Written by Harold Oster, MD. Results suggest that an anti-inflammatory diet is associated with a lower risk of dementia in older adults with or without cardiometabolic diseases.
Dementia is an acquired loss of cognition across multiple domains, severely affecting social and occupational function. It is estimated that 50 million people worldwide are living with dementia, and that number is expected to increase1. The prevalence of comorbidities in individuals with dementia is high, in part due to poor access to medical care2. Additionally, chronic inflammation is a significant risk factor in the development of dementia and various cardiometabolic diseases (CMDs), including diabetes, ischemic heart disease, and stroke3. Diet plays a role in the development of chronic inflammation. The Dietary Inflammatory Index (DII) is a measure of the pro-inflammatory and anti-inflammatory constituents in an individual’s diet4.
Abigail Dove, MSc et al. studied the associations between CMDs, the Dietary Inflammatory Index, and the risk of dementia and brain MRI findings associated with impaired cognition and dementia. The authors analyzed data gathered for the UK Biobank, a biomedical database containing health information from over 500,000 older individuals5. 84,559 Biobank participants aged sixty or older were evaluated by questionnaires and medical examinations between 2006 and 2010. Between 2014 and 2020, 8,917 of these participants completed a brain MRI scan. Information regarding diabetes, heart disease, and stroke was assessed through blood testing for hemoglobin A1C and examination of medical records. Dietary Inflammatory Index was assessed with the Oxford WebQ, a 24-hour dietary questionnaire6, administered at baseline and up to four times during the follow-up period. Participants were placed into three categories based on their scores: anti-inflammatory, neutral, and pro-inflammatory. The diagnosis of dementia was ascertained through medical records and self-reporting. Brain MRI scans were analyzed for findings associated with dementia: total brain volume (TBV), gray matter volume (GMV), white matter volume (WMV), hippocampal volume (HV), and white matter hyperintensity volume (WMHV)7. Possible covariables were assessed by questionnaire and physical examination and included demographics, educational level, medical history, blood pressure, body mass index, and lifestyle factors.
The authors noted the following:
- Based on inclusion criteria, data from 84,342 participants was used for the study.
- The average age of participants was 64.1 years, and 51.2% were female.
- 1,559 (1.9%) individuals developed dementia.
- After adjustment for covariables, the presence of any CMDs was associated with an 81% increased risk of developing dementia compared to those without any CMDs.
- Those reporting an anti-inflammatory diet had a lower risk of developing dementia than those with a pro-inflammatory diet. (HR of 0.79)
- Participants with CMDs who were on an anti-inflammatory diet had a lower risk of dementia than those on a pro-inflammatory diet. (HR of 0.69)
- The presence of CMDs was associated with smaller TBV, GMV, WMV, and HV and larger WMHV on brain MRI, all findings being consistent with cognitive decline.
- Compared to those on a proinflammatory diet, participants on an anti-inflammatory diet had a larger TBV, GMV, and WMV but no difference in HV.
- Participants with CMDs and a pro-inflammatory diet had smaller GMV and larger WMHV (consistent with cognitive decline) than those with CMDs and an anti-inflammatory diet.
Results suggest that in older individuals with or without cardiometabolic diseases, an anti-inflammatory diet is associated with a lower risk of developing dementia and brain MRI findings commonly seen in dementia and cognitive decline. The study’s limitations include its cross-sectional design, possible selection bias, the use of questionnaires to assess diet, and possible residual confounding.
Source: Dove, Abigail, Michelle M. Dunk, Jiao Wang, Jie Guo, Rachel A. Whitmer, and Weili Xu. “Anti-inflammatory diet and dementia in older adults with cardiometabolic diseases.” JAMA Network Open 7, no. 8 (2024): e2427125-e2427125.
Open Access. This is an open access article distributed under the terms of the CC-BY License
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Posted September 24, 2024.
Harold Oster, MD graduated from medical school in Miami, Florida in 1992 and moved to Minnesota in 2004. After more than 25 years of practicing Internal Medicine, he recently retired. Dr. Oster is especially interested in nutrition, weight management, and disease prevention. Visit his website at haroldoster.com.
References:
- Arvanitakis Z, Shah RC, Bennett DA. Diagnosis and Management of Dementia: Review. Jama. Oct 22 2019;322(16):1589-1599. doi:10.1001/jama.2019.4782
- Bunn F, Burn AM, Goodman C, et al. Comorbidity and dementia: a scoping review of the literature. BMC Med. Oct 31 2014;12:192. doi:10.1186/s12916-014-0192-4
- Furman D, Campisi J, Verdin E, et al. Chronic inflammation in the etiology of disease across the life span. Nat Med. Dec 2019;25(12):1822-1832. doi:10.1038/s41591-019-0675-0
- Shivappa N, Steck SE, Hurley TG, Hussey JR, Hébert JR. Designing and developing a literature-derived, population-based dietary inflammatory index. Public Health Nutr. Aug 2014;17(8):1689-96. doi:10.1017/s1368980013002115
- Sudlow C, Gallacher J, Allen N, et al. UK biobank: an open access resource for identifying the causes of a wide range of complex diseases of middle and old age. PLoS Med. Mar 2015;12(3):e1001779. doi:10.1371/journal.pmed.1001779
- Liu B, Young H, Crowe FL, et al. Development and evaluation of the Oxford WebQ, a low-cost, web-based method for assessment of previous 24 h dietary intakes in large-scale prospective studies. Public Health Nutr. Nov 2011;14(11):1998-2005. doi:10.1017/s1368980011000942
- Furtner J, Prayer D. Neuroimaging in dementia. Wiener medizinische Wochenschrift (1946). Sep 2021;171(11-12):274-281. Bildgebung in der Demenzdiagnostik. doi:10.1007/s10354-021-00825-x
