Race/ethnicity and gender modify the association between diet and cognition in US older adults: National Health and Nutrition Examination Survey 2011-2014

Authors: GU, YIAN - Columbia University - New York; GUO, JING - Columbia University - New York; Moshfegh, Alanna

Submitted to: Alzheimer's & Dementia
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 11/25/2020
Publication Date: 2/14/2021
Citation: Gu, Y., Guo, J., Moshfegh, A.J. 2021. Race/ethnicity and gender modify the association between diet and cognition in US older adults: National Health and Nutrition Examination Survey 2011-2014. Alzheimer's & Dementia. 7(1). https://doi.org/10.1002/trc2.12128.
DOI: https://doi.org/10.1002/trc2.12128

Interpretive Summary: With an ageing population, cognitive impairment and dementia has emerged as a public health challenge worldwide. Currently, there is no effective medical treatment for dementia. Primary prevention through modifiable risk factors, such as healthy dietary habits, is thus an urgent priority to reduce the incidence of cognitive impairment and dementia. The Mediterranean diet (MeDi), characterized by a high consumption of olive oil, leafy green vegetables, fruits, cereals, legumes and nuts, fish, low intake of meat and dairy products, and moderate consumption of alcohol; is the most commonly examined dietary pattern in the cognitive aging literature and shows a promising beneficial role on cognitive function in older adults, although the findings are not always consistent. This study examines the association between diet and global cognition of 2,435 participants (>/=60 years) of the NHANES 2011-2014. Results show that a high adherence to MeDi was associated with better cognition in older adults aged 60 and above. Furthermore, the positive association between MeDi and cognition seemed to be dependent on race/ethnicity and gender, with stronger association in men than in women, and in non-Hispanic whites than in other racial/ethnic groups. These results confirm previous reports on adherence to Mediterranean-type diet and cognition in NHANES study population.

Technical Abstract: With an ageing population, cognitive impairment and dementia has emerged as a public health challenge worldwide. Currently, there is no effective medical treatment for dementia. Primary prevention through modifiable risk factors, such as healthy dietary habits, is thus an urgent priority to reduce the incidence of cognitive impairment and dementia. The Mediterranean diet (MeDi), characterized by a high consumption of olive oil, leafy green vegetables, fruits, cereals, legumes and nuts, fish, low intake of meat and dairy products, and moderate consumption of alcohol; is the most commonly examined dietary pattern in the cognitive aging literature and shows a promising beneficial role on cognitive function in older adults. It is unclear whether the association between MeDi and cognition is similar across different racial/ethnic groups or between women and men. The current study included 2,435 participants (>/=60 years) of the NHANES 2011-2014. Linear regression models were applied to examine the association between diet and global cognition, adjusted for multiple demographic variables. Interaction between MeDi and race/ethnicity (non-Hispanic white, non-Hispanic black, Hispanic, Other), and between MeDi and gender, were examined, followed by stratified analyses. One score increase in MeDi was associated with (ß=0.039, 95%CI=0.016-0.062) higher global cognitive z score. Significant associations between MeDi and global cognition and between MeDi and immediate recall were found in the non-Hispanic white only (p-interaction=0.057 and 0.059, respectively). MeDi was associated with increased score of animal fluency score in men but not in women (p-interaction=0.082). These results confirm previous reports on adherence to Mediterranean-type diet and cognition in NHANES study population.