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Background and aim Frailty is characterized by several deficits in multiple health related domains. Although cognition is among the important components of frailty, there is lack of evidence on the role of specific neuro-cognitive dimensions. The primary aim of the present work was to evaluate the multidimensional definition of frailty, and to assess whether neuro-cognitive function is a constituent of the frailty syndrome among adults aged ≥50 years living in three European countries. As a secondary aim, the construct validity of the created frailty index was tested (with inpatient and outpatient hospitalization), as well as its determinants. Methods Data were obtained from a cross-sectional, community-based, nationally-representative survey conducted in Finland, Poland and Spain ( n  = 7987 individuals aged ≥50 years). Socio-demographic, clinical, lifestyle and social factors were assessed using validated procedures. Cognitive function was assessed with the following tests: learning and short-term memory, working memory and verbal fluency. A frailty index was constructed based on 31 frailty attributes. Principal component analysis was used to identify the components of the frailty index. Logistic and Poisson regression analysis was also conducted. Results The factor analysis on the components of the index extracted three main dimensions for frailty ( disability and daily functioning , cognitive function, chronic health conditions ), confirming the multiple dimensions of frailty. Various socio-demographic (e.g., financial status, education level) and lifestyle habits (alcohol consumption) were related with frailty. The presence of frailty was associated with 3.1 times higher odds for inpatient hospitalization (95%CI 2.75 to 3.51). Frailty was also related with higher frequency of outpatient visits. Conclusions These findings suggest that frailty is a multidimensional concept with three major dimensions. Neuro-congitive function seems to be a separate dimension of the frailty syndrome. Smoking habits and alcohol intake were positively related with frailty while inpatient and outpatient hospitalization were found to be associated to the level of frailty. [ABSTRACT FROM AUTHOR]

Purpose: The aim of the present work was to evaluate the relation between car use and the level of successful aging of a random sample of older adults living in the Mediterranean basin.Methods: During 2005-2011, 2749 older (aged 65-100 years) from 22 islands and the rural Mani region (Peloponnesus) of Greece were voluntarily enrolled in the Mediterranean islands cross-sectional study. Sociodemographics, medical conditions, and dietary and lifestyle habits were derived throughout standard procedures. Car use was recorded with a standard binary question. A successful aging index ranging from 0-10 was used.Results: Older adults who used a car on regular basis had significantly higher levels of successful aging, as well as less prevalence of obesity and hypertension while were more physically active (P < .001). After adjusting for several confounders car use was still positively related with elderly islander's successful aging level (beta coefficient [95% confidence interval]: 0.65 [0.54-0.77]).Conclusions: In conclusion, the activity of car use seems to be an indicator of quality of life among older adults, as measured through successful aging. [ABSTRACT FROM AUTHOR]

Background The determinants that promote successful ageing still remain unknown. The aim of the present work was to evaluate the role of skeletal muscle mass and body fat percentage (BF%), in the level of successful ageing. Methods during 2005–2011, 2663 older (aged 65–100 years) from 21 Mediterranean islands and the rural Mani region (Peloponnesus) of Greece were voluntarily enrolled in the study. Appendicular skeletal muscle mass (ASM), skeletal muscle mass index (SMI) and BF% were calculated using population formulas. Dietary habits, energy intake, expenditure and energy balance were derived throughout standard procedures. A successful ageing index ranging from 0 to 10 was used. Results The mean ASM mass was 24 ± 6.0 kg, the SMI was 0.84 ± 0.21 and the BF% was 44%. Females had lower SMI and higher BF% in comparison with males, respectively [(SMI: 0.66 ± 0.09 vs. 1.03 ± 0.11; BF%: 51% vs. 34%, (p < 0.001)]. High successful agers had better rates in ASM (p = 0.01), SMI (p < 0.001) and BF% (p < 0.001), compared with the medium and low successful ones. Changes in SMI [b-coefficient (95% CI):2.14 (1.57 to 2.71)] were positively associated with successful ageing, while changes in BF% [b-coefficient (95% CI): −0.04 (−0.05 to −0.03)] were inversely associated with successful ageing. Results from sensitivity analysis showed that the effects of variations on body composition were consistent, less pronounced in the positive energy balance group and more pronounced among the oldest old. Conclusions Body composition changes seem to be associated with lower quality of life in the older adults, as measured through successful ageing. [ABSTRACT FROM AUTHOR]

