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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.
GLOSSARY:
- AD=
- Alzheimer disease;
- BMI=
- body mass index;
- CI=
- confidence interval;
- DBP=
- diastolic blood pressure;
- DM=
- diabetes mellitus;
- FFQ=
- Food Frequency Questionnaire;
- MeD=
- Mediterranean diet;
- OR=
- odds ratio;
- REGARDS=
- Reasons for Geographic and Racial Differences in Stroke;
- SBP=
- systolic blood pressure;
- SIS=
- Six-item Screener
Footnotes
Go to Neurology.org for full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the article.
Supplemental data at www.neurology.org
- Received September 20, 2012.
- Accepted in final form January 22, 2013.
- © 2013 American Academy of Neurology
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