Dietary Patterns Are Related to Clinical Characteristics in Memory Clinic Patients with Subjective Cognitive Decline: The SCIENCe Project

Abstract

As nutrition is one of the modifiable risk factors for cognitive decline, we studied the relationship between dietary quality and clinical characteristics in cognitively normal individuals with subjective cognitive decline (SCD). We included 165 SCD subjects (age: 64 ± 8 years; 45% female) from the SCIENCe project, a prospective memory clinic based cohort study on SCD. The Dutch Healthy Diet Food Frequency Questionnaire (DHD-FFQ) was used to assess adherence to Dutch guidelines on vegetable, fruit, fibers, fish, saturated fat, trans fatty acids, salt and alcohol intake (item score 0–10, higher score indicating better adherence). We measured global cognition (Mini Mental State Examination), cognitive complaints (Cognitive Change Index self-report; CCI) and depressive symptoms (Center for Epidemiologic Studies Depression Scale; CES-D). Using principal component analysis, we identified dietary components and investigated their relation to clinical characteristics using linear regression models adjusted for age, sex and education. We identified three dietary patterns: (i) “low-Fat-low-Salt”, (ii) “high-Veggy”, and (iii) “low-Alcohol-low-Fish”. Individuals with lower adherence on “low-Fat-low-Salt” had more depressive symptoms (β −0.18 (−2.27–−0.16)). Higher adherence to “high-Veggy” was associated with higher MMSE scores (β 0.30 (0.21–0.64)). No associations were found with the low-Alcohol-low-Fish component. We showed that in SCD subjects, dietary quality was related to clinically relevant outcomes. These findings could be useful to identify individuals that might benefit most from nutritional prevention strategies to optimize brain health.

Nutritional Status Is Associated With Clinical Progression in Alzheimer's Disease: The NUDAD Project

“…10e14, 42 In patients with SCD, a lower vegetable intake was associated with higher risk of clinical progression, which is complementary to our previous finding that patients with SCD reporting the lowest vegetable intake had the most cognitive complaints. 43 Previous multidomain lifestyle interventions including dietary advice showed beneficial effects on cognition in individuals at risk of cognitive decline. 44,45 Our study provides further evidence that a healthy dietary pattern is related to a slower rate of clinical progression across the complete AD spectrum, and this could be further evaluated in dietary intervention studies.…”

Dietary patterns are related to cognitive functioning in elderly enriched with individuals at increased risk for Alzheimer’s disease

“…These samples are expected to include more subjects with AD pathology, which could be counteracted by certain nutrients or diets, to be leveraged for secondary prevention. A recent study in memory-clinic patients with subjective cognitive decline (SCD), a group known to be at increased risk for AD [28], found a positive association between the 'high-Veggy' dietary pattern, characterized by fruit, vegetables, fish, and fibers, with global cognition using a data-driven approach [30].…”

A Suboptimal Diet Is Associated with Poorer Cognition: The NUDAD Project

“…This contrasts with the limited literature on this topic in clinical populations, where associations are more prominent in predementia stages. Adherence to the Mediterranean diet has been associated with global cognition in healthy controls, but not in MCI or AD dementia patients [14], and in a previous study, we found an association between vegetable intake and global cognition in cognitively healthy elderly [7]. While we did not specifically study the Mediterranean diet, the Dutch dietary guidelines are in line with the Mediterranean diet for the components vegetables, fruit, fibers, fish, salt, and trans fat.…”

“…Nutrition is one of the modifiable risk factors for cognitive decline and AD dementia [2], and is therefore highly relevant in the context of prevention. In cognitively normal populations, food groups including vegetables, fruit, or fish [3][4][5][6][7][8], and healthy dietary patterns such as the Mediterranean diet, dietary approaches to stop hypertension (DASH), or Mediterranean-DASH intervention for neurodegenerative delay (MIND) [9][10][11][12][13], have all been associated with less cognitive decline or reduced risk for mild cognitive impairment (MCI) or AD dementia. However, knowledge of dietary quality in clinical populations on the spectrum of AD dementia is lacking, while these patients may form a target group for interventions to prevent further cognitive decline.…”