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Association of Dietary Patterns in Midlife and Cognitive Function in Later Life in US Adults Without Dementia.

TitleAssociation of Dietary Patterns in Midlife and Cognitive Function in Later Life in US Adults Without Dementia.
Publication TypeJournal Article
Year of Publication2019
AuthorsDearborn-Tomazos JL, Wu A, Steffen LM, Anderson CAM, Hu EA, Knopman D, Mosley TH
Secondary AuthorsGottesman RF
JournalJAMA Netw Open
Volume2
Issue12
Paginatione1916641
Date Published2019 12 02
ISSN2574-3805
KeywordsAfrican Americans, Aged, Aged, 80 and over, Cognition, Cognition Disorders, Cognitive Aging, Cohort Studies, Diet, Diet Surveys, Diet, Healthy, European Continental Ancestry Group, Female, Humans, Independent Living, Male, Maryland, Middle Aged, Minnesota, Mississippi, North Carolina, Principal Component Analysis, Proportional Hazards Models
Abstract

Importance: The association of dietary patterns, or the combinations of different foods that people eat, with cognitive change and dementia is unclear.

Objective: To examine the association of dietary patterns in midlife with cognitive function in later life in a US population without dementia.

Design, Setting, and Participants: Observational cohort study with analysis of data collected from 1987 to 2017. Analysis was completed in January to February 2019. Community-dwelling black and white men and women from Washington County, Maryland; Forsyth County, North Carolina; Jackson, Mississippi; and suburban Minneapolis, Minnesota, participating in the Atherosclerosis Risk in Communities (ARIC) study were included.

Exposures: Two dietary pattern scores were derived from a 66-item food frequency questionnaire using principal component analysis. A Western, or unhealthy, dietary pattern was characterized by higher consumption of meats and fried foods. A so-called prudent, or healthier, dietary pattern was characterized by higher amounts of fruits and vegetables.

Main Outcomes and Measures: Results of 3 cognitive tests (Digit Symbol Substitution Test, Word Fluency Test, and Delayed Word Recall) performed at 3 points (1990-1992, 1996-1998, and 2011-2013) were standardized and combined to represent global cognitive function. The 20-year change in cognitive function was determined by tertile of diet pattern score using mixed-effect models. The risk of incident dementia was also determined by tertile of the diet pattern score.

Results: A total of 13 588 participants (7588 [55.8%] women) with a mean (SD) age of 54.6 (5.7) years at baseline were included; participants in the top third of Western and prudent diet pattern scores were considered adherent to the respective diet. Cognitive scores at baseline were lower in participants with a Western diet (z score for tertile 3 [T3], -0.17 [95% CI, -0.20 to -0.14] vs T1, 0.17 [95% CI, 0.14-0.20]) and higher in participants with a prudent diet (z score for T3, -0.09 [95% CI, -0.12 to -0.06] vs T1, -0.09 [95% -0.12 to -0.06]). Estimated 20-year change in global cognitive function did not differ by dietary pattern (difference of change in z score for Western diet, T3 vs T1: -0.01 [95% CI, -0.05 to 0.04]; and difference of change in z score for prudent diet, T3 vs T1: 0.02 [95% CI, -0.02 to 0.06]). The risk of incident dementia did not differ by dietary pattern (Western hazard ratio for T3 vs T1, 1.06 [95% CI, 0.92-1.22]; prudent hazard ratio for T3 vs T1, 0.99 [95% CI, 0.88-1.12]).

Conclusions and Relevance: This study found that the dietary pattern of US adults at midlife was not associated with processing speed, word fluency, memory, or incident dementia in later life.

DOI10.1001/jamanetworkopen.2019.16641
Alternate JournalJAMA Netw Open
PubMed ID31800068
PubMed Central IDPMC6902753
Grant ListU01 HL096812 / HL / NHLBI NIH HHS / United States
HHSN268201700004I / HL / NHLBI NIH HHS / United States
HHSN268201700002I / HL / NHLBI NIH HHS / United States
HHSN268201700005I / HL / NHLBI NIH HHS / United States
HHSN268201700003I / HL / NHLBI NIH HHS / United States
UL1 TR001863 / TR / NCATS NIH HHS / United States
HHSN268201700001I / HL / NHLBI NIH HHS / United States