Background Prior research has indicated that several factors are associated with low energy dietary reporting; however, there is comparatively little information on the association between body image, weight control, and low energy reporting. Objective Our aim was to evaluate the association between low energy reporting and aspects of weight perception, satisfaction, and control in a nationally representative US adult sample. Design This was a cross-sectional study. Participants/setting Data were analyzed from 13,581 adults aged 20 years and older who participated in the 2007-2012 National Health and Nutrition Examination Survey. Data on sociodemographic, clinical, and lifestyle characteristics, and weight perception, satisfaction, and control were collected. The ratio of reported energy intake to estimated basal metabolic rate (EI/BMR) was calculated and used for the assessment of low energy reporting. Main outcome measures The relationship of low energy reporting with various aspects of weight perception, satisfaction, and control was evaluated. Statistical analyses performed Multivariable logistic regression was used to assess the association between the variables. Results Low energy reporters were significantly more likely to consider themselves overweight (perception), want to weigh less (satisfaction), and to have tried to lose weight in the past 12 months (control). Compared with having no desire for weight change, wanting to weigh less was associated with 1.28 (95% CI 1.07 to 1.53) times higher odds for low energy reporting. Trying to lose weight was also associated with low energy reporting (odds ratio=1.56; 95% CI 1.38 to 1.76). Effect modification by obesity status was observed for the weight perception, satisfaction, and control variables where the odds ratios of these factors for low energy reporting were higher among those who were not obese. Conclusion Weight perception, satisfaction, and control are related to low energy reporting, and should be taken into account in nutritional assessments. In addition, the effect of these factors can differ by obesity status. [ABSTRACT FROM AUTHOR]

Introduction The role of mild cognitive impairment (MCI) on falls among older adults remains under-investigated. The aim of this study was to evaluate the association between MCI and number of falls or occurrence of non-accidental falls among older adults. Methods Data from the first wave of the Irish longitudinal Study on Ageing (TILDA) was analysed. The analytical sample consisted of 5364 individuals aged ≥ 50 years. MCI was defined as: Montreal Cognitive Assessment (MoCA) score < 26; the presence of subjective cognitive complaints; Mini-Mental State Examination (MMSE) score ≥ 14; and no limitations in activities of daily living (ADL). Multivariable Poisson and logistic regression analyses were conducted to assess the association between MCI and number of falls or the presence of non-accidental falls in the past 12 months. Results The prevalence of MCI was 10.1%. In the fully-adjusted model, MCI was associated with a higher rate of falls (PR = 1.41 95%CI = 1.05–1.89) and odds for non-accidental falls in the past 12 months (OR = 1.67 95%CI = 1.07–2.61). Muscle strength and performance indicators, and medical health conditions were influential factors in the association between MCI and falls but did not fully explain the association. Conclusion MCI is related with higher rates of falls and the occurrence of non-accidental falls among older adults. Future studies are warranted to clarify the underlying mechanism linking MCI and falls, and to establish interventions targeting MCI to reduce the risk of falls. [ABSTRACT FROM AUTHOR]

