University of Bordeaux, ISPED, Centre INSERM U897-Epidemiologie-Biostatistique, F-33000 Bordeaux, France.
Nutr Res Rev. 2012 Dec;25(2):207-22. doi: 10.1017/S0954422412000133. Epub 2012 Jul 4.
Cognitive decline may lead to dementia whose most frequent cause is Alzheimer's disease (AD). Among the many potential risk factors of cognitive decline and AD, diet raises increasing interest. Most studies considered diet in the frame of a single nutrient approach with inconsistent results. A novel approach to examine the link between nutrition and cognitive function is the use of dietary patterns. The aim of the present review was to update and complete the body of knowledge about dietary patterns in relationship with various cognitive outcomes in the elderly. Two approaches can be used: a priori and a posteriori patterns. A priori patterns are defined by the adhesion to a pre-defined healthy diet using a score such as the Mediterranean diet (MeDi) score, the Healthy Eating Index, the Canadian Healthy Eating Index, the French National Nutrition and Health Programme (Programme National Nutrition Santé) Guideline Score (PNNS-GS), the Recommended Food Score (RFS) and Dietary Approaches to Stop Hypertension (DASH). MeDi score, RFS, PNNS-GS and DASH have been associated with lower risks of cognitive impairment, cognitive decline, and dementia or AD. Principal components analysis, reduced rank regression and clustering methods allow the identification of 'healthy' patterns associated with lower risk of cognitive decline. However, some studies did not report any associations with cognitive outcomes and results are discordant especially regarding MeDi and the risk of dementia. Several methodological challenges should be overcome to provide a higher level of evidence supporting the development of nutritional policies to prevent cognitive decline and AD.
认知能力下降可能导致痴呆，而痴呆最常见的病因是阿尔茨海默病（AD）。在认知能力下降和 AD 的众多潜在危险因素中，饮食越来越受到关注。大多数研究都考虑了饮食作为单一营养素的方法，但结果不一致。一种新的方法是研究营养与认知功能之间的关系，即饮食模式。本综述的目的是更新和补充关于饮食模式与老年人各种认知结果之间关系的知识体系。有两种方法可以使用：先验和后验模式。先验模式是通过使用分数（如地中海饮食评分、健康饮食指数、加拿大健康饮食指数、法国国家营养与健康计划（Programme National Nutrition Santé）指导方针评分、推荐食物评分和停止高血压的饮食方法）来确定对预先定义的健康饮食的遵守程度来定义的。地中海饮食评分、推荐食物评分、法国国家营养与健康计划指导方针评分和停止高血压的饮食方法与认知障碍、认知能力下降和痴呆或 AD 的风险降低有关。主成分分析、降秩回归和聚类方法可以识别与认知能力下降风险降低相关的“健康”模式。然而，一些研究并未报告与认知结果之间的任何关联，结果存在分歧，尤其是关于地中海饮食和痴呆风险的研究。为了提供更高水平的证据来支持制定预防认知能力下降和 AD 的营养政策，需要克服几个方法学挑战。
