title: Mediterranean diet and mild cognitive impairment.
abstract: 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.
authors.affiliation: Department of Neurology, Columbia University Medical Center, New York, NY 10032, USA. ns257@columbia.edu
authors.forename: Nikolaos
authors.initials: N
authors.lastname: Scarmeas
authors.forename: Yaakov
authors.initials: Y
authors.lastname: Stern
authors.forename: Richard
authors.initials: R
authors.lastname: Mayeux
authors.forename: Jennifer J
authors.initials: JJ
authors.lastname: Manly
authors.forename: Nicole
authors.initials: N
authors.lastname: Schupf
authors.forename: Jose A
authors.initials: JA
authors.lastname: Luchsinger
mesh_terms: 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
chemical_list: D001057:Apolipoproteins E