Dietary patterns and cardiorespiratory fitness in midlife and subsequent all-cause dementia: findings from the cooper center longitudinal study.

IF 5.6 1区 医学 Q1 NUTRITION & DIETETICS
Clare Meernik, Sigal Eilat-Adar, David Leonard, Carolyn E Barlow, Yariv Gerber, Riki Tesler, Carmen Byker Shanks, Kelley Pettee Gabriel, Andjelka Pavlovic, Laura F DeFina, Kerem Shuval
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引用次数: 0

Abstract

Background: Identifying lifestyle factors that independently or jointly lower dementia risk is a public health priority given the limited treatment options available to patients. In this cohort study, we examined the associations between Mediterranean or Dietary Approaches to Stop Hypertension (DASH) diet adherence and cardiorespiratory fitness (CRF) with later-life dementia, and assessed whether the associations between dietary pattern and dementia are modified by CRF.

Methods: Data are from 9,095 adults seeking preventive care at the Cooper Clinic (1987-1999) who completed a 3-day dietary record and a maximal exercise test. Alzheimer's disease and related disorders or senile dementia (i.e., all-cause dementia) was identified from Medicare administrative claims (1999-2019). Illness-death models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for the associations between Mediterranean or DASH diet adherence (primary exposure), CRF (secondary exposure), and all-cause dementia, adjusted for demographic and clinical factors. An interaction term was included between diet score and CRF to assess effect modification by CRF.

Results: The mean age at baseline was 50.6 (standard deviation [SD]: 8.4) years, and a majority of the study sample were men (77.5%) and White (96.4%). 1449 cases of all-cause dementia were identified over a mean follow-up of 9.2 (SD: 5.8) years. Neither Mediterranean nor DASH diet adherence was associated with dementia risk in fully adjusted models (HR per SD of Mediterranean diet score: 1.00, 95% CI: 0.94, 1.05; HR per SD of DASH diet score: 1.02, 95% CI: 0.96, 1.08). However, participants with higher CRF had a decreased hazard of dementia (HR, per metabolic equivalent of task [MET] increase, Mediterranean model: 0.95, 95% CI: 0.92, 0.98; HR, per MET increase, DASH model: 0.96, 95% CI: 0.92, 0.97). No effect modification by CRF was observed in the association between diet and dementia.

Conclusions: In this sample of apparently healthy middle-aged adults seeking preventive care, higher CRF at midlife was associated with a lower risk of all-cause dementia, though adherence to a Mediterranean or DASH diet was not, and CRF did not modify the diet-dementia association. CRF should be emphasized in multimodal interventions for dementia prevention and investigated among diverse samples.

中年时期的饮食模式和心肺功能与随后的全因痴呆症:库珀中心纵向研究的发现。
背景:由于患者可选择的治疗方法有限,因此确定能够独立或共同降低痴呆症风险的生活方式因素是公共卫生的当务之急。在这项队列研究中,我们考察了地中海或达希饮食法(DASH)与晚年痴呆症之间的关系,并评估了饮食模式与痴呆症之间的关系是否会因达希饮食法而改变:数据来自库珀诊所(1987-1999 年)的 9095 名寻求预防保健的成年人,他们完成了 3 天的饮食记录和最大运动量测试。阿尔茨海默病及相关疾病或老年痴呆症(即全因痴呆症)是从医疗保险管理索赔(1999-2019 年)中确定的。疾病-死亡模型用于估计地中海或DASH饮食坚持率(主要暴露)、CRF(次要暴露)和全因痴呆之间的危险比(HRs)和95%置信区间(CIs),并对人口统计学和临床因素进行调整。饮食评分和CRF之间还包含一个交互项,以评估CRF对效果的修饰作用:基线时的平均年龄为 50.6 岁(标准差 [SD]:8.4),研究样本中大多数为男性(77.5%)和白人(96.4%)。在平均 9.2(标准差:5.8)年的随访期间,共发现了 1449 例全因痴呆症病例。在完全调整模型中,地中海饮食和DASH饮食的坚持率均与痴呆症风险无关(地中海饮食得分每标准差的HR:1.00,95% CI:0.94,1.05;DASH饮食得分每标准差的HR:1.02,95% CI:0.96,1.08)。然而,CRF 较高的参与者患痴呆症的风险较低(地中海模型中,每增加一个代谢当量 [MET],HR:0.95,95% CI:0.96,1.08):0.95, 95% CI: 0.92, 0.98; HR, per MET increase, DASH model:0.96,95% CI:0.92,0.97)。在饮食与痴呆症之间的关系中,没有观察到 CRF 的影响:结论:在这批寻求预防保健的明显健康的中年人样本中,中年时较高的CRF与较低的全因痴呆风险相关,但坚持地中海或DASH饮食则不然,而且CRF不会改变饮食与痴呆的关系。在预防痴呆症的多模式干预中应强调CRF,并在不同样本中进行调查。
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来源期刊
CiteScore
13.80
自引率
3.40%
发文量
138
审稿时长
4-8 weeks
期刊介绍: International Journal of Behavioral Nutrition and Physical Activity (IJBNPA) is an open access, peer-reviewed journal offering high quality articles, rapid publication and wide diffusion in the public domain. IJBNPA is devoted to furthering the understanding of the behavioral aspects of diet and physical activity and is unique in its inclusion of multiple levels of analysis, including populations, groups and individuals and its inclusion of epidemiology, and behavioral, theoretical and measurement research areas.
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