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Association of Midlife Diet With Subsequent Risk for Dementia.
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- Author(s): Akbaraly, Tasnime N.; Singh-Manoux, Archana; Dugravot, Aline; Brunner, Eric J.; Kivimäki, Mika; Sabia, Séverine
- Source:
JAMA: Journal of the American Medical Association. 3/12/2019, Vol. 321 Issue 10, p957-968. 12p. - Source:
- Additional Information
- Subject Terms: DEMENTIA; DIET; MIDDLE age; DEMENTIA risk factors; COMPARATIVE studies; FACTOR analysis; HEALTH behavior; INGESTION; LONGITUDINAL method; RESEARCH methodology; MEDICAL cooperation; MULTIVARIATE analysis; QUESTIONNAIRES; RESEARCH; RESEARCH funding; SURVEYS; SOCIOECONOMIC factors; EVALUATION research; RELATIVE medical risk; DISEASE incidence
- 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. [ABSTRACT FROM AUTHOR] - Abstract: Copyright of JAMA: Journal of the American Medical Association is the property of American Medical Association and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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