School of Public Health, Wuhan University, Wuhan, China.
Department of Medicine and Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China.
Am J Clin Nutr. 2023 Jul;118(1):201-208. doi: 10.1016/j.ajcnut.2023.05.018. Epub 2023 May 13.
It is unclear how changes in plant-based dietary quality are linked to the subsequent risk of cognitive impairment.
This study aims to evaluate this relationship using data from the Chinese Longitudinal Healthy Longevity Survey.
A total of 6662 participants free of cognitive impairment in 2008 were included and followed ≤2018. Plant-based dietary quality was assessed by 3 indices: overall plant-based diet index (PDI), healthful PDI (hPDI), and unhealthful PDI (uPDI). Changes in plant-based diet quality from 2008 to 2011 were classified into quintiles. In addition, we assessed incident cognitive impairment (from 2011 to 2018) by using the Mini-Mental State Examination. Cox proportional-hazards models were performed.
We recorded 1571 incident cases of cognitive impairment during a median of 10 y of follow-up. Compared with participants whose plant-based diet had no change or was relatively stable over 3 y, the full-adjusted hazard ratios (HRs) with 95% confidence intervals (CI) for cognitive impairment were 0.77 (0.64, 0.93), 0.72 (0.60, 0.86), and 1.50 (1.27, 1.77) among participants with a large increase in PDI, hPDI, and uPDI, respectively. The HRs with 95% CI were 1.22 (1.02, 1.44), 1.30 (1.11, 1.54), and 0.80 (0.67, 0.96) among participants with a large decrease in PDI, hPDI, and uPDI, respectively. Every 10-point increase in PDI and hPDI was associated with a 26% and 30% lower risk of cognitive impairment, whereas every 10-point increase in uPDI was associated with a 36% higher risk.
Older adults with increased adherence to an overall plant-based diet and a healthful plant-based diet over 3 y have a lower risk of cognitive impairment, whereas those with increased adherence to an unhealthy plant-based diet had a higher risk of cognitive impairment.
目前尚不清楚植物性饮食质量的变化与随后认知障碍风险之间的关系。
本研究旨在使用来自中国长寿纵向研究的数据来评估这种关系。
纳入了 2008 年无认知障碍的 6662 名参与者，并随访至≤2018 年。通过 3 项指标评估植物性饮食质量：整体植物性饮食指数（PDI）、健康 PDI（hPDI）和不健康 PDI（uPDI）。2008 年至 2011 年期间植物性饮食质量的变化分为五分位。此外，我们使用简易精神状态检查评估了 2011 年至 2018 年期间的新发认知障碍。采用 Cox 比例风险模型进行分析。
在中位 10 年的随访期间，我们记录了 1571 例新发认知障碍病例。与植物性饮食在 3 年内无变化或相对稳定的参与者相比，PDI、hPDI 和 uPDI 大幅增加的参与者发生认知障碍的全调整风险比（HR）及其 95%置信区间（CI）分别为 0.77（0.64，0.93）、0.72（0.60，0.86）和 1.50（1.27，1.77）；PDI、hPDI 和 uPDI 大幅降低的参与者发生认知障碍的 HR 及其 95%CI 分别为 1.22（1.02，1.44）、1.30（1.11，1.54）和 0.80（0.67，0.96）。PDI 和 hPDI 每增加 10 分，认知障碍的风险分别降低 26%和 30%，而 uPDI 每增加 10 分，认知障碍的风险则增加 36%。
在 3 年内坚持整体植物性饮食和健康植物性饮食的老年人认知障碍风险较低，而坚持不健康植物性饮食的老年人认知障碍风险较高。
