地中海饮食在降低认知障碍、痴呆和阿尔茨海默病风险中的作用:一项荟萃分析。

The role of the Mediterranean diet in reducing the risk of cognitive impairement, dementia, and Alzheimer's disease: a meta-analysis.

作者信息

Fekete Mónika, Varga Péter, Ungvari Zoltan, Fekete János Tibor, Buda Annamaria, Szappanos Ágnes, Lehoczki Andrea, Mózes Noémi, Grosso Giuseppe, Godos Justyna, Menyhart Otilia, Munkácsy Gyöngyi, Tarantini Stefano, Yabluchanskiy Andriy, Ungvari Anna, Győrffy Balázs

机构信息

Institute of Preventive Medicine and Public Health, Semmelweis University, Budapest, Hungary.

Doctoral College, Health Sciences Program, Semmelweis University, Budapest, Hungary.

出版信息

Geroscience. 2025 Jan 11. doi: 10.1007/s11357-024-01488-3.

Abstract

Age-related cognitive impairment and dementia pose a significant global health, social, and economic challenge. While Alzheimer's disease (AD) has historically been viewed as the leading cause of dementia, recent evidence reveals the considerable impact of vascular cognitive impairment and dementia (VCID), which now accounts for nearly half of all dementia cases. The Mediterranean diet-characterized by high consumption of fruits, vegetables, whole grains, fish, and olive oil-has been widely recognized for its cardiovascular benefits and may also reduce the risk of cognitive decline and dementia. To investigate the protective effects of the Mediterranean diet on cognitive health, we conducted a systematic literature review using PubMed, Web of Science, and Google Scholar, focusing on studies published between 2000 and 2024. The studies included in the meta-nalysis examined the adherence to the Mediterranean diet and the incidence of dementia and AD. We applied a random-effects model to calculate pooled hazard ratios (HRs) with 95% confidence intervals (CIs) and assessed heterogeneity through I-square statistics. Forest plots, funnel plots, and Z-score plots were used to visualize study outcomes. Of the 324 full-text records reviewed, 23 studies met the inclusion criteria. The combined HR for cognitive impairment among those adhering to the Mediterranean diet was 0.82 (95% CI 0.75-0.89); for dementia, the HR was 0.89 (95% CI 0.83-0.95); and for AD, the HR was 0.70 (95% CI 0.60-0.82), indicating substantial protective effects. Significant heterogeneity was observed across studies, though Z-score plots suggested sufficient sample sizes to support reliable conclusions for each condition. In conclusion, this meta-analysis confirms that adherence to the Mediterranean diet is associated with an 11-30% reduction in the risk of age-related cognitive disorders, including cognitive impairment, dementia, and AD. These findings underscore the Mediterranean diet's potential as a central element in neuroprotective public health strategies to mitigate the global impact of cognitive decline and dementia and to promote healthier cognitive aging.

摘要

与年龄相关的认知障碍和痴呆症给全球健康、社会和经济带来了重大挑战。虽然阿尔茨海默病(AD)在历史上一直被视为痴呆症的主要病因,但最近的证据显示了血管性认知障碍和痴呆症(VCID)的重大影响,目前其占所有痴呆症病例的近一半。以大量食用水果、蔬菜、全谷物、鱼类和橄榄油为特征的地中海饮食,因其对心血管的益处而被广泛认可,并且可能还会降低认知能力下降和患痴呆症的风险。为了研究地中海饮食对认知健康的保护作用,我们使用PubMed、科学网和谷歌学术进行了一项系统的文献综述,重点关注2000年至2024年发表的研究。纳入荟萃分析的研究考察了对地中海饮食的依从性以及痴呆症和AD的发病率。我们应用随机效应模型来计算合并风险比(HRs)及其95%置信区间(CIs),并通过I²统计量评估异质性。森林图、漏斗图和Z分数图用于直观展示研究结果。在审查的324篇全文记录中,有23项研究符合纳入标准。坚持地中海饮食者发生认知障碍的合并HR为0.82(95%CI 0.75 - 0.89);患痴呆症的HR为0.89(95%CI 0.83 - 0.95);患AD的HR为0.70(95%CI 0.60 - 0.82),表明有显著的保护作用。尽管Z分数图表明样本量足以支持对每种情况得出可靠结论,但各研究之间仍观察到显著的异质性。总之,这项荟萃分析证实,坚持地中海饮食与年龄相关认知障碍(包括认知损害、痴呆症和AD)风险降低11%至30%相关。这些发现强调了地中海饮食作为神经保护公共卫生策略的核心要素的潜力,以减轻认知能力下降和痴呆症的全球影响,并促进更健康的认知衰老。

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