1. Association of Midlife Diet With Subsequent Risk for Dementia
- Author
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Eric J. Brunner, Aline Dugravot, Mika Kivimäki, Archana Singh-Manoux, Tasnime N. Akbaraly, Séverine Sabia, Neuropsychiatrie : recherche épidémiologique et clinique (PSNREC), Université Montpellier 1 (UM1)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM), Mécanismes moléculaires dans les démences neurodégénératives (MMDN), Université de Montpellier (UM)-Université Montpellier 2 - Sciences et Techniques (UM2)-Institut National de la Santé et de la Recherche Médicale (INSERM)-École pratique des hautes études (EPHE), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL), Epidémiologie des déterminants sociaux et professionnels de la santé (INSERM U687 ), Hôpital Paul Brousse, Centre de recherche en épidémiologie et santé des populations (CESP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris-Sud - Paris 11 (UP11)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), Department of Epidemiology and Public Health, University College of London [London] (UCL), Finnish Institute of Occupational Health of Helsinki, École pratique des hautes études (EPHE), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Université Paris-Sud - Paris 11 (UP11)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM), and Université Montpellier 1 (UM1)-Université de Montpellier (UM)-Institut National de la Santé et de la Recherche Médicale (INSERM)
- Subjects
Male ,Mediterranean diet ,[SDV.NEU.NB]Life Sciences [q-bio]/Neurons and Cognition [q-bio.NC]/Neurobiology ,Health Behavior ,MESH: Energy Intake ,01 natural sciences ,Cohort Studies ,0302 clinical medicine ,Interquartile range ,MESH: Incidence ,030212 general & internal medicine ,Prospective cohort study ,MESH: Cohort Studies ,education.field_of_study ,MESH: Middle Aged ,MESH: Risk ,[SDV.NEU.PC]Life Sciences [q-bio]/Neurons and Cognition [q-bio.NC]/Psychology and behavior ,MESH: Healthy Diet ,Incidence ,Incidence (epidemiology) ,Hazard ratio ,MESH: Diet Surveys ,[SDV.NEU.SC]Life Sciences [q-bio]/Neurons and Cognition [q-bio.NC]/Cognitive Sciences ,General Medicine ,Middle Aged ,MESH: Dementia ,Female ,Diet, Healthy ,Cohort study ,Risk ,MESH: Socioeconomic Factors ,medicine.medical_specialty ,MESH: Health Behavior ,MESH: Factor Analysis, Statistical ,Population ,Diet Surveys ,Article ,MESH: Multivariate Analysis ,03 medical and health sciences ,MESH: Diet ,Internal medicine ,medicine ,Humans ,Dementia ,0101 mathematics ,education ,MESH: Humans ,business.industry ,010102 general mathematics ,medicine.disease ,MESH: Male ,Diet ,Socioeconomic Factors ,Multivariate Analysis ,Energy Intake ,Factor Analysis, Statistical ,business ,MESH: Female - Abstract
Importance Observational studies suggest that diet is linked to cognitive health. However, the duration of follow-up in many studies is not sufficient to take into account the long preclinical phase of dementia, and the evidence from interventional studies is not conclusive. Objective To examine whether midlife diet is associated with subsequent risk for dementia. Design, Setting, and Participants Population-based cohort study established in 1985-1988 that had dietary intake assessed in 1991-1993, 1997-1999, and 2002-2004 and follow-up for incident dementia until March 31, 2017. Exposures Food frequency questionnaire to derive the Alternate Healthy Eating Index (AHEI), an 11-component diet quality score (score range, 0-110), with higher scores indicating a healthier diet. Main Outcome and Measures Incident dementia ascertained through linkage to electronic health records. Results Among 8225 participants without dementia in 1991-1993 (mean age, 50.2 years [SD, 6.1 years]; 5686 [69.1%] were men), a total of 344 cases of incident dementia were recorded during a median follow-up of 24.8 years (interquartile range, 24.2-25.1 years). No significant difference in the incidence rate for dementia was observed in tertiles of AHEI exposure during 1991-1993, 1997-1999 (median follow-up, 19.1 years), and 2002-2004 (median follow-up, 13.5 years). Compared with an incidence rate for dementia of 1.76 (95% CI, 1.47-2.12) per 1000 person-years in the worst tertile of AHEI (lowest tertile of diet quality) in 1991-1993, the absolute rate difference for the intermediate tertile was 0.03 (95% CI, −0.43 to 0.49) per 1000 person-years and for the best tertile was 0.04 (95% CI, −0.42 to 0.51) per 1000 person-years. Compared with the worst AHEI tertile in 1997-1999 (incidence rate for dementia, 2.06 [95% CI, 1.62 to 2.61] per 1000 person-years), the absolute rate difference for the intermediate AHEI tertile was 0.14 (95% CI, −0.58 to 0.86) per 1000 person-years and for the best AHEI tertile was 0.14 (95% CI, −0.58 to 0.85) per 1000 person-years. Compared with the worst AHEI tertile in 2002-2004 (incidence rate for dementia, 3.12 [95% CI, 2.49 to 3.92] per 1000 person-years), the absolute rate difference for the intermediate AHEI tertile was −0.61 (95% CI, −1.56 to 0.33) per 1000 person-years and for the best AHEI tertile was −0.73 (95% CI, −1.67 to 0.22) per 1000 person-years. In the multivariable analysis, the adjusted hazard ratios (HRs) for dementia per 1-SD (10-point) AHEI increment were not significant as assessed in 1991-1993 (adjusted HR, 0.97 [95% CI, 0.87 to 1.08]), in 1997-1999 (adjusted HR, 0.97 [95% CI, 0.83 to 1.12]), or in 2002-2004 (adjusted HR, 0.87 [95% CI, 0.75 to 1.00]). Conclusions and Relevance In this long-term prospective cohort study, diet quality assessed during midlife was not significantly associated with subsequent risk for dementia.
- Published
- 2019
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