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Nutrition to Prevent or Treat Cognitive Impairment in Older Adults: A GRADE Recommendation

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Abstract

Aging is associated with cognitive declines leading to mild cognitive impairments or Alzheimer disease. Nutrition appear to protect from aging. Some dietary factors could either increase or protect against cognitive declines. This article aimed to provide GRADE recommendations related to nutrition aspects able to prevent or to treat cognitive impairments. A comprehensive literature review was performed using Medline database. The GRADE approach was used to classify quality of the existing evidence (systematic review or meta-analysis). The GRADE process led us to formulate seven key nutritional recommendations to manage cognitive declines, but did not allow us to do it for protein, vitamin B or antioxidants. Thus, 1) adherence to a Mediterranean diet (GRADE 1B); 2) high-level of consumption of mono- or poly- unsaturated fatty acids combined to a low consumption of saturated fatty acids (GRADE 1B); 3) high consumption of fruits and vegetables (GRADE 1B); 4) higher vitamin D intake (GRADE 1C) than the recommended daily allowance. In addition, a ketogenic diet, a low consumption of whole-fat dairy products or a caloric restriction are promising nutritional habits although the evidence does not yet support widespread uptake (GRADE 2C). In conclusion, nutrition is an important modifiable factor to prevent or protect against cognitive decline. Nevertheless, more studies are required to determine specific guidelines such as duration and amounts of nutrients to help older adult to maintain a healthy cognitive life.

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References

  1. Peracino A, Pecorelli S. The Epidemiology of Cognitive Impairment in the Aging Population: Implications for Hearing Loss. Audiology & neuro-otology 2016;21 Suppl 1:3.

    Article  Google Scholar 

  2. Ferri CP, Prince M, Brayne C, Brodaty H, Fratiglioni L, Ganguli M, Hall K, Hasegawa K, Hendrie H, Huang Y, Jorm A, Mathers C, Menezes PR, Rimmer E, Scazufca M. Global prevalence of dementia: a Delphi consensus study. Lancet (London, England) 2005;366: 2112.

    Article  Google Scholar 

  3. McGrattan AM, McEvoy CT, McGuinness B, McKinley MC, Woodside JV. Effect of dietary interventions in mild cognitive impairment: a systematic review. The British journal of nutrition 2018;120: 1388.

    Article  CAS  Google Scholar 

  4. Rochoy M, Rivas V, Chazard E, Decarpentry E, Saudemont G, Hazard PA, Puisieux F, Gautier S, Bordet R. Factors Associated with Alzheimer’s Disease: An Overview of Reviews. The journal of prevention of Alzheimer’s disease 2019;6: 121.

    CAS  PubMed  Google Scholar 

  5. WHO. Risk reduction of cognitive decline and dementia. In, France. 2019.

  6. Ogawa S. Nutritional management of older adults with cognitive decline and dementia. Geriatrics & gerontology international 2014;14 Suppl 2: 17.4

    Google Scholar 

  7. Yusufov M, Weyandt LL, Piryatinsky I. Alzheimer’s disease and diet: a systematic review. The International journal of neuroscience 2017;127: 161.

    Article  Google Scholar 

  8. Solfrizzi V, Panza F, Frisardi V, Seripa D, Logroscino G, Imbimbo BP, Pilotto A. Diet and Alzheimer’s disease risk factors or prevention: the current evidence. Expert review of neurotherapeutics 2011;11: 677.

    Article  CAS  Google Scholar 

  9. Samadi M, Moradi S, Moradinazar M, Mostafai R, Pasdar Y. Dietary pattern in relation to the risk of Alzheimer’s disease: a systematic review. Neurological sciences: official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology, 2019

  10. Brozek JL, Akl EA, Alonso-Coello P, Lang D, Jaeschke R, Williams JW, Phillips B, Lelgemann M, Lethaby A, Bousquet J, Guyatt GH, Schunemann HJ. Grading quality of evidence and strength of recommendations in clinical practice guidelines. Part 1 of 3. An overview of the GRADE approach and grading quality of evidence about interventions. Allergy 2009;64: 669.