According to World Health Organization older individuals is the fastest growing age-group around the globe, thanks to the tremendous improvements in medical and pharmaceutical therapies, as well as in quality of life. Unfortunately, this raise in life span is accompanied by significant increase in disease burden, and consequent economical costs. Lifestyle modifications and effective prevention strategies have shown considerable benefits as regards the development of age-oriented chronic diseases. Among lifestyle factors, nutrition is a key component for achieving good health. Nevertheless, this parameter has insufficiently been investigated in older people. This is a rather important scientific gap, considering the westernization of nutritional habits observed the last few decades, with high red meat consumption and its processed products being an indispensable part. Moreover, its adverse impact in cardiovascular disease and cancer has been extensively investigated, while in recent literature, interest has been remarkably oriented towards its subtypes (i.e., fresh and processed); however, outcomes as regards the older population are controversial with a variety of them proposing moderation of red meat mainly the processed type, whilst others recognizing fresh red meat, especially the lean type, an important source of high quality protein so as to manage muscle tissue loss, a common implication of advanced-age discount. The aim of the present review was to present an overview of studies which have investigated the association between red meat and its subtypes, with chronic diseases, in middle and advanced age individuals. [ABSTRACT FROM AUTHOR]

Background: The aim of this study was to evaluate the association of sarcopenia and sarcopenic obesity with disability among older adults (= 65 years old) in nine high-, middle- and low-income countries from Asia, Africa, Europe, and Latin America. Methods: Data were available for 53,289 people aged = 18 years who participated in the Collaborative Research on Ageing in Europe (COURAGE) survey conducted in Finland, Poland, and Spain, and the WHO Study on global AGEing and adult health (SAGE) survey conducted in China, Ghana, India, Mexico, Russia, and South Africa, between 2007 and 2012. Skeletal muscle mass, skeletal muscle mass index, and percent body fat were calculated with specific population formulas. Sarcopenia and sarcopenic obesity were defined by specific cut-offs used in previous studies. Disability was assessed with the WHODAS 2.0 score (range 0-100) with higher scores corresponding to higher levels of disability. Multivariable linear regression analysis was conducted with disability as the outcome. Results: The analytical sample consisted of 18,363 people (males; n = 8116, females; n = 10247) aged = 65 years with mean (SD) age 72.9 (11.1) years. In the fully-adjusted overall analysis, sarcopenic obesity was associated with greater levels of disability [b-coefficient 3.01 (95% CI 1.14-4.88)]. In terms of country-wise analyses, sarcopenia was associated with higher WHODAS 2.0 scores in China [b-coefficient 4.56 (95% CI: 3.25-5.87)], Poland [b-coefficient 6.66 (95% CI: 2.17-11.14)], Russia [b-coefficient 5.60 (95% CI: 2.03-9.16)], and South Africa [b-coefficient 7.75 (95% CI: 1.56-13.94)]. Conclusions: Prevention of muscle mass decline may contribute to reducing the global burden of disability. [ABSTRACT FROM AUTHOR]

The aim of the study was to evaluate the association between various factors and diabetes type II (DM) with a particular emphasis on indicators of central obesity, and to compare the effect of DM on disability among elder populations (≥ 50 years old) in nine countries. Data were available for 52,946 people aged ≥ 18 years who participated in the WHO Study on global AGEing and adult health and the Collaborative Research on Ageing in Europe studies conducted between 2007 and 2012. DM was defined as self-report of physician diagnosis. Height, weight, and waist circumference were measured. Disability status was assessed with the WHODAS II questionnaire. The overall prevalence of DM was 7.9% and ranged from 3.8% (Ghana) to 17.6% (Mexico). A 10 cm increase in waist circumference and waist-to-height ratio of > 0.5 were associated with a significant 1.26 (India) to 1.77 (Finland), and 1.68 (China, Spain) to 5.40 (Finland) times higher odds for DM respectively. No significant associations were observed in Mexico and South Africa. DM was associated with significantly higher disability status in all countries except Mexico in the model adjusted for demographics and smoking. The inclusion of chronic conditions associated with diabetes in the model attenuated the coefficients in varying degrees depending on the country. A considerable proportion of the studied older population had DM. Central obesity may be a key factor for the prevention of DM among older populations globally. Prevention of DM especially among the older population globally may contribute to reducing the burden of disability. [ABSTRACT FROM AUTHOR]

