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Mediterranean diet and cognitive decline over time in an elderly Mediterranean population

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Abstract

Purpose

Evidence suggests that dietary patterns compatible with the traditional Mediterranean diet (MD) may protect against cognitive decline. We prospectively assessed whether adherence to MD in the Mediterranean country of Greece is inversely associated with cognitive decline in the elderly and whether any particular MD component may play a key role.

Methods

Elderly men and women (N = 401) residing in the greater Athens area had dietary variables ascertained in 1994–1999. Adherence to MD was represented by the MD score [MDS, 0–3 (low), 4–5 (intermediate), 6–9 (high)]. The mini-mental state examination (MMSE) was administered by trained professionals to individuals aged 65 years or older in 2004–2006 (first assessment) and re-administered in 2011–2012 (second assessment). MMSE change (cMMSE) was categorized as: improved/unchanged (cMMSE ≥ 0), mildly lower (cMMSE −1 to −4) or substantially lower (cMMSE ≤ −5). Associations were evaluated through multinomial logistic regression.

Results

Decline in MMSE performance was inversely associated with adherence to MD. For mild versus no decline, odds ratio (OR) comparing high to low MD adherence was 0.46 [95 % confidence interval (CI) 0.25–0.87, p = 0.012]. For substantial versus no decline, OR comparing high to low MD adherence was 0.34 (95 % CI 0.13–0.89, p = 0.025). Among the nine MDS components, only vegetable consumption exhibited a significant inverse association with cognitive decline.

Conclusions

Closer adherence to the traditional MD is highly likely to protect against cognitive decline in this elderly Mediterranean population. Higher vegetable consumption appears to play a key role, possibly in synergy with additional components of the diet.

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Abbreviations

MDS:

Mediterranean diet score

MMSE:

Mini-mental state examination

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Acknowledgments

AT is the PI of EPIC-Greece and the initiator of the study. AK provided expertise in neurology and neuroepidemiology. MR and MK undertook the statistical analysis. DT, CL and PL were senior epidemiologists in the study. All authors contributed to the drafting and the revision of the manuscript and have all approved the submitted version. The study was supported by the Hellenic Health Foundation, the European Union CHANCES project and the Stavros Niarchos Foundation.

Conflict of interest

None of the authors has any conflict of interest.

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Authors and Affiliations

  1. Hellenic Health Foundation, 13 Kaisareias and Alexandroupoleos Street, 115 27, Athens, Greece

    Antonia Trichopoulou, Andreas Kyrozis, Michalis Katsoulis & Dimitrios Trichopoulos

  2. Bureau of Epidemiologic Research, Academy of Athens, 23 Alexandroupoleos Street, 115 27, Athens, Greece

    Antonia Trichopoulou, Dimitrios Trichopoulos & Pagona Lagiou

  3. 1st Department of Neurology, Eginition Hospital, University of Athens Medical School, 74 Vas. Sofias Avenue, 11528, Athens, Greece

    Andreas Kyrozis

  4. Dipartimento di Epidemiologia, IRCCS - Istituto di Ricerche Farmacologiche Mario Negri, via La Masa, 19, 20156, Milan, Italy

    Marta Rossi & Carlo La Vecchia

  5. Department of Epidemiology, Harvard School of Public Health, 677 Huntington Avenue, Boston, MA, 02115, USA

    Dimitrios Trichopoulos & Pagona Lagiou

  6. Department of Clinical Sciences and Community Health, University of Milan, Via Venezian 5, 20133, Milan, Italy

    Carlo La Vecchia

  7. Department of Hygiene, Epidemiology and Medical Statistics, University of Athens Medical School, 75 M. Asias Street, Goudi, 115 27, Athens, Greece

    Pagona Lagiou

Authors
  1. Antonia Trichopoulou
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  2. Andreas Kyrozis
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  4. Michalis Katsoulis
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Correspondence to Andreas Kyrozis.

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Trichopoulou, A., Kyrozis, A., Rossi, M. et al. Mediterranean diet and cognitive decline over time in an elderly Mediterranean population. Eur J Nutr 54, 1311–1321 (2015). https://doi.org/10.1007/s00394-014-0811-z

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  • DOI: https://doi.org/10.1007/s00394-014-0811-z

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