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Published in: The journal of nutrition, health & aging 10/2017

01-12-2017

Dietary diversity and cognitive function among elderly people: A population-based study

Authors: Z. Yin, Z. Fei, C. Qiu, M. S. Brasher, V. B. Kraus, Wenhua Zhao, Xiaoming Shi, Yi Zeng

Published in: The journal of nutrition, health & aging | Issue 10/2017

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Abstract

Objectives

To explore associations of dietary diversity with cognitive function among Chinese elderly.

Design

This cross-sectional study was conducted in 2011-2012, data were analyzed using multiple linear regression and logistic regression models.

Setting

community-based setting in the 23 provinces in China.

Subjects

8,571 elderly participants, including 2984 younger elderly aged 65-79 and 5587 oldest old aged 80+ participated in this study.

Measurement

Intake frequencies of food groups was collected and dietary diversity (DD) was assessed based on the mean of DD score. Cognitive function was assessed using the Chinese version of Mini-Mental State Examination (MMSE), and cognitive impairment was defined using education-based cutoffs. Information about socio-demographics, lifestyles, resilience and health status was also collected.

Results

Poor dietary diversity was significantly associated with cognitive function, with β (95% CI) of -0.11(-0.14, -0.08) for – log (31-MMSE score) and odds ratio (95% CI) of 1.29 (1.14, 1.47) for cognitive impairment. Interaction effect of age with DD was observed on cognitive impairment (P interaction=0.018), but not on–log (31-MMSE score) (P interaction=0.08). Further separate analysis showed that poor DD was significantly associated with increased risk of cognitive impairment in the oldest old (p<0.01), with odds ratio (95% CI) of 1.34 (1.17, 1.54), while not in the younger elderly (p>0.05), with OR (95% CI) being 1.09 (0.80, 1.47) in the fully adjusted model. Similar results were obtained when DD was categorized into four groups.

