Zhang Yu, Liu Yuxi, Li Yanping, Li Yuhan, Gu Xiao, Kang Jae H, Eliassen A Heather, Wang Molin, Rimm Eric B, Willett Walter C, Hu Frank B, Stampfer Meir J, Wang Dong D
Department of Nutrition, T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts.
Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Harvard University, Boston, Massachusetts.
JAMA. 2026 Feb 9. doi: 10.1001/jama.2025.27259.
Evidence linking coffee and tea to cognitive health remains inconclusive, and most studies fail to differentiate caffeinated from decaffeinated coffee.
To investigate associations of coffee and tea intake with dementia risk and cognitive function.
DESIGN, SETTING, AND PARTICIPANTS: Prospective cohort study that included female participants from the Nurses' Health Study (NHS; n = 86 606 with data from 1980-2023) and male participants from the Health Professionals Follow-up Study (HPFS; n = 45 215 with data from 1986-2023) who did not have cancer, Parkinson disease, or dementia at study entry (baseline) in the US.
The primary exposures were intakes of caffeinated coffee, decaffeinated coffee, and tea. Dietary intake was collected every 2 to 4 years using validated food frequency questionnaires.
The primary outcome was dementia, which was identified via death records and physician diagnoses. The secondary outcomes included subjective cognitive decline assessed by a questionnaire-based score (range, 0-7; higher scores indicate greater perceived decline; cases defined as those with a score ≥3) and objective cognitive function assessed only in the NHS cohort using telephone-based neuropsychological tests such as the Telephone Interview for Cognitive Status (TICS) score (range, 0-41) and a measure of global cognition (a standardized mean z score for all 6 administered cognitive tests).
Among 131 821 participants (mean age at baseline, 46.2 [SD, 7.2] years in the NHS cohort and 53.8 [SD, 9.7] years in the HPFS cohort; 65.7% were female) during up to 43 years of follow-up (median, 36.8 years; IQR, 28-42 years), there were 11 033 cases of incident dementia. After adjusting for potential confounders and pooling results across cohorts, higher caffeinated coffee intake was significantly associated with lower dementia risk (141 vs 330 cases per 100 000 person-years comparing the fourth [highest] quartile of consumption with the first [lowest] quartile; hazard ratio, 0.82 [95% CI, 0.76 to 0.89]) and lower prevalence of subjective cognitive decline (7.8% vs 9.5%, respectively; prevalence ratio, 0.85 [95% CI, 0.78 to 0.93]). In the NHS cohort, higher caffeinated coffee intake was also associated with better objective cognitive performance. Compared with participants in the lowest quartile, those in the highest quartile had a higher mean TICS score (mean difference, 0.11 [95% CI, 0.01 to 0.21]) and a higher mean global cognition score (mean difference, 0.02 [95% CI, -0.01 to 0.04]); however, the association with global cognition was not statistically significant (P = .06). Higher intake of tea showed similar associations with these cognitive outcomes, whereas decaffeinated coffee intake was not associated with lower dementia risk or better cognitive performance. A dose-response analysis showed nonlinear inverse associations of caffeinated coffee and tea intake levels with dementia risk and subjective cognitive decline. The most pronounced associated differences were observed with intake of approximately 2 to 3 cups per day of caffeinated coffee or 1 to 2 cups per day of tea.
Greater consumption of caffeinated coffee and tea was associated with lower risk of dementia and modestly better cognitive function, with the most pronounced association at moderate intake levels.
将咖啡和茶与认知健康联系起来的证据尚无定论，并且大多数研究未能区分含咖啡因咖啡和脱咖啡因咖啡。
研究咖啡和茶的摄入量与痴呆风险及认知功能之间的关联。
设计、背景和参与者：前瞻性队列研究，纳入了美国护士健康研究（NHS；n = 86606，有1980 - 2023年的数据）中的女性参与者以及健康专业人员随访研究（HPFS；n = 45215，有1986 - 2023年的数据）中的男性参与者，这些参与者在研究入组（基线）时没有癌症、帕金森病或痴呆。
主要暴露因素为含咖啡因咖啡、脱咖啡因咖啡和茶的摄入量。使用经过验证的食物频率问卷每2至4年收集一次饮食摄入量。
主要结局是痴呆，通过死亡记录和医生诊断来确定。次要结局包括通过基于问卷的评分评估的主观认知下降（范围为0 - 7；分数越高表明感知到的下降越大；病例定义为得分≥3的人）以及仅在NHS队列中使用基于电话的神经心理学测试评估的客观认知功能，如认知状态电话访谈（TICS）评分（范围为0 - 41）和一项整体认知测量指标（所有6项实施的认知测试的标准化平均z分数）。
在131821名参与者中（NHS队列基线时的平均年龄为46.2[标准差，7.2]岁，HPFS队列基线时的平均年龄为53.8[标准差，9.7]岁；65.7%为女性），在长达43年的随访期间（中位数为36.8年；四分位间距为28 - 42年），有11033例新发痴呆病例。在调整潜在混杂因素并汇总各队列结果后，较高的含咖啡因咖啡摄入量与较低的痴呆风险显著相关（每10万人年中，消费第四[最高]四分位数与第一[最低]四分位数相比，分别为141例和330例；风险比为0.82[95%置信区间，0.76至0.89]）以及较低的主观认知下降患病率（分别为7.8%和9.5%；患病率比为0.85[95%置信区间，0.78至0.93]）。在NHS队列中，较高的含咖啡因咖啡摄入量还与更好的客观认知表现相关。与最低四分位数的参与者相比，最高四分位数的参与者有更高的平均TICS评分（平均差异为0.11[95%置信区间，0.01至0.21]）和更高的平均整体认知评分（平均差异为0.02[95%置信区间， - 0.01至0.04]）；然而，与整体认知的关联无统计学意义（P = 0.06）。较高的茶摄入量与这些认知结局显示出相似的关联，而脱咖啡因咖啡摄入量与较低的痴呆风险或更好的认知表现无关。剂量反应分析显示含咖啡因咖啡和茶的摄入量水平与痴呆风险及主观认知下降呈非线性负相关。在每天摄入约2至3杯含咖啡因咖啡或1至2杯茶时观察到最明显的关联差异。
更多地饮用含咖啡因咖啡和茶与较低的痴呆风险及适度更好的认知功能相关，在适度摄入量水平时关联最为明显。
