Department of Clinical Biochemistry, Copenhagen University Hospital - Rigshospitalet, Blegdamsvej 9, 2100 Copenhagen, Denmark.
Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3, 2200 Copenhagen, Denmark.
Epidemiol Psychiatr Sci. 2022 Oct 10;31:e71. doi: 10.1017/S2045796022000567.
Recent estimates suggest that 40% of dementia cases could be avoided by treating recognised cardiovascular risk factors such as hypertension, diabetes, smoking and physical inactivity. Whether diet is associated with dementia remains largely unknown. We tested if low adherence to established dietary guidelines is associated with elevated lipids and lipoproteins and with increased risk of Alzheimer's disease and non-Alzheimer's dementia – a dementia subtype with a high frequency of cardiovascular risk factors.
We used the prospective Copenhagen General Population Study including 94 184 individuals with dietary information and free of dementia at baseline. Mean age at study entry was 58 years, and 55% ( = 51 720) were women and 45% ( = 42 464) were men. Adherence to dietary guidelines was grouped into low, intermediate and high adherence based on food frequency questionnaires. Main outcomes were non-Alzheimer's dementia and Alzheimer's disease.
Low-density lipoprotein cholesterol, non-high-density lipoprotein cholesterol and plasma triglyceride levels were higher in individuals with intermediate and low adherence to dietary guidelines compared with individuals with high adherence (all for trends <0.001). Age and sex-adjusted hazard ratios (HRs) for non-Alzheimer's dementia individuals with high adherence were 1.19 (95% confidence interval 0.97–1.46) for intermediate adherence, and 1.54 (1.18–2.00) for low adherence. Corresponding HRs in multivariable-adjusted models including genotype were 1.14 (0.92–1.40) and 1.35 (1.03–1.79). These relationships were not observed in individuals on lipid-lowering therapy.
Low adherence to national dietary guidelines is associated with an atherogenic lipid profile and with increased risk of non-Alzheimer's dementia – the subtype of dementia with a high frequency of vascular risk factors. This study suggests that implementation of dietary guidelines associated with an anti-atherogenic lipid profile could be important for prevention of non-Alzheimer's dementia.
最近的估计表明，通过治疗高血压、糖尿病、吸烟和缺乏身体活动等已识别的心血管危险因素，40%的痴呆病例可能得到预防。饮食是否与痴呆有关尚不清楚。我们检测了低遵从既定饮食指南是否与升高的血脂和脂蛋白以及阿尔茨海默病和非阿尔茨海默病痴呆（一种心血管危险因素高发的痴呆亚型）的风险增加相关。
我们使用前瞻性哥本哈根一般人群研究，其中包括 94184 名在基线时无痴呆且有饮食信息的个体。研究开始时的平均年龄为 58 岁，55%（=51720 人）为女性，45%（=42464 人）为男性。根据食物频率问卷，将饮食指南的遵从程度分为低、中、高。主要结局是非阿尔茨海默病痴呆和阿尔茨海默病。
与高遵从饮食指南的个体相比，中、低遵从饮食指南的个体的低密度脂蛋白胆固醇、非高密度脂蛋白胆固醇和血浆甘油三酯水平更高（所有趋势 P<0.001）。年龄和性别调整后的非阿尔茨海默病痴呆风险比（HR）分别为中遵从的个体为 1.19（95%置信区间 0.97-1.46），低遵从的个体为 1.54（1.18-2.00）。多变量调整模型包括基因型的相应 HR 分别为 1.14（0.92-1.40）和 1.35（1.03-1.79）。这些关系在接受降脂治疗的个体中并未观察到。
低遵从国家饮食指南与动脉粥样硬化脂质谱升高以及非阿尔茨海默病痴呆的风险增加相关，非阿尔茨海默病痴呆是一种心血管危险因素高发的痴呆亚型。这项研究表明，实施与抗动脉粥样硬化脂质谱相关的饮食指南可能对预防非阿尔茨海默病痴呆很重要。
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