IANA task force on nutrition and cognitive decline with aging.
Cognitive impairment can be influenced by a number of factors. The potential effect of nutrition has become a topic of increasing scientific and public interest. In particular, there are arguments that nutrients (food and/or supplements) such as vitamins, trace minerals, lipids, can affect the risk of cognitive decline and dementia, especially in frail elderly people at risk of deficiencies. Our objective in this paper is to review data relating diet to risk of cognitive decline and dementia, especially Alzheimer's disease (AD). We chose to focus our statements on homocysteine-related vitamins (B-vitamins), antioxidant nutrients (vitamins E and C, carotenoids, flavonoids, enzymatic cofactors) and dietary lipids. Results of epidemiological studies may sometimes appeared conflicting; however, certain associations are frequently found. High intake of saturated and trans-unsaturated (hydrogenated) fats were positively associated with increased risk of AD, whereas intake of polyunsaturated and monounsaturated fats were protective against cognitive decline in the elderly in prospective studies. Fish consumption has been associated with lower risk of AD in longitudinal cohort studies. Moreover, epidemiologic data suggest a protective role of the B-vitamins, especially vitamins B9 and B12, on cognitive decline and dementia. Finally, the results on antioxidant nutrients may suggest the importance of having a balanced combination of several antioxidant nutrients to exert a significant effect on the prevention of cognitive decline and dementia, while taking into account the potential adverse effects of these nutrients. There is no lack of attractive hypotheses to support research on the relationships between nutrition and cognitive decline. It is important to stress the need to develop further prospective studies of sufficiently long duration, including subjects whose diet is monitored at a sufficiently early stage or at least before disease or cognitive decline exist. Meta analyses should be developed, and on the basis of their results the most appropriate interventional studies can be planned. These studies must control for the greatest number of known confounding factors and take into account the impact of the standard social determinants of food habits, such as the regional cultures, social status, and educational level.
Gillette Guyonnet
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S
Service de Medecine Interne et de Gerontologie Clinique, Pavillon J.P. Junod, Centre Hospitalier Universitaire La Grave-Casselardit, Toulouse cedex 9, France. gillette.s@chu-toulouse.fr
Abellan Van Kan
G
G
Andrieu
S
S
Barberger Gateau
P
P
Berr
C
C
Bonnefoy
M
M
Dartigues
J F
JF
de Groot
L
L
Ferry
M
M
Galan
P
P
Hercberg
S
S
Jeandel
C
C
Morris
M C
MC
Nourhashemi
F
F
Payette
H
H
Poulain
J P
JP
Portet
F
F
Roussel
A M
AM
Ritz
P
P
Rolland
Y
Y
Vellas
B
B
D000368:Aged; D000375:Aging / Q000502:physiology / Q000523:psychology*; D000544:Alzheimer Disease / Q000453:epidemiology / Q000209:etiology; D003071:Cognition / Q000502:physiology*; D003072:Cognition Disorders / Q000453:epidemiology* / Q000209:etiology; D004032:Diet; D005260:Female; D006801:Humans; D008297:Male; D009747:Nutritional Physiological Phenomena / Q000502:physiology*; D012307:Risk Factors