Mediterranean Lifestyle in Relation to Cognitive Health: Results from the HELIAD Study

Abstract

Many lifestyle factors have been linked to cognitive function but little is known about their combined effect. An overall lifestyle pattern for people living in the Mediterranean basin has been proposed, including diet, but also physical activity, sleep and daily living activities with social/intellectual aspects. We aimed to examine the associations between a combination of these lifestyle factors and detailed cognitive performance. A total of 1716 participants from the Hellenic Longitudinal Investigation of Ageing and Diet (HELIAD), a population-based study of participants ≥65 years, were included in this analysis. Lifestyle factors were evaluated using standard, validated questionnaires and a Total Lifestyle Index (TLI) was constructed. Cognitive outcomes included mild cognitive impairment (MCI) diagnosis, a composite z-score (either continuous or with a threshold at the 25th percentile) and z-scores for five cognitive domains. A higher TLI was associated with 65% reduced odds for MCI in the non-demented individuals and 43% reduced odds for low global cognition when MCI participants were excluded, a risk reduction equivalent to 9 and 2.7 fewer years of ageing, respectively. Each lifestyle factor was differentially associated with domain-specific cognitive performance. Our results suggest that a TLI, more so than single lifestyle parameters, may be related to cognitive performance.

Sex differences in the relationship between dietary pattern adherence and cognitive function among older adults: findings from the NuAge study

“…Thus, it is important to consider additional lifestyle behaviours that may be impacting the results. Indeed, the influence of multiple unhealthy lifestyle behaviours in addition to poor dietary intake, such as smoking, lack of physical activity, and medical comorbidities other than diabetes and hypertension, often cluster and may interact with one another to exert effects on cognitive functioning in late life [45,46]. As such, future research should consider additional lifestyle behaviours when assessing the sexdependent relationship between dietary pattern intake and cognitive function in later life.…”

Diet and Inflammation in Cognitive Ageing and Alzheimer’s Disease

“…Observational studies that have evaluated the MD for cognitive health are summarised in Table 1 . In summary, greater concordance to the MD has been associated with better cognitive performance [ 53 , 54 , 57 , 58 , 65 ], slower rate of cognitive decline [ 61 , 66 – 68 ] and reduced risk of cognitive impairment [ 53 , 55 , 56 , 61 ] and AD [ 36 ]. However, the variable and sometimes disparate study findings [ 27 , 59 , 60 , 62 – 64 ] are likely due to differences between studies in the populations investigated and methods used to assess diet and cognition.…”

“… Higher MD adherence was associated with a slower rate of cognitive decline. Mediterranean lifestyle in relation to cognitive health: results from the HELIAD study [ 68 ] N = 1716 ≥ 65 years Greece MD Diagnosis of Mild Cognitive Impairment (MCI), a composite Z-score for global cognitive functioning and Z-scores for 5 domains: memory, language, attention-speed of information processing, and executive and visual-spatial functioning Greater MD adherence was associated with better cognitive performances in the domains of memory, visual- spatial functioning and language and composite cognitive Z –score. Mediterranean diet and preserved brain structural connectivity in older subjects [ 46 ] N = 146 ~ 73 years France MD 3-T magnetic resonance imaging measuring Brain Grey matter and White matter volumes as well as a battery of neuropsychological tests Greater MD adherence was significantly associated with preserved white matter microstructure in extensive brain areas.…”

Sex differences in the relationship between dietary pattern adherence and cognitive function among older adults: Findings from the NuAge study

“…Thus, it is important to consider additional lifestyle behaviours that may be confounding the results. Indeed, the in uence of multiple unhealthy lifestyle behaviours in addition to poor dietary intake, such as smoking, lack of physical activity, and medical comorbidities other than diabetes and hypertension, often cluster and may interact with one another to exert effects on cognitive functioning in late life (45,46). As such, future research should consider additional lifestyle behaviours when assessing the sex-dependent relationship between dietary pattern intake and cognitive function in later life.…”