Conclusions

Poor dietary diversity was associated with worse global cognitive function among Chinese elderly, and particularly for the oldest old. This finding would be very meaningful for prevention of cognitive impairment.
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Literature
1.
go back to reference Chan KY, Wang W, Wu JJ, et al. Epidemiology of Alzheimer’s disease and other forms of dementia in China, 1990-2010: a systematic review and analysis. Lancet 2013; 81: 2016–2023.CrossRef Chan KY, Wang W, Wu JJ, et al. Epidemiology of Alzheimer’s disease and other forms of dementia in China, 1990-2010: a systematic review and analysis. Lancet 2013; 81: 2016–2023.CrossRef
2.
go back to reference Krebs-Smith SM, Smiciklas-Wright H, Guthrie HA, et al. The effects of variety in food choices on dietary quality. J Am Diet Assoc 1987; 87: 897–903.PubMed Krebs-Smith SM, Smiciklas-Wright H, Guthrie HA, et al. The effects of variety in food choices on dietary quality. J Am Diet Assoc 1987; 87: 897–903.PubMed
3.
go back to reference World Health Organization (WHO). Preparation and Use of Food-Based Dietary Guidelines: Report of a Joint Fao/Who Consultation. WHO; Geneva, Switzerland, 1998. World Health Organization (WHO). Preparation and Use of Food-Based Dietary Guidelines: Report of a Joint Fao/Who Consultation. WHO; Geneva, Switzerland, 1998.
4.
go back to reference Mirmiran P, Azadbakht L, Esmaillzadeh A, et al. Dietary diversity score in adolescents-a good indicator of the nutritional adequacy of diets: Tehran lipid and glucose study. Asia Pac J Clin Nutr 2004;13, 56–60.PubMed Mirmiran P, Azadbakht L, Esmaillzadeh A, et al. Dietary diversity score in adolescents-a good indicator of the nutritional adequacy of diets: Tehran lipid and glucose study. Asia Pac J Clin Nutr 2004;13, 56–60.PubMed
5.
go back to reference Oldewage-Theron WH, Kruger R. Food Variety and Dietary Diversity as Indicators of the Dietary Adequacy and Health Status of an Elderly Population in Sharpeville, South Africa. J Nutr Elder 2008; 7: 101–133.CrossRef Oldewage-Theron WH, Kruger R. Food Variety and Dietary Diversity as Indicators of the Dietary Adequacy and Health Status of an Elderly Population in Sharpeville, South Africa. J Nutr Elder 2008; 7: 101–133.CrossRef
6.
go back to reference Beydoun MA, Gamaldo AA, Beydoun HA, et al. Caffeine and alcohol intakes and overall nutrient adequacy are associated with longitudinal cognitive performance among U.S. adults. J Nutr 2014; 144: 890–901.CrossRefPubMed Beydoun MA, Gamaldo AA, Beydoun HA, et al. Caffeine and alcohol intakes and overall nutrient adequacy are associated with longitudinal cognitive performance among U.S. adults. J Nutr 2014; 144: 890–901.CrossRefPubMed
7.
go back to reference Otsuka R, Nishita Y, Tange C, et al. Dietary diversity decreases the risk of cognitive decline among Japanese older adult. Geriatr Gerontol Int 2016, doi: 10.1111/ggi.12817. Otsuka R, Nishita Y, Tange C, et al. Dietary diversity decreases the risk of cognitive decline among Japanese older adult. Geriatr Gerontol Int 2016, doi: 10.1111/ggi.12817.
8.
go back to reference Pilleron S, Desport JC, Jésus P, et al. Diet, Alcohol Consumption and Cognitive Disorders in Central Africa: A Study from the EPIDEMCA Program. J Nutr Health Aging, 2015; 19: 657–667.CrossRefPubMed Pilleron S, Desport JC, Jésus P, et al. Diet, Alcohol Consumption and Cognitive Disorders in Central Africa: A Study from the EPIDEMCA Program. J Nutr Health Aging, 2015; 19: 657–667.CrossRefPubMed
9.
go back to reference Singh B, Parsaik AK, Mielke MM, et al. Association of mediterranean diet with mild cognitive impairment and Alzheimer’s disease: a systematic review and metaanalysis. J Alzheimers Dis 2014; 39: 271–282PubMedPubMedCentral Singh B, Parsaik AK, Mielke MM, et al. Association of mediterranean diet with mild cognitive impairment and Alzheimer’s disease: a systematic review and metaanalysis. J Alzheimers Dis 2014; 39: 271–282PubMedPubMedCentral
10.
go back to reference Alexander M, Perera G, Ford L, et al. Age-Stratified Prevalence of Mild Cognitive Impairment and Dementia in European Populations: A Systematic Review. J Alzheimers Dis 2015; 48: 355–359.CrossRefPubMed Alexander M, Perera G, Ford L, et al. Age-Stratified Prevalence of Mild Cognitive Impairment and Dementia in European Populations: A Systematic Review. J Alzheimers Dis 2015; 48: 355–359.CrossRefPubMed
11.
go back to reference Yi Zeng. Towards Deeper Research and Better Policy for Healthy Aging—Using the Unique Data of Chinese Longitudinal Healthy Longevity Survey. China Economic Journal 2012; 5: 2–3, 131-149. Yi Zeng. Towards Deeper Research and Better Policy for Healthy Aging—Using the Unique Data of Chinese Longitudinal Healthy Longevity Survey. China Economic Journal 2012; 5: 2–3, 131-149.