    Article  CAS  Google Scholar 

  11. Aurora RN, Zak RS, Auerbach SH, Casey KR, Chowdhuri S, Karippot A, Maganti RK, Ramar K, Kristo DA, Bista SR, Lamm CI, Morgenthaler TI. Best practice guide for the treatment of nightmare disorder in adults. Journal of clinical sleep medicine: JCSM: official publication of the American Academy of Sleep Medicine 2010; 6: 389.

    Google Scholar 

  12. Otaegui-Arrazola A, Amiano P, Elbusto A, Urdaneta E, Martinez-Lage P. Diet, cognition, and Alzheimer’s disease: food for thought. European journal of nutrition 2014;53: 1.

    Article  CAS  Google Scholar 

  13. Aridi YS, Walker JL, Wright ORL. The Association between the Mediterranean Dietary Pattern and Cognitive Health: A Systematic Review. Nutrients 2017;9.

  14. Cao GY, Li M, Han L, Tayie F, Yao SS, Huang Z, Ai P, Liu YZ, Hu YH, Xu B. Dietary Fat Intake and Cognitive Function among Older Populations: A Systematic Review and Meta-Analysis. The journal of prevention of Alzheimer’s disease2019; 6: 204.

  15. Zhang Y, Chen J, Qiu J, Li Y, Wang J, Jiao J. Intakes of fish and polyunsaturated fatty acids and mild-to-severe cognitive impairment risks: a dose-response meta-analysis of 21 cohort studies. The American journal of clinical nutrition 2016;103: 330.

    Article  CAS  Google Scholar 

  16. Mottaghi T, Amirabdollahian F, Haghighatdoost F. Fruit and vegetable intake and cognitive impairment: a systematic review and meta-analysis of observational studies. European journal of clinical nutrition 2018;72: 1336.

    Article  Google Scholar 

  17. Wesselman LMP, Doorduijn AS, de Leeuw FA, Verfaillie SCJ, van Leeuwenstijn-Koopman M, Slot RER, Kester MI, Prins ND, van de Rest O, de van der Schueren MAE, Scheltens P, Sikkes SAM, van der Flier WM. Dietary Patterns Are Related to Clinical Characteristics in Memory Clinic Patients with Subjective Cognitive Decline: The SCIENCe Project. Nutrients 2019;11.

  18. Krause D, Roupas P. Effect of Vitamin Intake on Cognitive Decline in Older Adults: Evaluation of the Evidence. The journal of nutrition, health & aging 2015;19: 745.

    Article  CAS  Google Scholar 

  19. Sommer I, Griebler U, Kien C, Auer S, Klerings I, Hammer R, Holzer P, Gartlehner G. Vitamin D deficiency as a risk factor for dementia: a systematic review and meta-analysis. BMC geriatrics 2017;17: 16.

    Article  Google Scholar 

  20. Goodwill AM, Szoeke C. A Systematic Review and Meta-Analysis of The Effect of Low Vitamin D on Cognition. Journal of the American Geriatrics Society 2017; 65: 2161.

    Article  Google Scholar 

  21. Butler M, Nelson VA, Davila H, Ratner E, Fink HA, Hemmy LS, McCarten JR, Barclay TR, Brasure M, Kane RL. Over-the-Counter Supplement Interventions to Prevent Cognitive Decline, Mild Cognitive Impairment, and Clinical Alzheimer-Type Dementia: A Systematic Review. Annals of internal medicine 2018;168: 52.

    Article  Google Scholar 

  22. Wlodarek D. Role of Ketogenic Diets in Neurodegenerative Diseases (Alzheimer’s Disease and Parkinson’s Disease). Nutrients 2019;11.

  23. White; H, Venkatesh; K, Venkatesh B. Systematic Review of the Use of Ketones in the Management of Acute and Chronic Neurological Disorders. Journal of neurology and neuroscience 2017;8: 188.

    Article  Google Scholar 

  24. Lilamand M, Porte B, Cognat E, Hugon J, Mouton-Liger F, Paquet C. Are ketogenic diets promising for Alzheimer’s disease? A translational review. Alzheimer’s research & therapy 2020;12: 42.

    Article  Google Scholar 

  25. Lee J, Fu Z, Chung M, Jang DJ, Lee HJ. Role of milk and dairy intake in cognitive function in older adults: a systematic review and meta-analysis. Nutrition journal 2018;17: 82.

