Mediterranean Diet, Physical Activity, Cognitive Function, and Dementia Risk

Gad A. Marshall, MD


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Abstract and Introduction


Two new studies addressed whether diet and physical activity in elders affect cognitive decline and dementia.


In two large, prospective, population-based studies, researchers examined whether better adherence to a Mediterranean-type diet, with or without greater physical activity, is associated with less global cognitive decline or lower incidence of Alzheimer disease.

Scarmeas and colleagues investigated the association between amount of physical activity, alone or in combination with adherence to a Mediterranean-type diet, and incidence of Alzheimer disease (AD). For a mean of 5.4 years, the investigators followed 1880 community-dwelling, nondemented elders in New York City. Approximately every 1.5 years, participants completed physical-activity and food-frequency questionnaires and underwent cognitive and clinical assessments to determine dementia onset. A total of 282 participants developed AD. After adjustments for multiple confounders (including age, education, sex, ethnic background, presence of apolipoprotein E ε4 gene, baseline cognitive function, body-mass index, caloric intake, leisure activities, medical comorbidities, and smoking), the risk for AD was lower in participants with a high diet score (hazard ratio, 0.60), high physical activity (HR, 0.67), or both (HR, 0.65).

Féart and colleagues investigated the associations of adherence to a Mediterranean-type diet with cognitive decline and with dementia incidence. The investigators followed 1410 community-dwelling, nondemented elders from Bordeaux, France. Participants completed a food-frequency questionnaire and underwent cognitive tests and clinical assessments at least twice during a 5-year period. A total of 99 participants developed dementia (66 AD). After adjustment for potential confounders (including age, education, sex, marital status, presence of apolipoprotein E ε4 gene, physical activity, energy intake, multiple medications intake, depression, stroke, and cardiovascular risk factors), less cognitive decline on the Mini-Mental State Examination (but not in individual cognitive domains) was associated with greater adherence to a Mediterranean-type diet (measured as a continuous variable), whereas reduction in dementia risk was not.


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