12.
go back to reference Zhang MY, Katzman R, Salmon D et al. The prevalence of dementia and Alzheimer’s disease in Shanghai, China: impact of age, gender, and education. Ann Neurol 1990; 27: 428–437.CrossRefPubMed Zhang MY, Katzman R, Salmon D et al. The prevalence of dementia and Alzheimer’s disease in Shanghai, China: impact of age, gender, and education. Ann Neurol 1990; 27: 428–437.CrossRefPubMed
13.
go back to reference Bravo G, Hebert R. Age-and education-specific reference values for the Mini-Mental and modified Mini-Mental State Examinations derived from a non-demented elderly population. Int J Geriatr Psychiatry 1997;12:1008–1018.CrossRefPubMed Bravo G, Hebert R. Age-and education-specific reference values for the Mini-Mental and modified Mini-Mental State Examinations derived from a non-demented elderly population. Int J Geriatr Psychiatry 1997;12:1008–1018.CrossRefPubMed
14.
go back to reference Grigoletto F, Zappalà G, Anderson DW, et al. Norms for the Mini-Mental State Examination in a healthy population. Neurology 1999; 53: 315–320.CrossRefPubMed Grigoletto F, Zappalà G, Anderson DW, et al. Norms for the Mini-Mental State Examination in a healthy population. Neurology 1999; 53: 315–320.CrossRefPubMed
15.
go back to reference Yin Z, Yan Z, Liang Y, et al. Interactive effects of diabetes and impaired kidney function on cognitive performance in old age: a population-based study. BMC Geriatr 2016;16:7.CrossRefPubMedPubMedCentral Yin Z, Yan Z, Liang Y, et al. Interactive effects of diabetes and impaired kidney function on cognitive performance in old age: a population-based study. BMC Geriatr 2016;16:7.CrossRefPubMedPubMedCentral
16.
go back to reference Ruel MT. Operationalizing Dietary Diversity: A Review of Measurement Issues and Research Priorities. J Nutr. 2003;133: 3911S–3926S.CrossRefPubMed Ruel MT. Operationalizing Dietary Diversity: A Review of Measurement Issues and Research Priorities. J Nutr. 2003;133: 3911S–3926S.CrossRefPubMed
17.
go back to reference Yin Z, Shi X, Kraus VB, et al. Gender-dependent Association of Body Mass Index and Waist Circumference with Disability in the Chinese Oldest Old. Obesity (Silver Spring) 22:1918-1925. Yin Z, Shi X, Kraus VB, et al. Gender-dependent Association of Body Mass Index and Waist Circumference with Disability in the Chinese Oldest Old. Obesity (Silver Spring) 22:1918-1925.
19.
go back to reference Yin ZX, Shi XM, Xu JW, et al. Association between the hypersensitive C-reactive protein and diabetes in the senile elders. Chinese Journal of Diabetes, 2012; 20: 332–335. Yin ZX, Shi XM, Xu JW, et al. Association between the hypersensitive C-reactive protein and diabetes in the senile elders. Chinese Journal of Diabetes, 2012; 20: 332–335.
20.
go back to reference Zeng Y, Shen K. Resilience significantly contributes to Exceptional longevity. Curr Gerontol Geriatr Res 2010: 525693. Zeng Y, Shen K. Resilience significantly contributes to Exceptional longevity. Curr Gerontol Geriatr Res 2010: 525693.
21.
go back to reference Katz S., Ford AB, Moscowitz RW, JACKSON BA, JAFFE MW. The index of ADL: A standardized measure of biological and psychosocial function. JAMA, 1963; 185: 914–919.CrossRefPubMed Katz S., Ford AB, Moscowitz RW, JACKSON BA, JAFFE MW. The index of ADL: A standardized measure of biological and psychosocial function. JAMA, 1963; 185: 914–919.CrossRefPubMed
22.
go back to reference Kennedy G, Ballard T & Dop MC. Guidelines for Measuring Household and Individual Dietary Diversity. Rome: FAO of the UN 2013. Kennedy G, Ballard T & Dop MC. Guidelines for Measuring Household and Individual Dietary Diversity. Rome: FAO of the UN 2013.
23.
go back to reference M. Fotuhi, B. Lubinski, M. Trullinger, et al. A personalized 12-week ‘brain fitness program’ for improving cognitive function and increasing the volume of hippocampus in elderly with mild cognitive impairment. J Prev Alz Dis 2016; 3: 133–137. M. Fotuhi, B. Lubinski, M. Trullinger, et al. A personalized 12-week ‘brain fitness program’ for improving cognitive function and increasing the volume of hippocampus in elderly with mild cognitive impairment. J Prev Alz Dis 2016; 3: 133–137.
24.
go back to reference Rathnayake KM, Madushani P, Silva K. Use of dietary diversity score as a proxy indicator of nutrient adequacy of rural elderly people in Sri Lanka. BMC Res Notes 2012;5:469.CrossRefPubMedPubMedCentral Rathnayake KM, Madushani P, Silva K. Use of dietary diversity score as a proxy indicator of nutrient adequacy of rural elderly people in Sri Lanka. BMC Res Notes 2012;5:469.CrossRefPubMedPubMedCentral
25.
