From the Centre for Public Health (C.T.M.), School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Northern Ireland, UK; Global Brain Health Institute (C.T.M., K.Y.), Department of Neurology (K.Y.), and Department of Epidemiology and Biostatistics (K.Y.), University of California, San Francisco; Trinity College Dublin (C.T.M.), Ireland; Northern California Institute for Research and Education (T.H.), San Francisco; Division of Research (S.S.), Kaiser Permanente Northern California, Oakland; Division of Epidemiology and Community Health (L.M.S., D.R.J.), School of Public Health, University of Minnesota, Minneapolis; Division of Preventive Medicine (J.M.S.), School of Medicine, University of Alabama at Birmingham; Department of Preventive Medicine and Medicine (Cardiology) (J.T.W.), Northwestern University Feinberg School of Medicine, Chicago, IL; and San Francisco Veterans Affairs Medical Center (K.Y.), CA.
Neurology. 2019 Apr 2;92(14):e1589-e1599. doi: 10.1212/WNL.0000000000007243. Epub 2019 Mar 6.
To investigate whether dietary patterns (Mediterranean diet [MedDiet], Dietary Approaches to Stop Hypertension [DASH], and A Priori Diet Quality Score [APDQS]) during adulthood are associated with midlife cognitive performance.
We studied 2,621 Coronary Artery Risk Development in Young Adults (CARDIA) participants; 45% were black, 57% were female, and mean age was 25 ± 3.5 years at baseline (year 0). Mean diet scores were calculated from diet history at baseline, year 7, and year 20 (mean age 25, 32, and 45 years, respectively). Cognitive function was assessed at years 25 and 30 (mean age 50 and 55 years, respectively). Linear models were used to examine association between tertiles of diet score and change in composite cognitive function and cognitive scores (verbal memory [Rey Auditory Verbal Learning Test], processing speed [Digit Symbol Substitution Test], and executive function [Stroop Interference test]) and the Montreal Cognitive Assessment (MoCA) at year 30.
DASH was not associated with change in cognitive performance. Higher MedDiet and APDQS scores were associated with less decline in cognitive function (MedDiet: low -0.04, middle 0.03, high 0.03, = 0.03; APDQS: low -0.04, middle -0.00, high 0.06, < 0.01) and Stroop Interference (MedDiet: low 0.09, middle -0.06, high -0.03; APDQS: low 0.10, middle 0.01, high -0.09, both < 0.01). Odds ratios (95% confidence interval) for poor global cognitive function (≥1 SD below mean MoCA score) comparing extreme tertiles of diet scores were 0.54 (0.39-0.74) for MedDiet, 0.48 (0.33-0.69) for APDQS, and 0.89 (0.68-1.17) for DASH.
Greater adherence to MedDiet and APDQS dietary patterns during adulthood was associated with better midlife cognitive performance. Additional studies are needed to define the combination of foods and nutrients for optimal brain health across the life course.
研究成年期的饮食模式（地中海饮食[MedDiet]、停止高血压的饮食方法[DASH]和预先饮食质量评分[APDQS]）是否与中年认知表现有关。
我们研究了 2621 名冠状动脉风险发展在年轻人（CARDIA）参与者；45%是黑人，57%是女性，基线时的平均年龄为 25 ± 3.5 岁（0 年）。从基线、第 7 年和第 20 年的饮食史中计算平均饮食得分（分别为平均年龄 25、32 和 45 岁）。认知功能在 25 岁和 30 岁时进行评估（分别为平均年龄 50 和 55 岁）。线性模型用于研究饮食评分三分位数与复合认知功能和认知评分（听觉词语学习测试[Rey 听觉词语学习测试]的言语记忆、数字符号替换测试[数字符号替换测试]的处理速度和 Stroop 干扰测试[Stroop 干扰测试]的执行功能）以及 30 岁时的蒙特利尔认知评估（MoCA）变化之间的关系。
DASH 与认知表现的变化无关。较高的 MedDiet 和 APDQS 评分与认知功能下降较少相关（MedDiet：低 -0.04、中 0.03、高 0.03，= 0.03；APDQS：低 -0.04、中 -0.00、高 0.06，<0.01）和 Stroop 干扰（MedDiet：低 0.09、中 -0.06、高 -0.03；APDQS：低 0.10、中 0.01、高 -0.09，均<0.01）。比较饮食评分极端三分位数的全球认知功能差（MoCA 评分平均值以下≥1 个标准差）的比值比（95%置信区间）为 0.54（0.39-0.74）为 MedDiet，0.48（0.33-0.69）为 APDQS，0.89（0.68-1.17）为 DASH。
成年期更严格地遵循 MedDiet 和 APDQS 饮食模式与中年认知表现较好有关。需要进一步的研究来确定在整个生命周期中促进大脑健康的食物和营养素的组合。
