Phillip H. Hwang, Boston University School of Public Health, Department of Epidemiology, 715 Albany Street, T3E, Boston, MA 02118, E-mail:
J Prev Alzheimers Dis. 2024;11(5):1270-1279. doi: 10.14283/jpad.2024.116.
Fruits are an important source of flavonoids, and greater intake of dietary flavonoids in older adults has been shown to be associated with decreased risk of dementia. It is unclear whether this relationship is similar or different between younger adults and older adults.
We examined for associations between midlife and late-life intake of flavonoid-rich fruits and incident dementia. We hypothesized that greater total cumulative intake of flavonoid-rich fruits in midlife and late-life adults would be associated with reduced risk of all-cause dementia.
Longitudinal, cohort study design.
Framingham Heart Study, which is a longitudinal, multi-generational community-based cohort based in Framingham, Massachusetts, USA.
Participants from the Framingham Heart Study Offspring cohort were included (n = 2,790) who attended the fifth core exam between 1991 to 1995, and were dementia-free and at least 45 years of age at that time, as well as had valid food frequency questionnaires from the fifth to ninth core exams.
Consumption of fruits with high flavonoid content or are important contributors to overall flavonoid intake was collected via food frequency questionnaire. Flavonoid-rich fruits from the food frequency questionnaire included raisins or grapes, prunes, bananas, fresh apples or pears, apple juice or cider, oranges, orange juice, grapefruit, grapefruit juice, strawberries, blueberries, and peaches, apricots, or plums. Dementia ascertainment was based on a multidisciplinary consensus committee, and included all-cause dementia and Alzheimer's disease dementia diagnoses based on research criteria. Cox models were used to examine associations between cumulative fruit intake and incident dementia, stratified by midlife (45-59 years; n = 1,642) and late-life (60-82 years; n = 1,148).
Greater cumulative total fruit intake in midlife, but not late-life, was significantly associated with a 44% decreased risk of all-cause dementia (HR = 0.56; 95% CI = 0.32 - 0.98; p = 0.044). Decreased risk of all-cause dementia was also associated with higher intake of apples or pears in midlife and late-life, as well as higher intake of raisins or grapes in midlife only, and higher intake of oranges, grapefruit, blueberries, and peaches, apricots, or plums in late-life only.
Among participants from the Framingham Heart Study, greater overall consumption of flavonoid-rich fruits in midlife was associated with reduced risk of dementia, though intake of specific fruits in midlife and late-life may have a protective role against developing dementia. These findings may help to inform future recommendations on when dietary interventions may be most beneficial to healthy brain aging across the life course.
水果是类黄酮的重要来源，老年人摄入更多的膳食类黄酮与痴呆风险降低有关。目前尚不清楚这种关系在年轻人和老年人之间是否相似或不同。
我们研究了中年人晚期摄入富含类黄酮的水果与痴呆症发病之间的关系。我们假设，中年人晚期摄入更多的富含类黄酮的水果与降低所有原因导致的痴呆症风险有关。
纵向、队列研究设计。
弗雷明汉心脏研究，这是一个基于美国马萨诸塞州弗雷明汉的纵向、多代社区为基础的队列。
包括弗雷明汉心脏研究后代队列的参与者（n=2790），他们参加了 1991 年至 1995 年的第五次核心检查，当时无痴呆症且年龄至少 45 岁，并且第五至第九次核心检查时具有有效的食物频率问卷。
通过食物频率问卷收集高类黄酮含量或对整体类黄酮摄入量有重要贡献的水果的摄入量。食物频率问卷中的富含类黄酮的水果包括葡萄干或葡萄、李子、香蕉、新鲜苹果或梨、苹果汁或苹果酒、橙子、橙汁、葡萄柚、葡萄柚汁、草莓、蓝莓和桃子、杏、李子或李子。痴呆症的确定是基于一个多学科共识委员会，包括基于研究标准的所有原因导致的痴呆症和阿尔茨海默病痴呆症的诊断。Cox 模型用于检查中年人（45-59 岁；n=1642）和老年人（60-82 岁；n=1148）的累积水果摄入量与新发痴呆症之间的关联。
中年人累积总水果摄入量与所有原因导致的痴呆症风险降低 44%显著相关（HR=0.56；95%CI=0.32-0.98；p=0.044）。在中年人晚期，摄入更多的苹果或梨以及更多的葡萄干或葡萄与所有原因导致的痴呆症风险降低有关，而在中年人晚期，摄入更多的橙子、葡萄柚、蓝莓和桃子、杏、李子或李子与所有原因导致的痴呆症风险降低有关。
在弗雷明汉心脏研究的参与者中，中年人总体上摄入更多的富含类黄酮的水果与痴呆症风险降低有关，尽管中年人晚期和老年人晚期摄入某些特定的水果可能具有预防痴呆症的作用。这些发现可能有助于为未来关于饮食干预何时对整个生命周期的健康大脑衰老最有益的建议提供信息。