go back to reference Mirmiran P, Azadbakht L, Azizi F. Dietary diversity within food groups: an indicator of specific nutrient adequacy in Teheranian women. J Am Coll Nutr 2006; 25: 354–361.CrossRefPubMed Mirmiran P, Azadbakht L, Azizi F. Dietary diversity within food groups: an indicator of specific nutrient adequacy in Teheranian women. J Am Coll Nutr 2006; 25: 354–361.CrossRefPubMed
26.
go back to reference Wang HP, Liang J, Kuo LM, et al. Trajectories of Nutritional Status and Cognitive Impairment among Older Taiwanese with Hip Fracture. J Nutr Health Aging 2017; 21(1): 38–45.CrossRefPubMed Wang HP, Liang J, Kuo LM, et al. Trajectories of Nutritional Status and Cognitive Impairment among Older Taiwanese with Hip Fracture. J Nutr Health Aging 2017; 21(1): 38–45.CrossRefPubMed
27.
go back to reference Chen LY, Liu LK, Hwang AC, et al. Impact of Malnutrition on Physical, Cognitive Function and Mortality among Older Men Living in Veteran Homes by Minimum Data Set: A Prospective Cohort Study in Taiwan. J Nutr Health Aging 2016; 20: 41–47.CrossRefPubMed Chen LY, Liu LK, Hwang AC, et al. Impact of Malnutrition on Physical, Cognitive Function and Mortality among Older Men Living in Veteran Homes by Minimum Data Set: A Prospective Cohort Study in Taiwan. J Nutr Health Aging 2016; 20: 41–47.CrossRefPubMed
28.
go back to reference Narmaki E, Siassi F, Fariba Koohdani, et al. Dietary diversity as a proxy measure of blood antioxidant status in women. Nutrition 2015; 31: 722–726.CrossRefPubMed Narmaki E, Siassi F, Fariba Koohdani, et al. Dietary diversity as a proxy measure of blood antioxidant status in women. Nutrition 2015; 31: 722–726.CrossRefPubMed
29.
go back to reference Moreira PL, Villas Boas PJ, Ferreira AL. Association between oxidative stress and nutritional status in the elderly. Rev Assoc Med Bras 2014; 60: 75–83.CrossRefPubMed Moreira PL, Villas Boas PJ, Ferreira AL. Association between oxidative stress and nutritional status in the elderly. Rev Assoc Med Bras 2014; 60: 75–83.CrossRefPubMed
30.
go back to reference Guidi I, Galimberti D, Lonati S, et al. Oxidative imbalance in patients with mild cognitive impairment and Alzheimer’s disease. Neurobiol Aging 2006; 27: 262–269.CrossRefPubMed Guidi I, Galimberti D, Lonati S, et al. Oxidative imbalance in patients with mild cognitive impairment and Alzheimer’s disease. Neurobiol Aging 2006; 27: 262–269.CrossRefPubMed
31.
go back to reference Phillips RM. Nutrition and depression in the community-based oldest old. Home Healthc Nurse, 2012; 30: 462–471.CrossRefPubMed Phillips RM. Nutrition and depression in the community-based oldest old. Home Healthc Nurse, 2012; 30: 462–471.CrossRefPubMed
32.
go back to reference Andriollo-Sanchez M, Hininger-Favier I, Meunier N, et al. Age-related oxidative stress and antioxidant parameters in middle-aged and older European subjects: the ZENITH study. Eur J Clin Nutr 2005;59: S58–62.CrossRefPubMed Andriollo-Sanchez M, Hininger-Favier I, Meunier N, et al. Age-related oxidative stress and antioxidant parameters in middle-aged and older European subjects: the ZENITH study. Eur J Clin Nutr 2005;59: S58–62.CrossRefPubMed
33.
go back to reference Hassina Massudi, Ross Grant, Nady Braidy, Jade Guest, Bruce Farnsworth, Gilles J. Guillemin. Age-Associated Changes In Oxidative Stress and NAD+ Metabolism In Human Tissue. PLoS One, 2012;7: e42357. Hassina Massudi, Ross Grant, Nady Braidy, Jade Guest, Bruce Farnsworth, Gilles J. Guillemin. Age-Associated Changes In Oxidative Stress and NAD+ Metabolism In Human Tissue. PLoS One, 2012;7: e42357.
34.
go back to reference Semenchenko GV, Khazaeli AA, Curtsinger JW, Yashin AI. Stress resistance declines with age: analysis of data from a survival experiment with Drosophila melanogaster. Biogerontology 2004;5:17–30.CrossRef Semenchenko GV, Khazaeli AA, Curtsinger JW, Yashin AI. Stress resistance declines with age: analysis of data from a survival experiment with Drosophila melanogaster. Biogerontology 2004;5:17–30.CrossRef
35.
go back to reference Troncale JA. The aging process: physiologic changes and pharmacologic implications. Postgrad Med 1996;99:111–114, 120–122.CrossRef Troncale JA. The aging process: physiologic changes and pharmacologic implications. Postgrad Med 1996;99:111–114, 120–122.CrossRef
Metadata
Title
Dietary diversity and cognitive function among elderly people: A population-based study
Authors
Z. Yin
Z. Fei
C. Qiu
M. S. Brasher
V. B. Kraus
Wenhua Zhao
Xiaoming Shi
Yi Zeng
Publication date
01-12-2017
Publisher
Springer Paris
Published in
The journal of nutrition, health & aging / Issue 10/2017
Print ISSN: 1279-7707
Electronic ISSN: 1760-4788
DOI
https://doi.org/10.1007/s12603-017-0912-5

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