Objective : The aim of this study was to evaluate the factors associated with different components of arterial blood pressure in nine nationally-representative samples of people aged ≥50 years. Methods : Data were available for 53,289 people aged ≥18 years who participated in the SAGE (WHO Study on global AGEing and adult health) study conducted in China, Ghana, India, Mexico, Russia, and South Africa, and the COURAGE (Collaborative Research on Ageing in Europe) study conducted in Finland, Poland, and Spain, between 2007 and 2012. Standard procedures were used to obtain diastolic and systolic blood pressure (DBP, SBP) measurements to identify hypertensive participants, and to determine mean arterial blood pressure (MAP) and pulse pressure (PP). Results : The analytical sample consisted of 42,116 people aged 50 years or older. South Africa had the highest prevalence of hypertension (78.3%), and the highest measurements of MAP ± SD (113.6 ± 36.4 mmHg), SBP ± SD (146.4 ± 49.5 mmHg), and DBP ± SD (97.2 ± 33.9 mmHg). In the adjusted models, dose-dependent positive associations between Body Mass Index (BMI) and MAP or PP were observed in most countries ( p < 0.05). Diabetes was positively associated with PP in most countries but the association between diabetes and MAP was less consistent. Stroke was associated with both higher MAP and PP in China, Ghana, and South Africa ( p < 0.05). Conclusions : Obesity and diabetes remain important modifiable risk factors for arterial peripheral resistance and stiffness as reflected by MAP and PP respectively. Controlling arterial pressure abnormalities after stroke events may be important for secondary prevention, particularly in developing countries. [ABSTRACT FROM AUTHOR]

The definition and determinants of successful aging is still controversial. Although dietary habits have long been associated with aging, eating habits and behaviors have rarely been included in various proposed indices of successful aging. The aim of this work was to evaluate determinants of successful aging together with assessment of dietary habits in relation to healthcare facility use among elders living in the Mediterranean basin. During 2005–2011, 2663 elderly (aged 65–100 years) individuals from 21 Mediterranean islands and rural Mani region (Peloponnesus) were voluntarily enrolled in the study. A successful aging index ranging from a score of 0 to a score of 10 was constructed using 10 attributes, i.e., education, financial status, physical activity, body mass index, depression, participation in social activities with friends and family, number of yearly excursions, number of cardiovascular disease risk factors and adherence to the Mediterranean diet. The applied factor analysis on the components of the index extracted three main components for successful aging: psychosocial-economic, bioclinical and lifestyle; confirming the multiple dimensions of aging. After adjusting for confounders, a 1/10-unit increase in the successful aging index was associated with 0.8 less annual visits to healthcare centers (95% CI − 1.3 to −0.2). Stratified analysis by gender revealed heterogeneity of factors predicting successful aging. These findings suggest that successful aging is a multidimensional and complex concept that exhibits gender heterogeneity. Annual use of health care services by the elders was found to be related to level of successful aging. [ABSTRACT FROM AUTHOR]

Abstract: Background: The role of nutritional policy and services on the quality of life of older individuals has not been extensively studied. Thus, the aim of the present study was to evaluate the association between nutritional services within the public health care system and older people''s health status. Methods: During 2010, information of various nutritional services provided in 9 Greek Islands and Cyprus Republic was retrieved through local health care authorities. With the exception of the Cyprus Republic, a large proportion of dieticians in the rest of the studied islands participated in this survey (n=88). The health status of the referent older population was retrieved from the Mediterranean islands'' (MEDIS) study. Results: After various adjustment, islands that had nutritional services offered within the public health care system had lower likelihood of observing the prevalence of hypercholesterolemia, diabetes and obesity above the median rate of the referent population (odds ratio (95% CI), hypercholesterolemia, 0.11 (0.02, 0.55), diabetes, 0.03 (0.02, 0.26), and obesity, 0.10 (0.02, 0.50). Continuous and higher education status of dieticians and the completion of nutrition sessions seem also to contribute to the reduction of the CVD risk burden in these islanders. Conclusions: Active nutritional policy and enhancement of nutritional services within the public health care system may contribute to improved health and quality of life among older populations. [Copyright &y& Elsevier]

