The Association Among Inflammatory Diet, Glycohemoglobin, and Cognitive Function Impairment in the Elderly: Based on the NHANES 2011–2014

Abstract

Background: Dietary inflammatory index (DII) was associated with Type 2 diabetes mellitus and cognitive function impairment (CFI). Objective: The aim of this study was to explore whether the associations among DII, glycohemoglobin (HbA1c), and CFI were similar in the participants with or without diabetes. Methods: A total of 1,198 participants aged 60 and over from the National Health and Nutrition Examination Survey (NHANES) in 2011–2014 were involved in this study, dividing into subgroups as diabetes and non-diabetes for further analysis. Results: We found that participants with pro-inflammatory diet had higher proportion of CFI patients (p < 0.05). Pro-inflammatory diet and HbA1c were positively associated with the risk of CFI; participants with pro-inflammatory diet was 1.479 times on occurrence of CFI compared with anti-inflammatory diet group. The interaction between inflammatory diet and HbA1c was positive on the risk of CFI and was negative on the CERAD-immediate and CERAD-delayed, respectively. Among the participants without diabetes, the associations of Energy-adjusted DII (E-DII) with Animal Fluency test and Digit Symbol Substitution Test (DSST) were partially mediated by HbA1c, and the mediated proportion was 5.8% and 6.6%, respectively. However, there was no such mediation effect in the diabetes patients. Conclusion: In elderly participants without diabetes, there was an interaction between inflammatory diet and HbA1c on the association with CFI, especially for the dimension of CERAD-immediate and CERAD-delayed. Besides, the associations of E-DII with Animal Fluency test and DSST were partially mediated by HbA1c. For diabetic patients, HbA1c, rather than the inflammatory diet has a positive effect on the CFI risk.

Association between dietary inflammatory index and cognitive impairment: A meta-analysis

“…A total of 9 studies met inclusion criteria, which contained 19,379 subjects (Hayden et al, 2017 ; Shin et al, 2018 ; Charisis et al, 2021 ; Liu et al, 2021 ; Skoczek-Rubińska et al, 2021a ; Zhang et al, 2021 ; Song et al, 2022 ; Sun et al, 2022 ; Wang et al, 2022 ). Two studies were performed in Europe, four studies were performed in Asia and three studies were performed in Americas.…”

Meta-analysis of the association between dietary inflammatory index and cognitive health

“…The characteristics of the included studies are summarized in Table 1. Of these studies (11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)25) were published between 2017 and 2022, and their sample sizes varied from 222 to 7,085 participants with a total number of 24,823 individuals from seven countries on four continents. Four studies were carried out in the United States, three studies (12)(13)(14) in China, and one each in France (20), Greece (15), Poland (17), Australia (25), and South Korea (16).…”

“…The average age of participants varied from 61.00 to 74.04. In terms of dietary assessment, six studies (11)(12)(13)(14)(15)25) used Food Frequency Questionnaire (FFQ), five studies (16,(18)(19)(20)(21) used 24-h recall, and only one study (17) used three-day food diaries. Regarding the number of food parameters used to calculate DII score, two studies (15, 17) used all 45 parameters; three studies (18,21,25) used the E-DII score, which contains 27…”

“…There were eight (12-14, 16-18, 20, 25) studies. And the outcome variables of five of them (12,14,(16)(17)(18) were categorical variables while the other three's (13,20,25) were continuous variables. As to the five studies that used categorical variables, there is a negative association (OR = 1.56; 95% CI = 1.32-1.85) between DII and global cognition with no evidence of statistically significant heterogeneity between the studies (I 2 = 54%, p = 0.07).…”

“…All studies on the relationship between DII and the incidence of MCI or AD showed a positive relationship (11)(12)(13)(14)(15). Some studies showed a negative relationship between DII and global cognition and verbal fluency (12,14,(16)(17)(18)(19)(20). Other studies searched for a relationship between DII and episodic memory and executive function and found none (19)(20)(21).…”