Dietary patterns and transition from normal cognition to mild cognitive impairment and its reversion: A longitudinal study of older adults

IF 6.6 2区医学 Q1 NUTRITION & DIETETICS

Clinical nutrition Pub Date : 2025-05-17 DOI:10.1016/j.clnu.2025.05.010

Xiaofu Du , Bin Gao , Jiangtao Zhang , Jing Guo

{"title":"Dietary patterns and transition from normal cognition to mild cognitive impairment and its reversion: A longitudinal study of older adults","authors":"Xiaofu Du , Bin Gao , Jiangtao Zhang , Jing Guo","doi":"10.1016/j.clnu.2025.05.010","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><div>The reversion from mild cognitive impairment (MCI) to normal cognition (NC) has received less attention than the progression to dementia. We aimed to estimate the MCI-to-NC reversion rate and examine dietary patterns associated with the cognitive transition among older adults.</div></div><div><h3>Methods</h3><div>Longitudinal data from 11,211 adults aged 65 years and older were analyzed. Four dietary patterns including plant-based diet index (PDI), simplified healthy eating index (SHEI), dietary diversity score (DDS), and the Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND) were assessed with the food frequency questionnaire. Cognitive function was quantified with the Mini-Mental State Examination. The multi-state Markov models were applied to estimate associations between each dietary pattern and transition of cognitive status with four states: NC, MCI, dementia, and death.</div></div><div><h3>Results</h3><div>Participants (mean [SD] age, 85.80 [11.13] years; 6211 women [55.40 %] and 5000 men [44.60 %]) were followed over a mean time of 4.76 (SD = 3.14) years. The rate of reversion from MCI to NC was 9.4 %. Hazard ratios (HRs, 95 % confidence interval [CI]) for the progression from NC to MCI were 0.87 (0.77–0.97), 0.81 (0.73–0.91), 0.95 (0.92–0.99), and 0.95 (0.92–0.99) for dietary patterns of healthful PDI (hPDI), SHEI, DDS, and MIND, respectively. Besides, a better adherence to hPDI (HR = 1.21, 95 % CI = 1.03 to 1.43) and SHEI (HR = 1.20, 95 % CI = 1.02 to 1.41) was associated with increased likelihoods to revert from MCI to NC.</div></div><div><h3>Conclusions</h3><div>Dietary patterns of hPDI, SHEI, DDS, and MIND were linked to decreased risks of NC-to-MCI progression, and hPDI and SHEI were associated with higher likelihoods of MCI-to-NC reversion in older adults. Interventional studies with dietary patterns were warranted to confirm our findings.</div></div>","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"50 ","pages":"Pages 137-145"},"PeriodicalIF":6.6000,"publicationDate":"2025-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Clinical nutrition","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0261561425001384","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"NUTRITION & DIETETICS","Score":null,"Total":0}

引用次数: 0

Abstract

Background

The reversion from mild cognitive impairment (MCI) to normal cognition (NC) has received less attention than the progression to dementia. We aimed to estimate the MCI-to-NC reversion rate and examine dietary patterns associated with the cognitive transition among older adults.

Methods

Longitudinal data from 11,211 adults aged 65 years and older were analyzed. Four dietary patterns including plant-based diet index (PDI), simplified healthy eating index (SHEI), dietary diversity score (DDS), and the Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND) were assessed with the food frequency questionnaire. Cognitive function was quantified with the Mini-Mental State Examination. The multi-state Markov models were applied to estimate associations between each dietary pattern and transition of cognitive status with four states: NC, MCI, dementia, and death.

Results

Participants (mean [SD] age, 85.80 [11.13] years; 6211 women [55.40 %] and 5000 men [44.60 %]) were followed over a mean time of 4.76 (SD = 3.14) years. The rate of reversion from MCI to NC was 9.4 %. Hazard ratios (HRs, 95 % confidence interval [CI]) for the progression from NC to MCI were 0.87 (0.77–0.97), 0.81 (0.73–0.91), 0.95 (0.92–0.99), and 0.95 (0.92–0.99) for dietary patterns of healthful PDI (hPDI), SHEI, DDS, and MIND, respectively. Besides, a better adherence to hPDI (HR = 1.21, 95 % CI = 1.03 to 1.43) and SHEI (HR = 1.20, 95 % CI = 1.02 to 1.41) was associated with increased likelihoods to revert from MCI to NC.

Conclusions

Dietary patterns of hPDI, SHEI, DDS, and MIND were linked to decreased risks of NC-to-MCI progression, and hPDI and SHEI were associated with higher likelihoods of MCI-to-NC reversion in older adults. Interventional studies with dietary patterns were warranted to confirm our findings.

查看原文本刊更多论文

饮食模式与从正常认知到轻度认知障碍的转变及其逆转：一项老年人的纵向研究

从轻度认知障碍（MCI）到正常认知障碍（NC）的逆转比痴呆症的进展受到的关注要少。我们的目的是估计mci到nc的逆转率，并检查与老年人认知转变相关的饮食模式。方法对11,211名65岁及以上老年人的纵向资料进行分析。采用食物频率问卷对植物性饮食指数（PDI）、简化健康饮食指数（SHEI）、饮食多样性评分（DDS）和地中海- dash干预治疗神经退行性延迟（MIND）等4种饮食模式进行评估。认知功能用简易精神状态检查进行量化。应用多状态马尔可夫模型来估计每种饮食模式与认知状态转变之间的关联，包括四种状态：NC、MCI、痴呆和死亡。结果参与者平均[SD]年龄85.80[11.13]岁；6211名女性（55.40%）和5000名男性（44.60%）被随访，平均时间为4.76 （SD = 3.14）年。从MCI到NC的复发率为9.4%。健康PDI （hPDI）、SHEI、DDS和MIND饮食模式从NC到MCI进展的风险比（hr， 95%可信区间[CI]）分别为0.87（0.77-0.97）、0.81（0.73-0.91）、0.95（0.92-0.99）和0.95（0.92-0.99）。此外，较好的hPDI依从性（HR = 1.21, 95% CI = 1.03至1.43）和SHEI依从性（HR = 1.20, 95% CI = 1.02至1.41）与MCI恢复为NC的可能性增加相关。结论：hPDI、SHEI、DDS和MIND的饮食模式与nc向mci进展的风险降低有关，hPDI和SHEI与老年人mci向nc逆转的可能性较高有关。饮食模式的介入研究证实了我们的发现。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Clinical nutrition 医学-营养学

CiteScore

14.10

自引率

6.30%

发文量

356

审稿时长

28 days

期刊介绍： Clinical Nutrition, the official journal of ESPEN, The European Society for Clinical Nutrition and Metabolism, is an international journal providing essential scientific information on nutritional and metabolic care and the relationship between nutrition and disease both in the setting of basic science and clinical practice. Published bi-monthly, each issue combines original articles and reviews providing an invaluable reference for any specialist concerned with these fields.