Abstract: Objectives: To evaluate the prevalence of low energy reporting (LER) and associations between LER and lifestyle, psychological and clinical parameters, in elderly people living in eastern Mediterranean islands. Methods: 1190 men and women, aged 65–100 years, participated in this cross-sectional study. Socio-demographic, clinical and lifestyle characteristics were recorded for the study participants. Among others, the ratio of energy intake to estimated basal metabolic rate (EI/BMR) was calculated and was used for the assessment of LER. Results: Prevalence of LER was 47.7%. Lower EI/BMR (i.e., higher risk for LER) was associated with older age (p =0.001), male sex (p <0.001), higher body mass index (BMI; p =0.04), lower adherence to the Mediterranean diet (p <0.001) and non-current smoking (p =0.007). The sex-specific analysis revealed that, lower EI/BMR values were associated with lower adherence to the Mediterranean diet and being non-current smoker in both men and women (p ≤0.05), as well as with older age (p =0.01), higher BMI (p =0.02) and hypercholesterolemia (p =0.02), only in women. Conclusion: In elderly, several clinical and lifestyle factors seem to be related to LER, and they should be taken into account in their nutritional assessment. [Copyright &y& Elsevier]

Abstract: Background: The proportion of elderly worlwide is increasing. This increase in life expectancy, is staggering posing tremendous challenges in disease burden, especially, in chronic diseases such as obesity, diabetes, hypertension, hypercholesterolemia, cancer and cardiovascular disease (CVD). Limited studies investigate the effect of Mediterranean diet on cardiovascular risk and cancer in older populations. In this review, findings from observational studies are summarized to evaluate the effect of Mediterranean diet on cancer and cardiovascular disease risk in elderly people. Methods: Published results from observational studies that assessed food habits on cancer and cardiovascular disease risk in elderly were retreived and summarized. Results: In all studies diet had an effect on cardiovascular disease risk. The Mediterranean diet, a high-qulaity diet and increased fruit and vegetable consumption were all found to be cardioprotective. Conclusion: The systematically reviewed studies reveal that a high adherence to a Mediterranean type of diet or “prudent diet” is associated with reduced risk of CVD and some types of cancer, even in the elderly. Also dietary intervention strategies can prevent morbidity, premature mortality and improve quality of life in older persons worldwide. [Copyright &y& Elsevier]

On March 12th, 2020, the WHO declared COVID-19 as a pandemic. The collective impact of environmental and ecosystem factors, as well as biodiversity, on the spread of COVID-19 and its mortality evolution remain empirically unknown, particularly in regions with a wide ecosystem range. The aim of our study is to assess how those factors impact on the COVID-19 spread and mortality by country. This study compiled a global database merging WHO daily case reports with other publicly available measures from January 21st to May 18th, 2020. We applied spatio-temporal models to identify the influence of biodiversity, temperature, and precipitation and fitted generalized linear mixed models to identify the effects of environmental variables. Additionally, we used count time series to characterize the association between COVID-19 spread and air quality factors. All analyses were adjusted by social demographic, country-income level, and government policy intervention confounders, among 160 countries, globally. Our results reveal a statistically meaningful association between COVID-19 infection and several factors of interest at country and city levels such as the national biodiversity index, air quality, and pollutants elements (PM 10, PM 2.5 , and O 3). Particularly, there is a significant relationship of loss of biodiversity, high level of air pollutants, and diminished air quality with COVID-19 infection spread and mortality. Our findings provide an empirical foundation for future studies on the relationship between air quality variables, a country's biodiversity, and COVID-19 transmission and mortality. The relationships measured in this study can be valuable when governments plan environmental and health policies, as alternative strategy to respond to new COVID-19 outbreaks and prevent future crises. Image 1 • National biodiversity index seems to be inversely related to COVID-19 spread. • Diminished air quality was associated with increased COVID-19 spread. • Air pollution was associated with increased COVID-19 spread and mortality. Main findings: Our results reveal a relationship between COVID-19 transmission and mortality and loss of biodiversity, high level of air pollutants, and diminished air quality at country and city levels. [ABSTRACT FROM AUTHOR]

