Mediterranean diet adherence is associated with reduced subjective cognitive decline in a healthy adult population

Abstract

Importance: Benefits of a Mediterranean diet on loss of cognition have been suggested, but epidemiologic studies have been relatively small and of limited duration. Objective: To assess prospectively the association between long-term adherence to the Mediterranean dietary pattern to self-reported subjective cognitive concerns. Design: Prospective observational study. Participants: The Health Professionals’ Follow-up Study, a prospective cohort of 51,529 men, 40-75 years of age when enrolled in 1986, of which 27,406 individuals were included in the primary analysis. Exposures: Mediterranean diet score, computed from the mean of 5 food frequency questionnaires, assessed every 4 years through to 2002. Main outcome measures: Self-reported subjective cognitive concerns (SCCs) assessed by a 6-item questionnaire in 2008 and 2012, and validated by association with genetic variants in APOE4. Results: Using the average of 2008 and 2012 SCC scores, 38.2% of men were considered to have moderate memory scores and 7.4% were considered to have poor memory scores. Specifically, in the multivariate model, having a cumulative MD score in the highest quintile as compared to the lowest quintile was associated with a 40% lower odds of a poor SCC score (Odds Ratio: 0.60, 95% CI: 0.51-0.71) and a 38% lower odds of a moderate SCC score (Odds Ratio: 0.72, 95% CI: 0.66-0.79). The trends for these logistic regression analyses across quintiles of the exposure were significant. A similar pattern was observed in the age-adjusted model. Conclusions and Relevance: Long-term adherence to the Mediterranean diet pattern was strongly related to lower subjective cognitive concerns. These findings provide further evidence that healthy dietary patterns may provide an important early intervention to prevent or delay cognitive decline.