Second Department of Neurology, School of Medicine, Attikon Hospital, University of Athens, Greece.
Neurology. 2013 Apr 30;80(18):1684-92. doi: 10.1212/WNL.0b013e3182904f69.
We sought to determine the relationship of greater adherence to Mediterranean diet (MeD) and likelihood of incident cognitive impairment (ICI) and evaluate the interaction of race and vascular risk factors.
A prospective, population-based, cohort of individuals enrolled in the Reasons for Geographic and Racial Differences in Stroke (REGARDS) Study 2003-2007, excluding participants with history of stroke, impaired cognitive status at baseline, and missing data on Food Frequency Questionnaires (FFQ), was evaluated. Adherence to a MeD (scored as 0-9) was computed from FFQ. Cognitive status was evaluated at baseline and annually during a mean follow-up period of 4.0 ± 1.5 years using Six-item-Screener.
ICI was identified in 1,248 (7%) out of 17,478 individuals fulfilling the inclusion criteria. Higher adherence to MeD was associated with lower likelihood of ICI before (odds ratio [lsqb]OR[rsqb] 0.89; 95% confidence interval [lsqb]CI[rsqb] 0.79-1.00) and after adjustment for potential confounders (OR 0.87; 95% CI 0.76-1.00) including demographic characteristics, environmental factors, vascular risk factors, depressive symptoms, and self-reported health status. There was no interaction between race (p = 0.2928) and association of adherence to MeD with cognitive status. However, we identified a strong interaction of diabetes mellitus (p = 0.0134) on the relationship of adherence to MeD with ICI; high adherence to MeD was associated with a lower likelihood of ICI in nondiabetic participants (OR 0.81; 95% CI 0.70-0.94; p = 0.0066) but not in diabetic individuals (OR 1.27; 95% CI 0.95-1.71; p = 0.1063).
Higher adherence to MeD was associated with a lower likelihood of ICI independent of potential confounders. This association was moderated by presence of diabetes mellitus.
我们旨在探讨地中海饮食（MeD）依从性与认知障碍事件（ICI）的相关性，并评估种族和血管危险因素的交互作用。
本研究为前瞻性、基于人群的队列研究，纳入了 2003-2007 年参加 Reasons for Geographic and Racial Differences in Stroke（REGARDS）研究的个体，排除了有中风病史、基线认知功能受损和食物频率问卷（FFQ）缺失数据的参与者。通过 FFQ 计算 MeD 依从性（评分 0-9）。在平均 4.0±1.5 年的随访期间，每年使用六项目筛查器评估认知状态。
符合纳入标准的 17478 名个体中，有 1248 名（7%）发生了 ICI。在调整潜在混杂因素（包括人口统计学特征、环境因素、血管危险因素、抑郁症状和自我报告的健康状况）前后，MeD 依从性与 ICI 的发生风险均呈负相关（未调整时的比值比[lsqb]OR[rsqb]0.89；95%置信区间[lsqb]CI[rsqb]0.79-1.00；调整后 OR 0.87；95% CI 0.76-1.00）。种族之间无交互作用（p=0.2928），MeD 依从性与认知状态之间的关联不受种族的影响。然而，我们发现糖尿病（p=0.0134）这一因素与 MeD 依从性与 ICI 之间的关系存在强烈的交互作用；在非糖尿病患者中，高 MeD 依从性与 ICI 的发生风险较低相关（OR 0.81；95% CI 0.70-0.94；p=0.0066），而在糖尿病患者中则无相关性（OR 1.27；95% CI 0.95-1.71；p=0.1063）。
无论潜在混杂因素如何，较高的 MeD 依从性与 ICI 的发生风险较低相关。这种关联受糖尿病的影响。