Background To evaluate modifiable, lifestyle risk factors of cardiovascular disease (CVD) among older adults, across ageing, in the Mediterranean area. Methods During 2005–2017, 3131 individuals from 26 Mediterranean islands of 5 countries, ≥65 years of age, were voluntarily enrolled. Anthropometrical, clinical and socio-demographic characteristics, dietary habits, lifestyle parameters were measured through standard procedures. Analyses were performed by year and across consecutive age groups of the participants. Results A decrease in the prevalence of current smoking ( p  < 0.001), engagement in physical activities ( p  = 0.001) and participation in social events ( p  = 0.001) for every year increase in age was found. Moderate alcohol drinking increased through ageing ( p  = 0.008), whereas adherence to Mediterranean diet remained stable, but adequate ( p  = 0.90). Trend analysis also revealed that a quadratic (U-shape) function better characterized the association between ageing and total cardiometabolic risk factors burden ( p for trend <0.001). Conclusions The gaps in the understanding of factors affecting longevity and healthy ageing remain; public health authorities and stakeholders should focus on the lifestyle determinants of healthy ageing, that seems to be an effective mean for improving older peoples' health. [ABSTRACT FROM AUTHOR]

The Act-Belong-Commit campaign is the world's first comprehensive, population-wide, community-based program designed to promote mental health. The campaign targets individuals to engage in mentally healthy activities, while at the same time, encouraging community organizations that offer such activities, to increase participation in their activities. Using nationally-representative data from Ireland, the aim of this study was to prospectively assess the association between indicators of the Act-Belong-Commit behavioral domains and incident depression, anxiety, and cognitive impairment. Data from two consecutive waves of the Irish Longitudinal Study on Ageing (TILDA) were analyzed. The analytical sample consisted of 6098 adults aged ≥ 50 years. Validated scales for depression, anxiety, and cognitive impairment were used. The number of social/recreational activities engaged in was used as an indicator of Act, social network integration as an indicator of Belong, and frequency of participation in these social/recreational activities as an indicator of Commit. Multivariable logistic regression analyses were conducted to assess associations between baseline indicators of Act-Belong-Commit and incident depression, anxiety, and cognitive impairment at two-year follow-up. The adjusted model showed that each increase in the number of social/recreational activities (Act) inversely predicted the onset of depression, anxiety, and cognitive impairment. The same was the case for social network integration (Belong); that is, being well integrated into social networks was a significant protective factor against all mental health outcomes. Finally, frequency of participation in social/recreational activities (Commit) significantly and inversely predicted the onset of depression and anxiety, while the protective effect against cognitive impairment was only marginally significant. Act-Belong-Commit indicators are shown to be protective against mental disorders and cognitive impairment among older Irish adults. This provides further evidence for the campaign's potential efficacy and has potentially wide-ranging implications for preventing the deterioration of mental health and cognitive decline in the aging community. [ABSTRACT FROM AUTHOR]

