Association between dietary diversity and cognitive impairment among the oldest-old: Findings from a nationwide cohort study

Zheng, Jiazhen; Zhou, Rui; Li, Furong; Chen, Liren; Wu, Keyi; Huang, Jinghan; Liu, Hua‐Min; Huang, Zhiwei; Xu, Lin; Yuan, Zelin; Chen, Mao; Wu, Xianbo

doi:10.1016/j.clnu.2021.02.041

Cited by 48 publications

(37 citation statements)

References 59 publications

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“…In this light, there has been increased interest shown by investigators worldwide in dietary patterns [ 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 ], including the Healthful Plant-Based Diet Index (HPDI) [ 11 , 12 ], the Healthy Eating Index–2015 (HEI-2015) [ 13 ], the Alternate Healthy Eating Index-2010 (AHEI-2010) [ 14 ] and the Alternate Mediterranean Diet (AMED) [ 15 ], etc. Accumulated evidence supports an association between high-quality diet and cognitive impairment [ 14 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 ], and indicates that higher adherence to the high-quality diet to be associated with better cognition in older people [ 27 , 28 , 29 ].…”

Section: Introductionmentioning

confidence: 99%

Association between Dietary Diversity Changes and Cognitive Impairment among Older People: Findings from a Nationwide Cohort Study

et al. 2022

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Background: Little is known about the role of dietary diversity changes in affecting cognitive function among older people. Therefore, we aimed to evaluate the associations between dietary diversity scores (DDS) changes with cognitive impairment among older adults in a large prospective cohort. Methods: Cognitive function was assessed using the Mini-Mental State Examination questionnaire at baseline and follow-up. A total of 9726 participants without Parkinson’s disease, dementia, or cognitive impairment were enrolled at baseline. Nine food groups were collected using simplified FFQ at baseline and follow-up surveys. Then nine food groups change patterns and DDS change patterns (overall, plant-based and animal-based) were assessed. The associations of above DDS changes patterns with subsequent cognitive impairment were evaluated. A multivariable-adjusted Cox proportional hazards model was used to estimate HRs and 95%CIs. Results: We documented 2805 cognitive impairments during 52,325 person-years of follow-up. Compared to high-to-high overall DDS change patterns, the multivariable adjusted HRs (95%CI) for high-to-medium, medium-to-medium, medium-to-low, low-to-medium and low-to-low DDS change patterns were 1.33 (1.12–1.57), 1.11 (0.94–1.32), 1.61 (1.39–1.86), 2.00 (1.66–2.40), 2.30 (1.90–2.78) and 2.80 (2.23–3.53), respectively. Compared with participants with stable DDS change pattern, those who in large improvement of DDS had a 13% lower risk of cognitive impairment (HRs, 0.87; 95%CI: 0.78–0.98). The associations of plant-based DDS, animal-based DDS, or nine food groups DDS change patterns with cognitive impairment were in a similar direction to the main result. Conclusions: Protective associations between maintaining high DDS and a reduced risk of cognitive impairment were observed. In contrast, lowering or maintaining a lower DDS increases the risk of cognitive impairment.

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Section: Introductionmentioning

confidence: 99%

Association between Dietary Diversity Changes and Cognitive Impairment among Older People: Findings from a Nationwide Cohort Study

et al. 2022

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“…The analyses of DDS in relation to healthy aging components showed that a higher DDS was associated with better cognitive function and fewer physical functional limitations and psychological stress, which was consistent with results from the literature. Prospective studies have proven that an increase in DDS is associated with reduced risk of cognitive impairment in elderly Chinese and Japanese people [ 34 , 35 ], and previous studies have also indicted that having a higher dietary diversity is associated with better physical function in elderly Japanese people [ 36 ]. We assumed that several pathways might contribute to the association between DDS and healthy aging.…”

Section: Discussionmentioning

confidence: 99%

Dietary Diversity and Healthy Aging: A Prospective Study

Zhang

Zhao

2021

Nutrients

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Population aging is a global phenomenon. The present study determined the effects of dietary diversity score (DDS) and food consumption on healthy aging. A subset of the data of the China Health and Nutrition Survey was utilized in this study. DDSs were calculated using the dietary data collected in the years 2009 and 2011. A healthy aging score (HAS) was calculated by summing the standardized scores on physical functional limitation, comorbidity, cognitive function, and psychological stress based on the data collected in the year 2015, with a lower HAS indicating a healthier aging process. Life quality was self-reported in the year 2015. This study found that DDS was inversely associated with HAS (T3 vs. T1: β −0.16, 95%CI −0.20 to −0.11, p-trend <0.001). The consumption of meat and poultry, aquatic products, and fruits was inversely associated with HAS, and participants in the highest tertile of staple foods consumption had a higher HAS than those in the lowest tertile. HAS was inversely associated with good self-reported life quality and positively associated with bad life quality. In conclusion, food consumption may influence the aging process, and adherence to a diverse diet is associated with a healthier aging process in elderly people.

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Section: Introductionmentioning

confidence: 99%

“…Cognitive impairment is an age-related deterioration in cognitive functions with increasing difficulties with language and memory [ 1 , 2 ]. With the rapid aging of the population, cognitive impairment is anticipated to be a serious public health issue worldwide [ 2 , 3 , 4 ]. Diet and other lifestyle behaviors, such as smoking, have been proven to be associated with cognitive health among older adults in previous studies [ 5 , 6 ].…”

Section: Introductionmentioning

confidence: 99%

The Effects of “Diet–Smoking–Gender” Three-Way Interactions on Cognitive Impairment among Chinese Older Adults

et al. 2022

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Investigations on gender variations in the risk factors of cognitive impairment are required to promote future precision medicine among older adults, as well as to contribute to a better understanding of the “male–female health-survival paradox”. With this study, we aimed to investigate the effects of “diet–smoking–gender” three-way interactions on cognitive impairments among Chinese older adults. We conducted a 16-year prospective cohort study among 15,953, 15,555, 16,849, 9716, 7116, and 13,165 older adults from the 2002, 2005, 2008–2009, 2011–2012, 2014, and 2017–2018 waves of the Chinese Longitudinal Healthy Longevity Survey (CLHLS), respectively. Cognitive impairment was measured by the Mini-Mental State Examination (MMSE). The dietary diversity score (DDS) was calculated using the CLHLS food frequency questionnaire. Generalized estimating equations (GEE) were used to assess the “diet–smoking–gender” three-way interaction effects on cognitive impairment across the six waves of CLHLS. We found that higher dietary diversity was associated with lower probability of cognitive impairment among older adults (OR = 0.92; 95%CI = 0.90, 0.98). However, smoking behavior may negatively influence the protective effect of higher dietary diversity on cognitive function among females (OR = 1.26; 95%CI = 1.07, 1.49). Our findings imply that we should take gender differences and lifestyle behaviors into consideration in implementing dietary interventions to improve cognitive function among older adults.

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Association between dietary diversity and cognitive impairment among the oldest-old: Findings from a nationwide cohort study

Cited by 48 publications

References 59 publications

Association between Dietary Diversity Changes and Cognitive Impairment among Older People: Findings from a Nationwide Cohort Study

Association between Dietary Diversity Changes and Cognitive Impairment among Older People: Findings from a Nationwide Cohort Study

Dietary Diversity and Healthy Aging: A Prospective Study

The Effects of “Diet–Smoking–Gender” Three-Way Interactions on Cognitive Impairment among Chinese Older Adults

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