Association between dietary oxidative balance score and cognitive function among older adults: A sex- and sex hormone-stratified analysis from the National Health and Nutrition Examination Surveys 2013-2014.

BACKGROUND

Cognitive decline is associated with oxidative stress, which varies between males and females. Nevertheless, the sex- and sex hormone-stratified relevance of dietary oxidative balance score (DOBS) with cognitive function in older adults is unclear.

METHODS

We analyzed 1094 participants aged 60 and older from the National Health and Nutrition Examination Surveys 2013-2014, assessed cognitive performance by animal fluency test (AFT), digit symbol substitution test (DSST), immediate recall tests (IRT) and delayed recall test (DRT), and created a total Z-score for impairment. DOBS was calculated from 16 dietary components, and relationships with cognitive function were explored using weighted generalized linear models, restricted cubic splines, and Quantile g-computation models, stratified by sex and sex hormones.

RESULTS

We found high DOBS is negatively associated with low cognitive performance in AFT (OR: 0.473, 95 % CI: 0.233-0.963), more pronounced in males (OR: 0.402, 95 % CI: 0.166-0.971). Similarly, we found high DOBS is negatively associated with low cognitive performance in DSST (OR: 0.429, 95 % CI: 0.253-0.728) and global cognition (OR: 0.451, 95 % CI: 0.208-0.977). In males, the DOBS-cognition association is largely across testosterone, estradiol, and sex hormone-binding globulin SHBG normal levels, while significant in females only for the SHBG normal group in DSST (OR: 0.277, 95 % CI: 0.101-0.760). Magnesium had the highest positive weight in the DOBS-cognition association for DRT and DSST, and the DOBS-cognition association was non-linear (P < 0.01).

CONCLUSIONS

We showed DOBS negatively and nonlinearly correlated with cognitive decline in older adults, particularly in males, providing a preventive basis for cognitive well-being.