Carrasco-Marín Fernanda, Parra-Soto Solange, Guerrero-Wyss Marion, Araya-Bastias Carolina, Boonpor Jirapitcha, Villagrán-Cerro Carla, Petermann-Rocha Fanny, Shannon Oliver M, Mathers John C, Livingstone Katherine M, Dingle Sara, Gálvez-Tejeda Sofía, Hernández-Peregrina Ana, Pranay Nishka, Molina-Recio Guillermo, Pell Jill, Ho Frederick, Celis-Morales Carlos, Molina-Luque Rafael
School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, UK.
Departamento de Enfermería, Farmacología y Fisioterapia, Facultad de Medicina y Enfermería, Universidad de Córdoba, Córdoba, Spain.
Diabetes Obes Metab. 2025 Oct;27(10):5612-5621. doi: 10.1111/dom.16609. Epub 2025 Jul 16.
Despite several modifiable risk factors for dementia being identified, diet is often excluded from consideration due to insufficient evidence. Although various healthy dietary indices have been associated with improved health outcomes, their link to dementia risk remains unclear. This study investigates the association between four dietary indices and dementia risk among UK Biobank participants.
This study utilized data from the UK Biobank cohort. Dietary intake was self-reported using repeated 24-h recalls (up to five occasions), averaged for analysis. Adherence to a healthy diet was assessed using four dietary indices: the Recommended Food Score (RFS), Healthy Diet Indicator (HDI), Mediterranean Diet Score (MDS) and the Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND) score. The primary outcome was incident all-cause dementia, Alzheimer disease, vascular dementia, and non-vascular dementia extracted from hospital and primary care records using ICD-10 codes. Censored Cox proportional hazards models were used to estimate the risk of developing dementia and reported as hazard ratios (HRs) with their 95% confidence interval (CI). Analyses were adjusted for age, sex, education and various lifestyle and health-related factors.
The analysis included 121 521 participants (mean age: 55.7 years; 53.5% women), followed for a median of 10.9 years. During follow-up, 621 participants developed dementia. Compared with individuals with the lowest dietary adherence (Quartile 1), those in the highest adherence group (Quartile 4) showed a lower risk of all-cause dementia for MDS (HR: 0.53; 95% CI: 0.45-0.63), MIND (HR: 0.61; 95% CI: 0.48-0.78), and RFS (HR: 0.66; 95% CI: 0.53-0.85). Similar associations were observed for Alzheimer disease and MDS (HR: 0.55; 95% CI: 0.46-0.67), RFS (HR: 0.61; 95% CI: 0.47-0.80), and MIND (HR: 0.66; 95% CI: 0.51-0.87). For vascular dementia, only MDS (HR: 0.46; 95% CI: 0.31-0.68) and MIND (HR: 0.68; 95% CI: 0.40-0.97) showed a lower risk. These associations remained in a 5-year landmark analysis. No associations were observed for HDI with any dementia outcome. Our findings indicate that higher adherence to specific dietary patterns, particularly the Mediterranean, RFS and MIND diet, is associated with a lower risk of dementia.
The Mediterranean Diet demonstrated the strongest association. These results highlight the potential of healthy dietary patterns to improve brain health in older adults.
尽管已确定了几种可改变的痴呆风险因素，但由于证据不足，饮食因素常被排除在考虑范围之外。虽然各种健康饮食指数与改善健康结果相关，但其与痴呆风险的联系仍不明确。本研究调查了英国生物银行参与者中四种饮食指数与痴呆风险之间的关联。
本研究使用了英国生物银行队列的数据。饮食摄入量通过重复的24小时回忆法（最多五次）进行自我报告，并取平均值用于分析。使用四种饮食指数评估对健康饮食的依从性：推荐食物评分（RFS）、健康饮食指标（HDI）、地中海饮食评分（MDS）和地中海-得舒饮食干预预防神经退行性延迟（MIND）评分。主要结局是使用国际疾病分类第10版（ICD-10）编码从医院和初级保健记录中提取的全因痴呆、阿尔茨海默病、血管性痴呆和非血管性痴呆。采用截尾Cox比例风险模型估计患痴呆的风险，并报告为风险比（HR）及其95%置信区间（CI）。分析对年龄、性别、教育程度以及各种生活方式和健康相关因素进行了调整。
分析纳入了121521名参与者（平均年龄：55.7岁；53.5%为女性），中位随访时间为10.9年。随访期间，621名参与者患上痴呆。与饮食依从性最低的个体（第一四分位数）相比，依从性最高组（第四四分位数）的个体在MDS（HR：0.53；95%CI：0.45-0.63）、MIND（HR：0.61；95%CI：0.48-0.78）和RFS（HR：0.66；95%CI：0.53-0.85）方面全因痴呆风险较低。在阿尔茨海默病与MDS（HR：0.55；95%CI：0.46-0.67）、RFS（HR：0.61；95%CI：0.47-0.80）和MIND（HR：0.66；95%CI：0.51-0.87）之间也观察到类似关联。对于血管性痴呆，只有MDS（HR：0.46；95%CI：0.31-0.68）和MIND（HR：0.68；95%CI：0.40-0.97）显示出较低风险。这些关联在5年的标志性分析中仍然存在。未观察到HDI与任何痴呆结局之间的关联。我们的研究结果表明，更高程度地坚持特定饮食模式，特别是地中海饮食模式、RFS和MIND饮食，与较低的痴呆风险相关。
地中海饮食表现出最强的关联。这些结果凸显了健康饮食模式对改善老年人脑健康的潜力。
