Cognitive Decline Related to Diet Pattern and Nutritional Adequacy in Alzheimer’s Disease Using Surface-Based Morphometry

Abstract

Dietary pattern (DP) results in nutrition adequacy and may influence cognitive decline and cortical atrophy in Alzheimer’s disease (AD). The study explored DP in 248 patients with AD. Two neurobehavioral assessments (intervals 13.4 months) and two cortical thickness measurements derived from magnetic resonance images (intervals 26.5 months) were collected as outcome measures. Reduced rank regression was used to assess the groups of DPs and a linear mixed-effect model to explore the cortical neurodegenerative patterns. At screening, underweight body mass index (BMI) was related to significant higher lipid profile, impaired cognitive function, smaller cortical thickness, lower protein DP factor loading scores and the non-spouse caregiver status. Higher mini-mental state examination (MMSE) scores were related to the DP of coffee/tea, compared to the lipid/sugar or protein DP group. The underweighted-BMI group had faster cortical thickness atrophy in the pregenual and lateral temporal cortex, while the correlations between cortical thickness degeneration and high HbA1C or low B12 and folate levels were localized in the medial and lateral prefrontal cortex. The predictive model suggested that factors related to MMSE score were related to the caregiver status. In conclusion, normal or overweight BMI, coffee/tea DP group and living with a spouse were considered as protective factors for better cognitive outcomes in patients with AD. The influence of glucose, B12 and folate on the cortical degeneration was spatially distinct from the pattern of AD degeneration.

Diet Pattern Analysis in Alzheimer’s Disease Implicates Gender Differences in Folate–B12–Homocysteine Axis on Cognitive Outcomes

“…It is noteworthy that coffee/tea consumption emerged as a common influencing factor in the dietary patterns of both genders. The intake of coffee/tea proved beneficial for cognition, directly impacting cognitive outcomes, consistent with other reports [ 20 , 29 , 30 ]. We believe that caffeine intake from coffee and tea affects MMSE cognitive performance, although there are conflicting findings in the literature [ 31 , 32 , 33 ].…”

“…The food frequency questionnaire (FFQ) contains 22 food groups, and it was conducted by trained interviewers to assess dietary intake in the AD patients. To avoid possible recall bias, the FFQ was recorded by the major caregiver of the patients [20]. The frequency of intake was coded as follows: (1) Never eat or eat less than once a month, (2) Eat 1-3 times a month, (3) Eat 1-2 times a week, (4) Eat 3-4 times a week, (5) Eat 5-6 times a week, (6) Eat 1-2 times a day, (7) Eat more than 3 times a day.…”

A seed and soil model of gut dysbiosis in Alzheimer’s disease

“…Specific foods and dietary habits can affect the structure and abundance of different strains of microbiota in the intestine, which is implicated in the maintenance of human homeostasis, more generally. As an example, a recent study has reported that AD patients with better global cognition had more ingestion of coffee or tea [ 8 ]. Furthermore, the Mediterranean diet pattern and high intake of plant-based foods, especially those rich in polyphenols might delay an AD diagnosis and increase the levels of fecal short chain fatty acids and bile acids [ 7 ].…”