Centre for Healthy Aging and Wellness, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Pahang, Kuala Lumpur, Malaysia.
Psychology Program, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Pahang, Kuala Lumpur, Malaysia.
Clin Interv Aging. 2019 Jul 22;14:1331-1342. doi: 10.2147/CIA.S211534. eCollection 2019.
Sugar is widely consumed in Malaysia, and the excessive intake of sugar has been associated with cognitive functions. However, the association between sugar intake and cognitive impairment among Malaysian older adults is yet to be determined. The objective of this study was to evaluate the associations between types and sources of sugar intake and cognitive functions and to identify their risk in predicting cognitive impairment (MMSE score <24). A total of 1,209 subjects aged ≥60 years were recruited through multi-stage random sampling from selected states in Malaysia. Dietary intake was derived using a 7-day dietary history questionnaire and supplemented with a quantitative food frequency questionnaire for added sugar intake. The prevalence of cognitive impairment as defined by Mini-Mental State Examination (MMSE) less than 24 was 31.9%, while the prevalence of mild cognitive impairment was 13.1%. The median (IQR) for total sugar intake was 44.60 g/day (26.21-68.81) or 8 tsp, and free sugar intake was 33.08 g/day (17.48-57.26) or 6 tsp. The higher intake of total sugars, free sugars, sucrose, lactose, sugar-sweetened beverages, sugar-sweetened cakes, and dessert was found to be significantly associated with a lower MMSE score, after adjusting for covariates. On the other hand, the consumption of cooked dishes and fruits was significantly associated with a better MMSE score. The adjusted OR for risk of cognitive impairment (MMSE score <24) was 3.30 (95% CI 2.15-5.08) for total sugars and 3.58 (95% CI 2.32-5.52) for free sugars, comparing the highest with the lowest intake percentiles. Excessive sugar consumption among older adults showed a notable association with poor cognitive functions, but longitudinal studies and clinical trials are further needed to clarify the direction of causality and to investigate the underlying mechanism.
糖在马来西亚被广泛消费，而过量摄入糖与认知功能有关。然而，糖摄入量与马来西亚老年人认知障碍之间的关系尚未确定。本研究旨在评估糖的类型和来源与认知功能之间的关联，并确定它们在预测认知障碍（MMSE 评分<24）方面的风险。共有 1209 名年龄≥60 岁的受试者通过多阶段随机抽样从马来西亚选定的州招募。饮食摄入量通过 7 天饮食史问卷得出，并补充了定量食物频率问卷以获取添加糖的摄入量。使用 Mini-Mental State Examination (MMSE) 定义的认知障碍患病率<24 为 31.9%，轻度认知障碍患病率为 13.1%。总糖摄入量的中位数（IQR）为 44.60 克/天（26.21-68.81）或 8 勺，游离糖摄入量为 33.08 克/天（17.48-57.26）或 6 勺。在调整了协变量后，发现总糖、游离糖、蔗糖、乳糖、加糖饮料、加糖蛋糕和甜点的摄入量越高，MMSE 评分越低。另一方面，食用熟食和水果与更好的 MMSE 评分显著相关。总糖和游离糖的最高摄入量与最低摄入量相比，认知障碍（MMSE 评分<24）的调整 OR 分别为 3.30（95%CI 2.15-5.08）和 3.58（95%CI 2.32-5.52）。老年人过量摄入糖与认知功能差有显著关联，但需要进一步进行纵向研究和临床试验以阐明因果关系，并探讨潜在机制。
