title: Low intakes of carotene, vitamin B2, pantothenate and calcium predict cognitive decline among elderly patients with diabetes mellitus: The Japanese Elderly Diabetes Intervention Trial.
abstract: OBJECTIVE
  The present study aimed to examine whether nutrient intakes predicted cognitive decline among elderly patients with diabetes mellitus.
  
  
  METHODS
  This study evaluated data from a 6-year prospective follow up of 237 elderly patients (aged ≥65 years) with diabetes mellitus, and the associations of baseline nutrient intakes with cognitive decline. Cognitive decline was defined as a ≥2-point decrease in the Mini-Mental State Examination (MMSE) score. Intakes of food and nutrients were assessed using a validated food frequency questionnaire, and were compared between patients with cognitive decline and intact cognition. Analysis of covariance and logistic regression analysis were used to compare the changes in the MMSE score during the follow up among intake tertile groups for each nutrient.
  
  
  RESULTS
  Compared with men with intact cognition, the men with cognitive decline had lower baseline intakes of calcium, vitamin A, vitamin B2, pantothenate, soluble fiber, green vegetables and milk. However, no significant associations between cognitive decline and nutrient intakes were observed among women. After adjusting for age, body mass index, glycated hemoglobin levels, history of severe hypoglycemia, previous stroke and baseline MMSE score, we found that cognitive decline was significantly associated with low intakes of carotene, vitamin B2, pantothenate, calcium and green vegetables. Multiple logistic regression analysis showed that intakes of nutrients and green vegetables predicted cognitive decline after adjusting for age, body mass index, glycated hemoglobin levels, baseline MMSE score, and incident stroke during the follow up.
  
  
  CONCLUSIONS
  These findings suggest that sufficient intakes of carotene, vitamin B2, pantothenate, calcium and vegetables could help prevent cognitive decline among elderly men with diabetes mellitus. Geriatr Gerontol Int 2017; 17: 1168-1175.
authors.affiliation: Department of Diabetes, Metabolism and Endocrinology, Tokyo Metropolitan Geriatric Hospital, Tokyo, Japan.
authors.forename: Atsushi
authors.initials: A
authors.lastname: Araki
authors.affiliation: Training Department of Administrative Dietitians, Faculty of Human Life Science, Shikoku University, Tokushima, Japan.
authors.forename: Yukio
authors.initials: Y
authors.lastname: Yoshimura
authors.affiliation: Center for Comprehensive Care and Research on Demented Disorders, National Center for Geriatrics and Gerontology, Obu, Aichi, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Sakurai
authors.affiliation: Department of Community Healthcare and Geriatric Medicine, University of Nagoya, Nagoya, Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Umegaki
authors.affiliation: Training Department of Administrative Dietitians, Faculty of Human Life Science, Shikoku University, Tokushima, Japan.
authors.forename: Chiemi
authors.initials: C
authors.lastname: Kamada
authors.affiliation: Department of Biostatistics, School of Public Health, Graduate School of Medicine, University of Tokyo, Tokyo, Japan.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Iimuro
authors.affiliation: Department of Biostatistics, School of Public Health, Graduate School of Medicine, University of Tokyo, Tokyo, Japan.
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Ohashi
authors.affiliation: Department of Diabetes, Metabolism and Endocrinology, Tokyo Metropolitan Geriatric Hospital, Tokyo, Japan.
authors.forename: Hideki
authors.initials: H
authors.lastname: Ito
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002118:Calcium / Q000172:deficiency*; D002338:Carotenoids / Q000172:deficiency*; D060825:Cognitive Dysfunction / Q000175:diagnosis / Q000453:epidemiology*; D015331:Cohort Studies; D015897:Comorbidity; D003920:Diabetes Mellitus / Q000175:diagnosis / Q000453:epidemiology*; D004032:Diet; D005260:Female; D015577:Geriatric Assessment; D006801:Humans; D015994:Incidence; D007564:Japan / Q000453:epidemiology; D016015:Logistic Models; D008297:Male; D015999:Multivariate Analysis; D017853:Phosphotransferases (Alcohol Group Acceptor) / Q000172:deficiency; D011237:Predictive Value of Tests; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012257:Riboflavin Deficiency / Q000453:epidemiology*; D018570:Risk Assessment; D012737:Sex Factors
chemical_list: D002338:Carotenoids; D017853:Phosphotransferases (Alcohol Group Acceptor); C023088:pantothenate kinase; D002118:Calcium
keywords: cognitive decline; diabetes mellitus; elderly; nutrition