Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA.
J Alzheimers Dis. 2012;32(2):329-39. doi: 10.3233/JAD-2012-120862.
High caloric intake has been associated with an increased risk of cognitive impairment. Total caloric intake is determined by the calories derived from macronutrients. The objective of the study was to investigate the association between percent of daily energy (calories) from macronutrients and incident mild cognitive impairment (MCI) or dementia. Participants were a population-based prospective cohort of elderly persons who were followed over a median 3.7 years (interquartile range, 2.5-3.9) of follow-up. At baseline and every 15 months, participants (median age, 79.5 years) were evaluated using the Clinical Dementia Rating scale, a neurological evaluation, and neuropsychological testing for a diagnosis of MCI, normal cognition, or dementia. Participants also completed a 128-item food-frequency questionnaire at baseline; total daily caloric and macronutrient intakes were calculated using an established database. The percent of total daily energy from protein (% protein), carbohydrate (% carbohydrate), and total fat (% fat) was computed. Among 937 subjects who were cognitively normal at baseline, 200 developed incident MCI or dementia. The risk of MCI or dementia (hazard ratio, [95% confidence interval]) was elevated in subjects with high % carbohydrate (upper quartile: 1.89 [1.17-3.06]; p for trend = 0.004), but was reduced in subjects with high % fat (upper quartile: 0.56 [0.34-0.91]; p for trend = 0.03), and high % protein (upper quartile 0.79 [0.52-1.20]; p for trend = 0.03) in the fully adjusted models. A dietary pattern with relatively high caloric intake from carbohydrates and low caloric intake from fat and proteins may increase the risk of MCI or dementia in elderly persons.
高卡路里摄入与认知障碍风险增加有关。总卡路里摄入量由宏量营养素的卡路里决定。研究的目的是调查宏量营养素提供的每日能量（卡路里）百分比与轻度认知障碍（MCI）或痴呆的发病风险之间的关系。参与者是一项基于人群的前瞻性队列研究，其中包括中位随访 3.7 年（四分位间距 2.5-3.9）的老年人。在基线和每 15 个月，参与者（中位年龄 79.5 岁）使用临床痴呆评定量表、神经学评估和神经心理学测试进行评估，以诊断 MCI、正常认知或痴呆。参与者还在基线时完成了 128 项食物频率问卷；总每日卡路里和宏量营养素摄入量使用已建立的数据库计算。总每日能量的蛋白质百分比（%蛋白质）、碳水化合物百分比（%碳水化合物）和总脂肪百分比（%脂肪）计算得出。在 937 名基线时认知正常的受试者中，有 200 名发生了 MCI 或痴呆。MCI 或痴呆的风险（风险比，[95%置信区间]）在高碳水化合物百分比的受试者中升高（最高四分位数：1.89 [1.17-3.06]；趋势检验的 p 值=0.004），而在高脂肪百分比的受试者中降低（最高四分位数：0.56 [0.34-0.91]；趋势检验的 p 值=0.03），高蛋白质百分比（最高四分位数 0.79 [0.52-1.20]；趋势检验的 p 值=0.03）的受试者中降低。碳水化合物提供的卡路里摄入相对较高，脂肪和蛋白质提供的卡路里摄入相对较低的饮食模式可能会增加老年人发生 MCI 或痴呆的风险。
