Marseglia Anna, Xu Weili, Fratiglioni Laura, Fabbri Cristina, Berendsen Agnes A M, Bialecka-Debek Agata, Jennings Amy, Gillings Rachel, Meunier Nathalie, Caumon Elodie, Fairweather-Tait Susan, Pietruszka Barbara, De Groot Lisette C P G M, Santoro Aurelia, Franceschi Claudio
Department of Neurobiology, Care Sciences and Society, Aging Research Center, Karolinska Institutet and Stockholm University, Stockholm, Sweden.
Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Tianjin, China.
Front Physiol. 2018 Apr 4;9:349. doi: 10.3389/fphys.2018.00349. eCollection 2018.
Findings from animal and epidemiological research support the potential neuroprotective benefits from healthy diets. However, to establish diet-neuroprotective causal relations, evidence from dietary intervention studies is needed. NU-AGE is the first multicenter intervention assessing whether a diet targeting health in aging can counteract the age-related physiological changes in different organs, including the brain. In this study, we specifically investigated the effects of NU-AGE's dietary intervention on age-related cognitive decline. NU-AGE randomized trial (NCT01754012, clinicaltrials.gov) included 1279 relatively healthy older-adults, aged 65-79 years, from five European centers. Participants were randomly allocated into two groups: "control" ( = 638), following a habitual diet; and, "intervention" ( = 641), given individually tailored dietary advice (NU-AGE diet). Adherence to the NU-AGE diet was measured over follow-up, and categorized into tertiles (low, moderate, high). Cognitive function was ascertained at baseline and at 1-year follow-up with the Consortium to Establish a Registry for Alzheimer's Disease (CERAD)-Neuropsychological Battery and five additional domain-specific single cognitive tests. The raw scores from the CERAD subtests [excluding the Mini-Mental State Examination (MMSE)] and the single tests were standardized into -scores. Global cognition (measured with MMSE and CERAD-total score), and five cognitive domains (perceptual speed, executive function, episodic memory, verbal abilities, and constructional praxis) were created. Cognitive changes as a function of the intervention were analyzed with multivariable mixed-effects models. After the 1-year follow-up, 571 (89.1%) controls and 573 (89.8%) from the intervention group participated in the post-intervention assessment. Both control and intervention groups showed improvements in global cognition and in all cognitive domains after 1 year, but differences in cognitive changes between the two groups were not statistically significant. However, participants with higher adherence to the NU-AGE diet showed statistically significant improvements in global cognition [β 0.20 (95%CI 0.004, 0.39), -value = 0.046] and episodic memory [β 0.15 (95%CI 0.02, 0.28), -value = 0.025] after 1 year, compared to those adults with lower adherence. High adherence to the culturally adapted, individually tailored, NU-AGE diet could slow down age-related cognitive decline, helping to prevent cognitive impairment and dementia.
动物研究和流行病学研究的结果支持了健康饮食对神经保护的潜在益处。然而，要确定饮食与神经保护之间的因果关系，还需要饮食干预研究的证据。NU-AGE是首个多中心干预研究，旨在评估针对老年人健康的饮食是否能抵消包括大脑在内的不同器官与年龄相关的生理变化。在本研究中，我们专门调查了NU-AGE饮食干预对与年龄相关的认知衰退的影响。NU-AGE随机试验（NCT01754012，clinicaltrials.gov）纳入了来自欧洲五个中心的1279名相对健康的65 - 79岁老年人。参与者被随机分为两组：“对照组”（n = 638），遵循习惯饮食；“干预组”（n = 641），给予个性化的饮食建议（NU-AGE饮食）。在随访期间测量对NU-AGE饮食的依从性，并分为三分位数（低、中、高）。在基线和1年随访时，使用阿尔茨海默病注册协会（CERAD）神经心理成套测验和另外五项特定领域的单项认知测试来确定认知功能。CERAD子测试（不包括简易精神状态检查表（MMSE））和单项测试的原始分数被标准化为z分数。创建了整体认知（用MMSE和CERAD总分测量）以及五个认知领域（感知速度、执行功能、情景记忆、语言能力和结构实践）。使用多变量混合效应模型分析作为干预函数的认知变化。1年随访后，571名（89.1%）对照组和573名（89.8%）干预组参与者参加了干预后评估。1年后，对照组和干预组在整体认知和所有认知领域均有改善，但两组之间的认知变化差异无统计学意义。然而，与依从性较低的成年人相比，对NU-AGE饮食依从性较高的参与者在1年后的整体认知[β 0.20（95%CI 0.004，0.39），P值 = 0.046]和情景记忆[β 0.15（95%CI 0.02，0.28），P值 = 0.025]方面有统计学意义的改善。高度依从根据文化调整的、个性化的NU-AGE饮食可以减缓与年龄相关的认知衰退，有助于预防认知障碍和痴呆。