    Article  Google Scholar 

  26. Siervo M, Arnold R, Wells JC, Tagliabue A, Colantuoni A, Albanese E, Brayne C, Stephan BC. Intentional weight loss in overweight and obese individuals and cognitive function: a systematic review and meta-analysis. Obesity reviews: an official journal of the International Association for the Study of Obesity 2011;12: 968.

    Article  CAS  Google Scholar 

  27. Gillette-Guyonnet S, Vellas B. Caloric restriction and brain function. Current opinion in clinical nutrition and metabolic care 2008;11: 686.

    Article  CAS  Google Scholar 

  28. Levenson CW, Rich NJ. Eat less, live longer? New insights into the role of caloric restriction in the brain. Nutrition reviews 2007;65: 412.

    Article  Google Scholar 

  29. Cremonini AL, Caffa I, Cea M, Nencioni A, Odetti P, Monacelli F. Nutrients in the Prevention of Alzheimer’s Disease. Oxidative medicine and cellular longevity 2019: 9874159.

  30. Glenn JM, Madero EN, Bott NT. Dietary Protein and Amino Acid Intake: Links to the Maintenance of Cognitive Health. Nutrients 2019;11.

  31. Koh F, Charlton K, Walton K, McMahon AT. Role of dietary protein and thiamine intakes on cognitive function in healthy older people: a systematic review. Nutrients 2015;7: 2415.

    Article  Google Scholar 

  32. Ford AH, Almeida OP. Effect of Vitamin B Supplementation on Cognitive Function in the Elderly: A Systematic Review and Meta-Analysis. Drugs & aging 2019;36: 419.

    Article  CAS  Google Scholar 

  33. Forbes SC, Holroyd-Leduc JM, Poulin MJ, Hogan DB. Effect of Nutrients, Dietary Supplements and Vitamins on Cognition: a Systematic Review and Meta-Analysis of Randomized Controlled Trials. Canadian geriatrics journal: CGJ 2015;18: 231.

    Article  Google Scholar 

  34. Rafnsson SB, Dilis V, Trichopoulou A. Antioxidant nutrients and age-related cognitive decline: a systematic review of population-based cohort studies. European journal of nutrition 2013;52: 1553.

    Article  CAS  Google Scholar 

  35. Crichton GE, Bryan J, Murphy KJ. Dietary antioxidants, cognitive function and dementia—a systematic review. Plant foods for human nutrition (Dordrecht, Netherlands) 2013;68: 279.

    Article  CAS  Google Scholar 

  36. Abdelhamid A, Bunn D, Copley M, Cowap V, Dickinson A, Gray L, Howe A, Killett A, Lee J, Li F, Poland F, Potter J, Richardson K, Smithard D, Fox C, Hooper L. Effectiveness of interventions to directly support food and drink intake in people with dementia: systematic review and meta-analysis. BMC geriatrics 2016;16: 26.

    Article  Google Scholar 

  37. Roberts HC, Lim SER, Cox NJ, Ibrahim K. The Challenge of Managing Undernutrition in Older People with Frailty. Nutrients 2019;11.

  38. Heelan M, Prieto J, Roberts H, Gallant N, Barnes C, Green S. The use of finger foods in care settings: an integrative review. Journal of human nutrition and dietetics: the official journal of the British Dietetic Association 2020;33: 187.

    Article  CAS  Google Scholar 

  39. G. Cuvelier VPAGLB. Attractiveness and consumption of finger foods in elderly Alzheimer’s disease patients. Food Quality and Preference 2014;34: 62.

    Article  Google Scholar 

  40. Cluskey M, Kim YK. Use and perceived effectiveness of strategies for enhancing food and nutrient intakes among elderly persons in long-term care. Journal of the American Dietetic Association 2001;101: 111.

    Article  CAS  Google Scholar 

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Funding

M. Aubertin-Leheudre and F. Buckinx are supported by the Fonds de Recherche du Québec Santé (FRQS). F. Buckinx is also supported by the IRSC (Instituts de recherche en santé du Canada).

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Correspondence to Mylene Aubertin-Leheudre.

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Buckinx, F., Aubertin-Leheudre, M. Nutrition to Prevent or Treat Cognitive Impairment in Older Adults: A GRADE Recommendation. J Prev Alzheimers Dis 8, 110–116 (2021). https://doi.org/10.14283/jpad.2020.40

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