  CAS  Google Scholar 

  59. Bamia C, Orfanos P, Ferrari P, Overvad K, Hundborg HH, Tjonneland A et al. Dietary patterns among older Europeans: the EPIC-Elderly study. Br J Nutr 2005; 94: 100–113.

    Article  CAS  Google Scholar 

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Acknowledgements

We acknowledge the contribution of Rosalind Miller (CSIRO) who developed the method of estimating the portion of fixed effect variance in linear mixed models. Samantha Gardener is supported by a University Postgraduate Award from the Dementia Collaborative Research Centres program. Funding for the study is provided by the CSIRO Flagship Collaboration Fund and the Science and Industry Endowment Fund (SIEF) in partnership with Edith Cowan University (ECU), The Florey Institute of Neuroscience and Mental Health, Alzheimer's Australia (AA), National Ageing Research Institute (NARI), Austin Health, CogState Ltd., Hollywood Private Hospital, and Sir Charles Gairdner Hospital. The study also receives funding from the National Health and Medical Research Council (NHMRC), the Dementia Collaborative Research Centres program (DCRC2) and the McCusker Alzheimer's Research Foundation and Operational Infrastructure Support from the Government of Victoria.

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Correspondence to R N Martins.

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Gardener, S., Rainey-Smith, S., Barnes, M. et al. Dietary patterns and cognitive decline in an Australian study of ageing. Mol Psychiatry 20, 860–866 (2015). https://doi.org/10.1038/mp.2014.79

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