Chatzispyrellis Stelios, Fragopoulou Elizabeth, Mamalaki Eirini, Ntanasi Eva, Maraki Maria I, Charisis Sokratis, Mourtzinos Ioannis, Kosmidis Mary H, Dardiotis Efthimios, Hadjigeorgiou Georgios M, Sakka Paraskevi, Gu Yian, Scarmeas Nikolaos, Yannakoulia Mary
Department of Nutrition and Dietetics, Harokopio University, Athens, Greece.
Department of Nutrition and Dietetics, Harokopio University, Athens, Greece; 1st Department of Neurology, Aiginition Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece.
J Nutr. 2025 Jul;155(7):2089-2099. doi: 10.1016/j.tjnut.2025.05.047. Epub 2025 May 31.
Polyphenols have been associated with brain health, but their impact on humans, especially in combinations, has been less explored.
This study aimed to investigate the association between dietary polyphenol patterns (PPs), dementia incidence, and cognitive changes over time in the elderly.
A total of 1041 individuals without dementia (mean age 73.1, standard deviation [SD] = 4.9) were followed longitudinally. Participants provided baseline dietary data via a validated food frequency questionnaire. Dementia was diagnosed through clinical and neuropsychological evaluations, and cognitive performance was assessed using a neuropsychological battery. Principal component analysis of 11 polyphenol classes identified 3 distinct PPs. Generalized Estimating Equations assessed cognitive decline rates, whereas Cox regression models evaluated dementia risk, adjusting for covariates such as age, sex, education, energy intake, physical activity, smoking, alcohol consumption, hypertension, diabetes mellitus, stroke history, coronary disease, and baseline mild cognitive impairment.
Over the follow-up period of 3.0 y (SD = 0.8), 62 participants developed dementia. The PPs explained up to 77.4% of the variance. The third polyphenol pattern (PP3), characterized by lignans, flavonols, and isoflavonoids, predominantly provided by cruciferous vegetables, pulses, and leafy vegetables, was associated with a slower rate of cognitive decline. A 1-unit increase in PP3 intake was associated with 0.9% of a SD less decline per year in the global cognitive score (β = 0.009; 95% confidence interval [CI]: 0.000, 0.017, P = 0.041). For incident dementia, participants in the third quartile of PP3 had a 71% lower risk than those in the first quartile (hazard ratio [HR]: 0.29; 95% CI: 0.12, 0.67, P-trend = 0.018). No significant associations were observed for the other PPs.
A PP high in lignans, flavonols, and isoflavonoids was associated with a reduced risk of dementia and cognitive decline in elderly Greeks. These findings offered encouraging evidence for combined polyphenol intake, suggesting further validation in different population samples.
多酚与大脑健康有关，但其对人类的影响，尤其是组合形式的影响，尚未得到充分研究。
本研究旨在调查老年人饮食多酚模式（PPs）、痴呆发病率和认知随时间变化之间的关联。
对1041名无痴呆的个体（平均年龄73.1岁，标准差[SD]=4.9）进行纵向随访。参与者通过经过验证的食物频率问卷提供基线饮食数据。通过临床和神经心理学评估诊断痴呆，并使用神经心理学测试组合评估认知表现。对11种多酚类别进行主成分分析，确定了3种不同的PPs。广义估计方程评估认知衰退率，而Cox回归模型评估痴呆风险，并对年龄、性别、教育程度、能量摄入、身体活动、吸烟、饮酒、高血压、糖尿病、中风病史、冠心病和基线轻度认知障碍等协变量进行调整。
在3.0年（SD=0.8）的随访期内，62名参与者患上了痴呆。PPs解释了高达77.4%的方差。第三种多酚模式（PP3）以木脂素、黄酮醇和异黄酮为特征，主要由十字花科蔬菜、豆类和叶菜类提供，与认知衰退速度较慢有关。PP3摄入量每增加1个单位，全球认知得分每年下降的标准差减少0.9%（β=0.009；95%置信区间[CI]：0.000，0.017，P=0.041）。对于新发痴呆，PP3第三四分位数的参与者比第一四分位数者的风险低71%（风险比[HR]：0.29；95%CI：0.12，0.67，P趋势=0.018）。其他PPs未观察到显著关联。
木脂素、黄酮醇和异黄酮含量高的PP与希腊老年人痴呆风险降低和认知衰退有关。这些发现为多酚组合摄入提供了令人鼓舞的证据，建议在不同人群样本中进一步验证。
