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Abstract
Objective To investigate whether dietary patterns (Mediterranean diet [MedDiet], Dietary Approaches to Stop Hypertension [DASH], and A Priori Diet Quality Score [APDQS]) during adulthood are associated with midlife cognitive performance.
Methods We studied 2,621 Coronary Artery Risk Development in Young Adults (CARDIA) participants; 45% were black, 57% were female, and mean age was 25 ± 3.5 years at baseline (year 0). Mean diet scores were calculated from diet history at baseline, year 7, and year 20 (mean age 25, 32, and 45 years, respectively). Cognitive function was assessed at years 25 and 30 (mean age 50 and 55 years, respectively). Linear models were used to examine association between tertiles of diet score and change in composite cognitive function and cognitive z scores (verbal memory [Rey Auditory Verbal Learning Test], processing speed [Digit Symbol Substitution Test], and executive function [Stroop Interference test]) and the Montreal Cognitive Assessment (MoCA) at year 30.
Results DASH was not associated with change in cognitive performance. Higher MedDiet and APDQS scores were associated with less decline in cognitive function (MedDiet: low −0.04, middle 0.03, high 0.03, p = 0.03; APDQS: low −0.04, middle −0.00, high 0.06, p < 0.01) and Stroop Interference (MedDiet: low 0.09, middle −0.06, high −0.03; APDQS: low 0.10, middle 0.01, high −0.09, both p < 0.01). Odds ratios (95% confidence interval) for poor global cognitive function (≥1 SD below mean MoCA score) comparing extreme tertiles of diet scores were 0.54 (0.39–0.74) for MedDiet, 0.48 (0.33–0.69) for APDQS, and 0.89 (0.68–1.17) for DASH.
Conclusion Greater adherence to MedDiet and APDQS dietary patterns during adulthood was associated with better midlife cognitive performance. Additional studies are needed to define the combination of foods and nutrients for optimal brain health across the life course.
Glossary
- APDQS=
- A Priori Diet Quality Score;
- BMI=
- body mass index;
- CARDIA=
- Coronary Artery Risk Development in Young Adults;
- CES-D=
- Center for Epidemiologic Studies Depression;
- CI=
- confidence interval;
- DASH=
- Dietary Approaches to Stop Hypertension;
- DSST=
- Digit Symbol Substitution Test;
- MedDiet=
- Mediterranean diet;
- MoCA=
- Montreal Cognitive Assessment;
- OR=
- odds ratio;
- RAVLT=
- Rey Auditory Verbal Learning Test
Footnotes
Go to Neurology.org/N for full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the article.
Editorial, page 645
CME Course: NPub.org/cmelist
- Received April 13, 2018.
- Accepted in final form November 28, 2018.
- © 2019 American Academy of Neurology
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- Author response: Dietary patterns during adulthood and cognitive performance in midlife: The CARDIA study
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