Reader response: Dietary patterns during adulthood and cognitive performance in midlife The CARDIA study
Mariana I.Muñoz-Garcia, PhD Student, University of Navarra
EstefaníaToledo, Associate professor, University of Navarra
Miguel A.Martinez-Gonzalez, Professor & Chair Preventive Medicine & Public Health, University of Navarra
Published April 01, 2019
The article by McEvoy et al.1 provided valuable information toward determining if dietary interventions during early adulthood can influence cognitive function later in life. The use of multiple dietary questionnaires that can correct for errors in measurement from one single dietary evaluation, the long-term follow-up, and the repeated cognitive evaluation represent considerable strengths of the study. We encourage the authors to further exploit how changes in adherence to dietary patterns over time can influence cognitive decline during aging by expanding follow-up and repeating cognitive testing with validated instruments, such as the Montreal Cognitive Assessment (MoCA), to model a trend in cognitive performance.2
It is surprising that global cognitive function, as assessed by the MoCA, appears to be poor for this cohort.1 The original MoCA cutoff to detect mild cognitive impairment (MCI) was 26;3 a meta-analysis including 20 studies proposed a cutoff of 24/25 for MCI with 80% sensitivity and specificity, considering a mean age of 70 years and 7 years of education.4 If the mean age at time of the MoCA was 55, with >94% having >12 years of education, why do McEvoy et al. choose 20 as a clinically relevant cutoff? Would the selection of this cutoff influence the reported results?
References
McEvoy CT, Hoang T, Sidney S, et al. Dietary patterns during adulthood and cognitive performance in midlife: The CARDIA study. Neurology 2019;92:e1589–e1599.
Bowman GL, Scarmeas N. Dietary patterns in early life pay dividends for midlife cognitive performance. Neurology 2019;92:645–656.
Nasreddine ZS, Phillips NA, Bedirian V, Charbonneau S, Whitehead V, Collin I, et al. The Montreal Cognitive Assessment, MoCA: a brief screening tool for mild cognitive impairment. J Am Geriatr Soc 2005;53:695–699.
Ciesielska N, Sokołowski R, Mazur E, Podhorecka M, Polak-Szabela A, Kędziora-Kornatowska K. Is the Montreal Cognitive Assessment (MoCA) test better suited than the Mini-Mental State Examination (MMSE) in mild cognitive impairment (MCI) detection among people aged over 60? Meta-analysis. Psychiatr Pol 2016;50:1039–1052.
The article by McEvoy et al.1 provided valuable information toward determining if dietary interventions during early adulthood can influence cognitive function later in life. The use of multiple dietary questionnaires that can correct for errors in measurement from one single dietary evaluation, the long-term follow-up, and the repeated cognitive evaluation represent considerable strengths of the study. We encourage the authors to further exploit how changes in adherence to dietary patterns over time can influence cognitive decline during aging by expanding follow-up and repeating cognitive testing with validated instruments, such as the Montreal Cognitive Assessment (MoCA), to model a trend in cognitive performance.2
It is surprising that global cognitive function, as assessed by the MoCA, appears to be poor for this cohort.1 The original MoCA cutoff to detect mild cognitive impairment (MCI) was 26;3 a meta-analysis including 20 studies proposed a cutoff of 24/25 for MCI with 80% sensitivity and specificity, considering a mean age of 70 years and 7 years of education.4 If the mean age at time of the MoCA was 55, with >94% having >12 years of education, why do McEvoy et al. choose 20 as a clinically relevant cutoff? Would the selection of this cutoff influence the reported results?
References
Footnote
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