地中海饮食防治高血压干预神经退行性延迟（MIND）饮食与痴呆风险的关联。

Association of the Mediterranean Dietary Approaches to Stop Hypertension Intervention for Neurodegenerative Delay (MIND) Diet With the Risk of Dementia.

机构信息

School of Public Health, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.

Rush Institute for Healthy Aging, Rush University Medical Center, Chicago, Illinois.

出版信息

JAMA Psychiatry. 2023 Jun 1;80(6):630-638. doi: 10.1001/jamapsychiatry.2023.0800.

DOI:10.1001/jamapsychiatry.2023.0800

PMID:37133875

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10157510/

Abstract

IMPORTANCE

Dementia threatens the well-being of older adults, making efforts toward prevention of great importance.

OBJECTIVE

To evaluate the association of the Mediterranean-Dietary Approaches to Stop Hypertension (DASH) Intervention for Neurodegenerative Delay (MIND) diet with the risk of dementia in 3 prospective studies and a meta-analysis.

DESIGN, SETTING, AND PARTICIPANTS: Cohort analyses included the Whitehall II study (WII), the Health and Retirement Study (HRS), and the Framingham Heart Study Offspring cohort (FOS), and the meta-analysis included 11 cohort studies. Participants were middle-aged and older women and men from WII in 2002 to 2004, HRS in 2013, and FOS in 1998 to 2001 without dementia at the study baseline. Data were analyzed from May 25 to September 1, 2022.

EXPOSURES

MIND diet score was measured using food frequency questionnaires, and scores ranged from 0 to 15, with a higher score indicating higher adherence to the MIND diet.

MAIN OUTCOME AND MEASURES

Incident all-cause dementia, with cohort-specific definitions.

RESULTS

Included in this study were 8358 participants (mean [SD] age, 62.2 [6.0] years; 5777 male [69.1%]) from WII, 6758 participants (mean [SD] age, 66.5 [10.4] years; 3965 female [58.7%]) from HRS, and 3020 participants (mean [SD] age, 64.2 [9.1] years; 1648 female [54.6%]) from FOS. The mean (SD) baseline MIND diet score was 8.3 (1.4) in WII, 7.1 (1.9) in HRS, and 8.1 (1.6) in FOS. Over 166 516 person-years, a total of 775 participants (220 in WII, 338 in HRS, and 217 in FOS) developed incident dementia. In the multivariable-adjusted Cox proportional hazard model, higher MIND diet score was associated with lower risk of dementia (pooled hazard ratio [HR] for every 3-point increment, 0.83; 95% CI, 0.72-0.95; P for trend = .01; I2 = 0%). The associations were consistently observed in subgroups defined by sex, age, smoking status, and body mass index. In the meta-analysis of 11 cohort studies with 224 049 participants (5279 incident dementia cases), the highest tertile of MIND diet score was associated with lower risk of dementia compared with the lowest tertile (pooled HR, 0.83; 95% CI, 0.76-0.90; I2 = 35%).

CONCLUSIONS AND RELEVANCE

Results suggest that adherence to the MIND diet was associated with lower risk of incident dementia in middle-aged and older adults. Further studies are warranted to develop and refine the specific MIND diet for different populations.

摘要

重要性

痴呆症威胁着老年人的福祉，因此努力预防痴呆症非常重要。

目的

在 3 项前瞻性研究和一项荟萃分析中评估地中海-高血压饮食法（DASH）干预神经退行性疾病延迟（MIND）饮食与痴呆风险的相关性。

设计、设置和参与者：队列分析包括白厅 II 研究（WII）、健康与退休研究（HRS）和弗雷明汉心脏研究后代队列（FOS），荟萃分析包括 11 项队列研究。参与者为 WII 于 2002 年至 2004 年、HRS 于 2013 年以及 FOS 于 1998 年至 2001 年无痴呆症的中年和老年女性和男性。数据于 2022 年 5 月 25 日至 9 月 1 日进行分析。

暴露因素

MIND 饮食评分通过食物频率问卷进行测量，评分范围为 0 至 15，得分越高表示对 MIND 饮食的依从性越高。

主要结果和测量指标

全因痴呆症的发病情况，各队列有特定的定义。

结果

本研究纳入了来自 WII 的 8358 名参与者（平均[标准差]年龄，62.2[6.0]岁；5777 名男性[69.1%]）、来自 HRS 的 6758 名参与者（平均[标准差]年龄，66.5[10.4]岁；3965 名女性[58.7%]）和来自 FOS 的 3020 名参与者（平均[标准差]年龄，64.2[9.1]岁；1648 名女性[54.6%]）。WII 的平均（SD）基线 MIND 饮食评分是 8.3（1.4）、HRS 是 7.1（1.9）、FOS 是 8.1（1.6）。在 166516 人年期间，共有 775 名参与者（WII 220 名、HRS 338 名、FOS 217 名）发生了痴呆症发病。在多变量调整后的 Cox 比例风险模型中，更高的 MIND 饮食评分与痴呆风险降低相关（每增加 3 分的 pooled hazard ratio [HR]，0.83；95%CI，0.72-0.95；P 趋势值=0.01；I2=0%）。这些关联在按性别、年龄、吸烟状况和体重指数定义的亚组中一致观察到。在包含 224049 名参与者（5279 例痴呆症发病）的 11 项队列研究的荟萃分析中，与最低三分位相比，MIND 饮食评分最高三分位与痴呆风险降低相关（pooled HR，0.83；95%CI，0.76-0.90；I2=35%）。