Mediterranean diet adherence and cognitive function in older UK adults: The European Prospective Investigation into Cancer and Nutrition-Norfolk (EPIC-Norfolk) Study

Shannon, Oliver M.; Stephan, Blossom C. M.; Granic, Antoneta; Lentjes, Marleen; Hayat, Shabina; Mulligan, Angela; Brayne, Carol; Khaw, Kay-Tee; Bundy, Rafe; Aldred, Sarah; Hornberger, Michael; Paddick, Stella-Maria; Muniz-Tererra, Graciela; Minihane, Anne-Marie; Mathers, John C; Siervo, Mario

Abstract

© 2019 American Society for Nutrition. Background: In Mediterranean countries, adherence to a traditional Mediterranean dietary pattern (MedDiet) is associated with better cognitive function and reduced dementia risk. It is unclear if similar benefits exist in non-Mediterranean regions. Objectives: The aims of this study were to examine associations between MedDiet adherence and cognitive function in an older UK population and to investigate whether associations differed between individuals with high compared with low cardiovascular disease (CVD) risk. Methods: We conducted an analysis in 8009 older individuals with dietary data at Health Check 1 (1993-1997) and cognitive function data at Health Check 3 (2006-2011) of the European Prospective Investigation into Cancer and Nutrition-Norfolk (EPIC-Norfolk). Associations were explored between MedDiet adherence and global and domain-specific cognitive test scores and risk of poor cognitive performance in the entire cohort, and when stratified according to CVD risk status. Results: Higher MedDiet adherence defined by the Pyramid MedDiet score was associated with better global cognition (β ± SE = -0.012 ± 0.002; P < 0.001), verbal episodic memory (β ± SE = -0.009 ± 0.002; P < 0.001), and simple processing speed (β ± SE = -0.002 ± 0.001; P = 0.013). Lower risk of poor verbal episodic memory (OR: 0.784; 95% CI: 0.641, 0.959; P = 0.018), complex processing speed (OR: 0.739; 95% CI: 0.601, 0.907; P = 0.004), and prospective memory (OR: 0.841; 95% CI: 0.724, 0.977; P = 0.023) was also observed for the highest compared with the lowest Pyramid MedDiet tertiles. The effect of a 1-point increase in Pyramid score on global cognitive function was equivalent to 1.7 fewer years of cognitive aging. MedDiet adherence defined by the Mediterranean Diet Adherence Screener (MEDAS) score (mapped through the use of both binary and continuous scoring) showed similar, albeit less consistent, associations. In stratified analyses, associations were evident in individuals at higher CVD risk only (P < 0.05). Conclusions: Higher adherence to the MedDiet is associated with better cognitive function and lower risk of poor cognition in older UK adults. This evidence underpins the development of interventions to enhance MedDiet adherence, particularly in individuals at higher CVD risk, aiming to reduce the risk of age-related cognitive decline in non-Mediterranean populations.

Citation

Shannon, O. M., Stephan, B. C. M., Granic, A., Lentjes, M., Hayat, S., Mulligan, A., …Siervo, M. (2019). Mediterranean diet adherence and cognitive function in older UK adults: The European Prospective Investigation into Cancer and Nutrition-Norfolk (EPIC-Norfolk) Study. American Journal of Clinical Nutrition, 110(4), 938-948. https://doi.org/10.1093/ajcn/nqz114

• Journal Article Type: Article
• Acceptance Date: May 6, 2019
• Online Publication Date: Jun 17, 2019
• Publication Date: Oct 1, 2019
• Deposit Date: Nov 20, 2019
• Publicly Available Date: Jun 18, 2020
• Journal: American Journal of Clinical Nutrition
• Print ISSN: 0002-9165
• Electronic ISSN: 1938-3207
• Publisher: Oxford University Press
• Peer Reviewed: Peer Reviewed
• Volume: 110
• Issue: 4
• Pages: 938-948
• DOI: https://doi.org/10.1093/ajcn/nqz114
• Keywords: Nutrition and Dietetics; Medicine (miscellaneous)
• Public URL: https://nottingham-repository.worktribe.com/output/3344326
• Publisher URL: https://academic.oup.com/ajcn/article/110/4/938/5519530
• Additional Information: This is a pre-copyedited, author-produced version of an article accepted for publication in American Journal of Clinical Nutrition following peer review. The version of record Oliver M Shannon, Blossom C M Stephan, Antoneta Granic, Marleen Lentjes, Shabina Hayat, Angela Mulligan, Carol Brayne, Kay-Tee Khaw, Rafe Bundy, Sarah Aldred, Michael Hornberger, Stella-Maria Paddick, Graciela Muniz-Tererra, Anne-Marie Minihane, John C Mathers, Mario Siervo, Mediterranean diet adherence and cognitive function in older UK adults: the European Prospective Investigation into Cancer and Nutrition–Norfolk (EPIC-Norfolk) Study, The American Journal of Clinical Nutrition, Volume 110, Issue 4, October 2019, Pages 938–948 is available online at: https://doi.org/10.1093/ajcn/nqz114