Mediterranean Diet and Risk of Dementia and Alzheimer’s Disease in the EPIC-Spain Dementia Cohort Study
The Mediterranean diet (MD) has shown to reduce the occurrence of several chronic diseases. To evaluate its potential protective role on dementia incidence we studied 16,160 healthy participants from the European Prospective Investigation into Cancer and Nutrition (EPIC)-Spain Dementia Cohort study...
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doaj-bb401d216470477db8ff26e232de26ac2021-02-23T00:01:42ZengMDPI AGNutrients2072-66432021-02-011370070010.3390/nu13020700Mediterranean Diet and Risk of Dementia and Alzheimer’s Disease in the EPIC-Spain Dementia Cohort StudyMaría Encarnación Andreu-Reinón0María Dolores Chirlaque1Diana Gavrila2Pilar Amiano3Javier Mar4Mikel Tainta5Eva Ardanaz6Rosa Larumbe7Sandra M. Colorado-Yohar8Fernando Navarro-Mateu9Carmen Navarro10José María Huerta11Section of Neurology, Department of Internal Medicine. Rafael Méndez Hospital. Murcia Health Service, 30813 Lorca, Murcia, SpainMurcia Biomedical Research Institute (IMIB-Arrixaca), 30120 Murcia, SpainMurcia Biomedical Research Institute (IMIB-Arrixaca), 30120 Murcia, SpainCIBER Epidemiología y Salud Pública (CIBERESP), 28029 Madrid, SpainBiodonostia Health Research Institute, 20014 San Sebastián, SpainCITA Alzheimer Foundation, 20019 Donostia-San Sebastián, SpainCIBER Epidemiología y Salud Pública (CIBERESP), 28029 Madrid, SpainPublic Health Institute of Navarra, IdiSNA, 31008 Pamplona, SpainMurcia Biomedical Research Institute (IMIB-Arrixaca), 30120 Murcia, SpainMurcia Biomedical Research Institute (IMIB-Arrixaca), 30120 Murcia, SpainMurcia Biomedical Research Institute (IMIB-Arrixaca), 30120 Murcia, SpainMurcia Biomedical Research Institute (IMIB-Arrixaca), 30120 Murcia, SpainThe Mediterranean diet (MD) has shown to reduce the occurrence of several chronic diseases. To evaluate its potential protective role on dementia incidence we studied 16,160 healthy participants from the European Prospective Investigation into Cancer and Nutrition (EPIC)-Spain Dementia Cohort study recruited between 1992–1996 and followed up for a mean (±SD) of 21.6 (±3.4) years. A total of 459 incident cases of dementia were ascertained through expert revision of medical records. Data on habitual diet was collected through a validated diet history method to assess adherence to the relative Mediterranean Diet (rMED) score. Hazard ratios (HR) of dementia by rMED levels (low, medium and high adherence levels: ≤6, 7–10 and ≥11 points, respectively) were estimated using multivariable Cox models, whereas time-dependent effects were evaluated using flexible parametric Royston-Parmar (RP) models. Results of the fully adjusted model showed that high versus low adherence to the categorical rMED score was associated with a 20% (HR = 0.80, 95%CI: 0.60–1.06) lower risk of dementia overall and HR of dementia was 8% (HR = 0.92, 0.85–0.99, p = 0.021) lower for each 2-point increment of the continuous rMED score. By sub-types, a favorable association was also found in women for non-AD (HR per 2-points = 0.74, 95%CI: 0.62–0.89), while not statistically significant in men for AD (HR per 2-points = 0.88, 0.76–1.01). The association was stronger in participants with lower education. In conclusion, in this large prospective cohort study MD was inversely associated with dementia incidence after accounting for major cardiovascular risk factors. The results differed by dementia sub-type, sex, and education but there was no significant evidence of effect modification.https://www.mdpi.com/2072-6643/13/2/700Mediterranean dietdementiaAlzheimer’s diseasecohort studyprospective analysisEPIC-Spain |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
