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Abstract
Background and Objectives Diet may reduce Alzheimer dementia risk and slow cognitive decline, but the understanding of the relevant neuropathologic mechanisms remains limited. The association of dietary patterns with Alzheimer disease (AD) pathology has been suggested using neuroimaging biomarkers. This study examined the association of Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND) and Mediterranean dietary patterns with β-amyloid load, phosphorylated tau tangles, and global AD pathology in postmortem brain tissue of older adults.
Methods Autopsied participants of the Rush Memory and Aging Project with complete dietary information (collected through a validated food frequency questionnaire) and AD pathology data (β-amyloid load, phosphorylated tau tangles, and global AD pathology [summarized neurofibrillary tangles and neuritic and diffuse plaques]) were included in this study. Linear regression models controlled for age at death, sex, education, APOE-ε4 status, and total calories were used to investigate the dietary patterns (MIND and Mediterranean diets) and dietary components associated with AD pathology. Further effect modification was tested for APOE-ε4 status and sex.
Results Among our study participants (N = 581, age at death: 91.0 ± 6.3 years; mean age at first dietary assessment: 84.2 ± 5.8 years; 73% female; 6.8 ± 3.9 years of follow-up), dietary patterns were associated with lower global AD pathology (MIND: β = −0.022, p = 0.034, standardized β = −2.0; Mediterranean: β = −0.007, p = 0.039, standardized β = −2.3) and specifically less β-amyloid load (MIND: β = −0.068, p = 0.050, standardized β = −2.0; Mediterranean: β = −0.040, p = 0.004, standardized β = −2.9). The findings persisted when further adjusted for physical activity, smoking, and vascular disease burden. The associations were also retained when participants with mild cognitive impairment or dementia at the baseline dietary assessment were excluded. Those in the highest tertile of green leafy vegetables intake had less global AD pathology when compared with those in the lowest tertile (tertile 3 vs tertile 1: β = −0.115, p = 0.0038).
Discussion The MIND and Mediterranean diets are associated with less postmortem AD pathology, primarily β-amyloid load. Among dietary components, higher green leafy vegetable intake was associated with less AD pathology.
Glossary
- AD=
- Alzheimer disease;
- FFQ=
- food frequency questionnaire;
- MAP=
- Memory and Aging Project;
- MCI=
- mild cognitive impairment;
- MIND=
- Mediterranean-DASH Intervention for Neurodegenerative Delay;
- PiB-PET=
- Pittsburgh compound B positron emission tomography
Footnotes
Go to Neurology.org/N for full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the article.
Submitted and externally peer reviewed. The handling editor was Associate Editor Linda Hershey, MD, PhD, FAAN.
Patient Page page e2321
- Received September 1, 2022.
- Accepted in final form January 26, 2023.
- © 2023 American Academy of Neurology
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