Clinical pathology selected abstracts

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Editor: Deborah Sesok-Pizzini, MD, MBA, professor, Department of Clinical Pathology and Laboratory Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, and chief, Division of Transfusion Medicine, Children’s Hospital of Philadelphia.

Dietary patterns during adulthood and cognitive performance in midlife

June 2019—Cognitive impairment is associated with an increased risk of mortality, disability, and late-life dementia, which contributes to the rising costs of health care. Several studies have demonstrated cognitive decline in midlife, and some data have linked this decline to cardiovascular disease risk factors or a more sedentary lifestyle. Diet is a modifiable exposure, but few studies have analyzed the risk of cognitive impairment due to dietary factors. The Mediterranean diet (MedDiet) and Dietary approaches to Stop Hypertension (DASH) have shown potential to slow cognitive decline and reduce the risk of dementia in later life. However, results from these studies have not been consistent. The authors examined the association between three heart-healthy diet patterns characterized by MedDiet, DASH, and CARDIA A Priori Diet Quality Score (APDQS) scores and cognitive performance in midlife. They assessed 2,621 participants in the Coronary Artery Risk Development in Young Adults (CARDIA) multicenter longitudinal study who were a mean age of 25 ± 3.5 years and calculated their mean diet scores at baseline, year seven, and year 20. Cognitive function was evaluated at years 25 and 30, representing a mean age of 50 and 55 years. The authors used general linear models to determine an association between diet scores and change in composite cognitive function testing. The results showed that DASH was not associated with a change in cognitive performance. However, higher MedDiet and APDQS scores were associated with less decline in cognitive function. In addition, study participants who adhered most closely to MedDiet or APDQS had a 46 to 52 percent lower risk of poor global cognitive function after adjusting for demographic, health, and lifestyle covariates. The authors concluded that the mechanisms in which diet can influence midlife cognitive function are not clear, but they likely involve oxidative stress and inflammatory and vascular disease pathways that contribute to cognitive decline and dementia. The study also showed that greater long-term adherence to the MedDiet and APDQS diet during adulthood was associated with better midlife cognitive performance. Additional studies are needed to further examine the preferred combinations of foods and nutrients for optimal brain health.

McEvoy CT, Hoang T, Sidney S, et al. Dietary patterns during adulthood and cognitive performance in midlife: the CARDIA study. Neurology. 2019;92:e1589–e1599. doi:10.1212/WNL.0000000000007243.

Correspondence: Dr. Claire T. McEvoy at mcevoy@qub.ac.uk