María Encarnación Andreu-Reinón María Dolores Chirlaque Diana Gavrila Pilar Amiano Javier Mar Mikel Tainta Eva Ardanaz Rosa Larumbe Sandra M. Colorado-Yohar Fernando Navarro-Mateu Carmen Navarro José María Huerta |
spellingShingle |
María Encarnación Andreu-Reinón María Dolores Chirlaque Diana Gavrila Pilar Amiano Javier Mar Mikel Tainta Eva Ardanaz Rosa Larumbe Sandra M. Colorado-Yohar Fernando Navarro-Mateu Carmen Navarro José María Huerta Mediterranean Diet and Risk of Dementia and Alzheimer’s Disease in the EPIC-Spain Dementia Cohort Study Nutrients Mediterranean diet dementia Alzheimer’s disease cohort study prospective analysis EPIC-Spain |
author_facet |
María Encarnación Andreu-Reinón María Dolores Chirlaque Diana Gavrila Pilar Amiano Javier Mar Mikel Tainta Eva Ardanaz Rosa Larumbe Sandra M. Colorado-Yohar Fernando Navarro-Mateu Carmen Navarro José María Huerta |
author_sort |
María Encarnación Andreu-Reinón |
title |
Mediterranean Diet and Risk of Dementia and Alzheimer’s Disease in the EPIC-Spain Dementia Cohort Study |
title_short |
Mediterranean Diet and Risk of Dementia and Alzheimer’s Disease in the EPIC-Spain Dementia Cohort Study |
title_full |
Mediterranean Diet and Risk of Dementia and Alzheimer’s Disease in the EPIC-Spain Dementia Cohort Study |
title_fullStr |
Mediterranean Diet and Risk of Dementia and Alzheimer’s Disease in the EPIC-Spain Dementia Cohort Study |
title_full_unstemmed |
Mediterranean Diet and Risk of Dementia and Alzheimer’s Disease in the EPIC-Spain Dementia Cohort Study |
title_sort |
mediterranean diet and risk of dementia and alzheimer’s disease in the epic-spain dementia cohort study |
publisher |
MDPI AG |
series |
Nutrients |
issn |
2072-6643 |
publishDate |
2021-02-01 |
description |
The Mediterranean diet (MD) has shown to reduce the occurrence of several chronic diseases. To evaluate its potential protective role on dementia incidence we studied 16,160 healthy participants from the European Prospective Investigation into Cancer and Nutrition (EPIC)-Spain Dementia Cohort study recruited between 1992–1996 and followed up for a mean (±SD) of 21.6 (±3.4) years. A total of 459 incident cases of dementia were ascertained through expert revision of medical records. Data on habitual diet was collected through a validated diet history method to assess adherence to the relative Mediterranean Diet (rMED) score. Hazard ratios (HR) of dementia by rMED levels (low, medium and high adherence levels: ≤6, 7–10 and ≥11 points, respectively) were estimated using multivariable Cox models, whereas time-dependent effects were evaluated using flexible parametric Royston-Parmar (RP) models. Results of the fully adjusted model showed that high versus low adherence to the categorical rMED score was associated with a 20% (HR = 0.80, 95%CI: 0.60–1.06) lower risk of dementia overall and HR of dementia was 8% (HR = 0.92, 0.85–0.99, p = 0.021) lower for each 2-point increment of the continuous rMED score. By sub-types, a favorable association was also found in women for non-AD (HR per 2-points = 0.74, 95%CI: 0.62–0.89), while not statistically significant in men for AD (HR per 2-points = 0.88, 0.76–1.01). The association was stronger in participants with lower education. In conclusion, in this large prospective cohort study MD was inversely associated with dementia incidence after accounting for major cardiovascular risk factors. The results differed by dementia sub-type, sex, and education but there was no significant evidence of effect modification. |
topic |
Mediterranean diet dementia Alzheimer’s disease cohort study prospective analysis EPIC-Spain |
url |
https://www.mdpi.com/2072-6643/13/2/700 |
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