Background: Evidence of an association between fish and meat
consumption and risk of dementia is inconsistent and nonexistent in populations
in developing countries.Objective: The objective was to investigate associations between
fish and meat consumption with dementia in low- and middle-income countries.Design: One-phase cross-sectional surveys were conducted in all
residents aged ≥65 y in 11 catchment areas in China, India, Cuba, the
Dominican Republic, Venezuela, Mexico, and Peru. A total of 14,960 residents
were assessed by using the 10/66 standardized protocol, which includes
face-to-face interviews for dietary habits and a cross-culturally validated
dementia diagnosis.Results: Dietary intakes and the prevalence of dementia varied
between sites. We combined site-specific Poisson regression prevalence ratios
(PRs) for the association between fish and meat consumption and dementia in 2
fixed-effect model meta-analyses adjusted for sociodemographic and health
characteristics and fish and meat consumption as appropriate. We found a
dose-dependent inverse association between fish consumption and dementia (PR:
0.81; 95% CI: 0.72, 0.91) that was consistent across all sites except India and
a less-consistent, dose-dependent, direct association between meat consumption
and prevalence of dementia (PR: 1.19; 95% CI: 1.07, 1.31).Conclusions: Our results extend findings on the associations of fish
and meat consumption with dementia risk to populations in low- and middle-income
countries and are consistent with mechanistic data on the neuroprotective
actions of omega-3 (n–3) long-chain polyunsaturated fatty acids
commonly found in fish. The inverse association between fish and prevalent
dementia is unlikely to result from poorer dietary habits among demented
individuals (reverse causality) because meat consumption was higher in those
with a diagnosis of dementia.