Association of Mediterranean Diet With Cognitive Decline Among Diverse Hispanic or Latino Adults From the Hispanic Community Health Study/Study of Latinos
Creators: name: Cai, Jianwen
name: Isasi, Carmen R.
name: Stickel, Ariana
name: González, Hector M.
name: Talavera, Gregory A.
name: Sotres-Alvarez, Daniela
name: Tarraf, Wassim
name: Trifan, Gabriela
name: Mattei, Josiemer
name: Testai, Fernando D.
name: Moustafa, Bayan
name: Daviglus, Martha L.
name: Lipton, Richard B.
Publisher: name: American Medical Association (AMA)
Year: 2022

description: <p>Importance: The Mediterranean diet may reduce the burden of Alzheimer disease and other associated dementias in Hispanic or Latino people. Objective: To investigate the association of a Mediterranean diet with cognitive performance among community-dwelling Hispanic or Latino adults. Design, Setting, and Participants: This cohort study analyzed data from the Hispanic Community Health Study/Study of Latinos (HCHS/SOL) and the Study of Latinos-Investigation of Neurocognitive Aging (SOL-INCA), an HCHS/SOL ancillary study. Cognition tests were administered in the HCHS/SOL from March 2008 to June 2011 (visit 1) and in the SOL-INCA from October 2015 to March 2018 (visit 2). Participants included in the present study had completed a diet assessment at visit 1 and neurocognitive evaluations at visits 1 and 2. Data were analyzed from September 2021 to May 2022. Exposures: Mediterranean diet adherence was ascertained using the Mediterranean diet score (MDS) and was categorized as low (MDS: 0-4 points), moderate (MDS: 5-6 points), or high (MDS: 7-9 points). The mean of two 24-hour dietary recalls was used to calculate the MDS. Main Outcomes and Measures: Cognitive change between visits 1 and 2 was calculated by subtracting the cognitive score at visit 2 from the cognitive score at visit 1 and adjusting by the time elapsed between visits and cognitive score at visit 1. Neurocognitive tests administered were Brief Spanish-English Verbal Learning Test (B-SEVLT) Sum, B-SEVLT Recall, word fluency, and Digit Symbol Substitution Test (DSST). Results of each test were z score-transformed and the means were averaged to create a global cognition score. Complex sample linear regression analysis was used to ascertain the association between MDS and neurocognitive performance at each visit and neurocognitive change. Results: A total of 6321 participants (mean [SE] age, 56.1 [0.18] years at visit 1; n&thinsp;=&thinsp;4077 women [57.8%]) were included. Mediterranean diet adherence weighted frequencies were 35.8% (n&thinsp;=&thinsp;2112 of 6321) for the low adherence group, 45.4% (n&thinsp;=&thinsp;2795) for the moderate adherence group, and 18.8% (n&thinsp;=&thinsp;1414) for the high adherence group. In the fully adjusted model, z score-transformed cognitive scores at visit 1 in the high vs low adherence groups were higher for B-SEVLT Sum (&beta;&thinsp;=&thinsp;0.11; 95% CI, 0.02-0.20), B-SEVLT Recall (&beta;&thinsp;=&thinsp;0.16; 95% CI, 0.07-0.25), and global cognition (&beta;&thinsp;=&thinsp;0.10; 95% CI, 0.04-0.16) tests. In the mean follow-up time of 7 years, cognitive change in the high vs low adherence groups was less pronounced for B-SEVLT Sum (&beta;&thinsp;=&thinsp;0.12; 95% CI, 0.05-0.20) and B-SEVLT Recall (&beta;&thinsp;=&thinsp;0.14; 95% CI, 0.05-0.23), but not for word fluency, DSST score, or global cognition score. Conclusions and Relevance: Results of this cohort study suggested that high adherence to a Mediterranean diet was associated with better cognitive performance and decreased 7-year learning and memory decline among middle-aged and older Hispanic or Latino adults. Culturally tailored Mediterranean diet may reduce the risk of cognitive decline and Alzheimer disease in this population.</p>