Background Restricted social networks have been associated with higher mortality in several developed countries but there are no studies on this topic from developing countries. This gap exists despite potentially greater dependence on social networks for support and survival due to various barriers to health care and social protection schemes in this setting. Thus, this study aims to examine how social network type at baseline predicts all-cause mortality among older adults in six Latin American countries, China, and India. Methods Population-based surveys were conducted of all individuals aged 65+ years in eight countries (Cuba, Dominican Republic, Peru, Venezuela, Mexico, Puerto Rico, China, and India). Data on mortality were obtained at follow-up (mean 3.8 years after cohort inception). Follow-up data for 13,891 individuals were analysed. Social network types were assessed using Wenger's Practitioner Assessment of Network Type (PANT). Cox proportional hazard models were constructed to estimate the impact of social network type on mortality risk in each country, adjusting for socio-demographics, receipt of pension, disability, medical conditions, and depression. Meta-analysis was performed to obtain pooled estimates. Results The prevalence of private network type was 64.4% in urban China and 1.6% in rural China, while the prevalence of locally integrated type was 6.6% in urban China and 86.8% in rural China. The adjusted pooled estimates across (a) all countries and (b) Latin America showed that, compared to the locally integrated social network type, the locally self-contained [(b) HR = 1.24, 95%CI 1.01–1.51], family dependent [(a) HR = 1.13, 95%CI 1.01–1.26; (b) HR = 1.13, 95%CI 1.001–1.28], and private [(a) HR = 1.36, 95%CI 1.06–1.73; (b) HR = 1.45, 95%CI 1.20–1.75] social network types were significantly associated with higher mortality risk. Conclusion Survival time is significantly reduced in individuals embedded in restricted social networks (i.e. locally self-contained, family dependent, and private network types). Social care interventions may be enhanced by addressing the needs of those most at risk of neglect and deteriorating health. Health policy makers in developing countries may use this information to plan efficient use of limited resources by targeting those embedded in restricted social networks. [ABSTRACT FROM AUTHOR]

Background Depression has been linked to a large and growing economic and societal burden worldwide. In Europe, depression is one of the most frequent mental disorders across all age groups, but particularly in people aged 65 years and over, and higher depressive symptoms have been reported among individuals with chronic diseases (e.g., diabetes and heart disease). Aim To evaluate the role of adherence to the Mediterranean diet (MedDiet) in depression in a sample of older people living in the Mediterranean basin. Methods Standard procedures were used to determine socio-demographic, lifestyle, and clinical characteristics of the participants, as well as their dietary habits, and depressive symptoms were evaluated using the Geriatric Depression Scale (GDS). Multi-adjusted logistic and linear regression analyses were carried out to evaluate the associations between participants' characteristics and depression. Results Participants classified as having mild or severe depression were less educated and physically active, and more diabetic, and they reported less adherence to the MedDiet. Adherence to the MedDiet was associated with the absence of depression [(OR, 95% CI): 0.65, 0.50−0.85]. In addition, daily tea drinking was also related to the absence of depression [(OR, 95% CI): 0.51, 0.40−0.65]. Conclusions Greater adherence to the MedDiet and daily tea drinking seem to have a beneficial effect on depressive symptoms in older adults. [ABSTRACT FROM AUTHOR]

Background Intake of n-3 fatty acids and adherence to the Mediterranean diet (MedDiet) have been shown to slow the progression of age-related cognitive decline, but the results are mixed. We summarized and evaluated the effect of n-3 fatty acids and MedDiet on cognitive outcomes in a cognitively healthy aged population. Methods Relevant published studies from January 2000 to May 2015 were identified by searching three electronic databases: Pubmed, Web of Science/MEDLINE, and CINHAL. Observational studies and randomized controlled trials (RCTs) were considered. Results Twenty-four studies were included for the systematic review. n-3 fatty acids were associated with better global cognition and some specific cognitive domains though some results were conflicting. Adherence to the MedDiet was also significantly associated with better cognitive performance and less cognitive decline. Finally, better cognitive performance was observed in men compared to women and mixed results were also found for the influence of APOE4 genotype on the association between n-3 fatty acids or MedDiet and cognition. Conclusions Studies suggest that n-3 fatty acids in the diet and adherence to the MedDiet are beneficial in slowing age-related cognitive decline. However, more high-quality RCTs would be useful to clarify the effect of n-3 fatty acid supplements on cognition. [ABSTRACT FROM AUTHOR]