| Title: | Anti-Inflammatory Diet and Dementia in Older Adults With Cardiometabolic Diseases |
| Journal: | JAMA Network Open |
| Published: | 1 Aug 2024 |
| Pubmed: | https://pubmed.ncbi.nlm.nih.gov/39133488/ |
| DOI: | https://doi.org/10.1001/jamanetworkopen.2024.27125 |
Publication 12942
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Abstract
Importance: Inflammation has been proposed as a mechanism linking cardiometabolic diseases (CMDs) to increased risk of dementia. However, whether an anti-inflammatory diet can support brain and cognitive health among people with CMDs is unclear.</p>
Objective: To examine CMD status and dietary inflammatory potential in association with dementia risk and brain magnetic resonance imaging (MRI) measures using joint effect analysis.</p>
Design, Setting, and Participants: The UK Biobank is an ongoing community-based cohort study with baseline assessments conducted between March 13, 2006, and October 1, 2010. The present study included 84 342 dementia-free older adults (≥60 years), who were followed up until January 20, 2022 (maximum, 15 years). A subsample (n = 8917) underwent brain MRI scans between May 2, 2014, and March 13, 2020.</p>
Exposures: Baseline CMDs (including type 2 diabetes, heart disease, and stroke) were ascertained from medical records. Dietary Inflammatory Index scores (anti-inflammatory [≤-1.5 points], neutral [>-1.5 to <0.5 points], or proinflammatory [≥0.5 points]) were calculated from participants' average intake of 31 nutrients, assessed up to 5 times using the Oxford WebQ, a web-based, 24-hour dietary assessment.</p>
Main Outcomes and Measures: Incident dementia was identified through linkage to medical records. Regional brain volumes were collected from brain MRI scans.</p>
Results: The study included 84 342 participants (mean [SD] age, 64.1 [2.9] years; 43 220 [51.2%] female). At baseline, 14 079 (16.7%) had at least 1 CMD. Over a median follow-up of 12.4 (IQR, 11.8-13.1) years, 1559 individuals (1.9%) developed dementia. With the use of joint effect analysis, the hazard ratio of dementia was 2.38 (95% CI, 1.93-2.93) for people with CMDs and a proinflammatory diet and 1.65 (95% CI, 1.36-2.00) for those with CMDs and an anti-inflammatory diet (reference: CMD-free, anti-inflammatory diet). Dementia risk was 31% lower (hazard ratio, 0.69; 95% CI, 0.55-0.88; P = .003) among people with CMDs and an anti-inflammatory diet. On brain MRI, participants with CMDs and an anti-inflammatory diet compared with a proinflammatory diet additionally had significantly larger gray matter volume (β = -0.15; 95% CI, -0.24 to -0.06 vs β = -0.27; 95% CI, -0.38 to -0.16) and smaller white matter hyperintensity volume (β = 0.05; 95% CI, -0.04 to 0.14 vs β = 0.16; 95% CI, 0.05-0.27).</p>
Conclusions and Relevance: In this cohort study, people with CMDs and an anti-inflammatory compared with proinflammatory diet had a significantly lower hazard ratio of dementia, larger gray matter volume, and smaller white matter hyperintensity volume.</p>
13 Keywords
- Aged
- Brain
- Cardiovascular Diseases
- Cohort Studies
- Dementia
- Diet
- Female
- Humans
- Inflammation
- Magnetic Resonance Imaging
- Male
- Middle Aged
- United Kingdom
6 Authors
- Abigail Dove
- Michelle M. Dunk
- Jiao Wang
- Jie Guo
- Rachel A. Whitmer
- Weili Xu
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