Mediterranean diet and mild cognitive impairment.
BACKGROUND
Higher adherence to the Mediterranean diet (MeDi) may protect from Alzheimer disease (AD), but its association with mild cognitive impairment (MCI) has not been explored.


OBJECTIVE
To investigate the association between the MeDi and MCI.


METHODS
In a multiethnic community study in New York, we used Cox proportional hazards to investigate the association between adherence to the MeDi (0-9 scale; higher scores indicate higher adherence) and (1) the incidence of MCI and (2) the progression from MCI to AD. All of the models were adjusted for cohort, age, sex, ethnicity, education, APOE genotype, caloric intake, body mass index, and duration between baseline dietary assessment and baseline diagnosis.


METHODS
Incidence of MCI and progression from MCI to AD.


RESULTS
There were 1393 cognitively normal participants, 275 of whom developed MCI during a mean (SD) follow-up of 4.5 (2.7) years (range, 0.9-16.4 years). Compared with subjects in the lowest MeDi adherence tertile, subjects in the middle tertile had 17% less risk (hazard ratio [HR] = 0.83; 95% confidence interval [CI], 0.62-1.12; P = .24) of developing MCI and those in the highest tertile had 28% less risk (HR = 0.72; 95% CI, 0.52-1.00; P = .05) of developing MCI (trend HR = 0.85; 95% CI, 0.72-1.00; P for trend = .05). There were 482 subjects with MCI, 106 of whom developed AD during a mean (SD) follow-up of 4.3 (2.7) years (range, 1.0-13.8 years). Compared with subjects in the lowest MeDi adherence tertile, subjects in the middle tertile had 45% less risk (HR = 0.55; 95% CI, 0.34-0.90; P = .01) of developing AD and those in the highest tertile had 48% less risk (HR = 0.52; 95% CI, 0.30-0.91; P = .02) of developing AD (trend HR = 0.71; 95% CI, 0.53-0.95; P for trend = .02).


CONCLUSIONS
Higher adherence to the MeDi is associated with a trend for reduced risk of developing MCI and with reduced risk of MCI conversion to AD.
Scarmeas
Nikolaos
N
Department of Neurology, Columbia University Medical Center, New York, NY 10032, USA. ns257@columbia.edu
Stern
Yaakov
Y
Mayeux
Richard
R
Manly
Jennifer J
JJ
Schupf
Nicole
N
Luchsinger
Jose A
JA
D017677:Age Distribution; D017668:Age of Onset; D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000178:diet therapy* / Q000453:epidemiology* / Q000517:prevention & control; D001057:Apolipoproteins E / Q000235:genetics; D015992:Body Mass Index; D003072:Cognition Disorders / Q000178:diet therapy* / Q000453:epidemiology* / Q000517:prevention & control; D015331:Cohort Studies; D038441:Diet, Mediterranean / Q000706:statistics & numerical data*; D018450:Disease Progression; D004522:Educational Status; D002149:Energy Intake / Q000502:physiology; D005006:Ethnicity; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D015233:Models, Statistical; D016016:Proportional Hazards Models; D017678:Sex Distribution
D001057:Apolipoproteins E