The Association of Adherence to the Mediterranean Diet with Depression in Older Adults Longitudinally Taking into Account Cognitive Status: Results from the HELIAD Study

Abstract

Although research has generally shown a negative association between depression and adherence to the Mediterranean diet (MeDi), the literature related to older adults is controversial, perhaps partially due to the fact that cognitive status has not been considered. The aim of the current work was to investigate the association between MeDi and incident depression in a representative cohort of people, taking into account their cognitive status in multiple ways. The sample was drawn from the HELIAD study, a longitudinal study including a follow-up of 3 years after the baseline assessment. In total, 879 participants without depression at baseline were included (55.4% women, mean age ± Standard Deviation: 73.3 ± 5.0 years). Depression was determined as a score in the Geriatric depression scale ≥6 and/or antidepressant medication and/or clinical diagnosis of depression. Cox proportional hazard models adjusted for age, sex and education were employed. In the basic model, adherence to the MeDi was negatively associated with depression. In the most conservative model, excluding participants with dementia and Mild Cognitive Impairment, and after controlling for the baseline Cognitive Status, each unit (range 0–55) increase in MeDi was associated with a 6.2% decrease in the risk for depression (p < 0.001). These findings indicate that MeDi is negatively associated with depression longitudinally in older adults, above and beyond cognitive status.

Association between healthy eating and depression symptoms among Chinese older adults: A cross-sectional study based on the Chinese Longitudinal Healthy Longevity survey

“…In a recent umbrella review reporting the association between seven dietary patterns and depression ( Gianfredi et al, 2023 ), the authors concluded that there is compelling or suggestive evidence for an inverse association between the Mediterranean diet, a dietary pattern based on vegetables and fruits, fish, grains and beans, and olive oil, and depression. The Hellenic Longitudinal Investigation of Aging and Diet study from Greece showed that after adjusting for age, gender, education, and baseline cognitive status, those in the highest quartile had a 46 % lower risk of depression compared to older adults with the lowest adherence to the Mediterranean diet (hazard ratio = 0.549; 95 % CI: 0.359 to 0.840) ( Mamalaki et al, 2023 ). We also noted that the lack of statistical-level associations between the first quartile of HEI and depressive symptoms may be explained by insufficient covariates adjusted for, and an important factor is physical activity, which has been shown to be strongly associated with the risk of depression ( Laird et al, 2023 ).…”

Adherence to Mediterranean diet is inversely associated with depressive symptoms in older women: findings from the NutBrain Study

“…Hodge et al (13) ( n 8660, aged 50–69 years) showed that MD was associated with less psychological distress, with the OR in the highest scoring group relative to the lowest scoring group being 0·72 (95 % CI = 0·54, 0·95). A very recent study carried out in Greece (Mamalaki et al ) (15) , including 879 participants aged 65 years and older without depression at baseline, showed that each unit increase in MD score was associated with a 6·2 % decrease in the risk of depression. Although Skarupsi et al (14) and the studies by Hodge (13) and Mamalaki (15) reported an inverse association between high adherence to MD and depressive symptoms in older people, they did not consider stratification by sex.…”

Co-Expression Network Analysis Identifies Molecular Determinants of Loneliness Associated with Neuropsychiatric and Neurodegenerative Diseases

“…Physical activity, for example, has been shown to promote synaptic growth and reduce inflammation, thus protecting the brain against oxidative stress and neurodegeneration [ 19 ]. Other lifestyle modifications, including diet, sleep hygiene, mindfulness, and meditation, have been proposed to benefit the brain against depression, cognitive decline, and neurodegeneration [ 117 , 118 , 119 , 120 ].…”