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ORIGINAL RESEARCH article
Front. Aging Neurosci.
Sec. Neurocognitive Aging and Behavior
Volume 17 - 2025 | doi: 10.3389/fnagi.2025.1556608
This article is part of the Research Topic Lifestyle and Environmental Influences on Alzheimer's Disease: Exploring the Roles of Diet, Exercise, Cognitive Reserve, Sleep, and Air Quality View all 19 articles
Correlation of cognitive impairment with Mediterranean diet and mortality: a prospective cohort study
Provisionally accepted- Department of Neurology, Beijing Tsinghua Changgeng Hospital, Tsinghua University, Beijing, China
Long-term adherence to the Mediterranean Diet has been shown to improve cognitive function in patients. However, there is a lack of evidence regarding the impact of the Mediterranean Diet and cognitive impairment on long-term mortality outcomes. This study aims to explore whether there is an interaction between the degree of adherence to the Mediterranean Diet and cognitive impairment on long-term mortality outcomes.The study included 2,520 participants from the National Health and Nutrition Examination Survey (NHANES) conducted between 2011 and 2014. The adherence to the Mediterranean Diet was assessed using the 9-point alternative Mediterranean Diet index (aMED index). Cognitive function was assessed using the Consortium to Establish a Registry for Alzheimer's Disease (CERAD), the Animal Fluency Test (AFT), and the Digital Symbol Substitution Test (DSST). By accessing public records from the National Death Index (NDI), NHANES participants' information was linked to death certificate records to determine mortality and causes of death during the follow-up period, up to December 31, 2019, with causes specified according to ICD-10. Participants were categorized based on the median aMED score into low adherence (scores 0-3), moderate adherence (score 4), and high adherence (scores 5-9) groups. Cognitive impairment was assessed by calculating the arithmetic mean of standardized scores (Z-scores) for each cognitive test. Participants with scores below the first quartile of the arithmetic mean were considered to have cognitive impairment. Cox proportional hazards regression models were used to assess the relationship between cognitive impairment, aMED, and all-cause and cardiovascular mortality outcomes. Additionally, the interaction between cognitive impairment and aMED on these outcomes was evaluated.
Keywords: mediterranean diet, cognitive impairment, All-cause mortality, NHANES, Cardiovascular mortality
Received: 07 Jan 2025; Accepted: 27 Mar 2025.
Copyright: © 2025 Li, Zheng, Ma, Zhu, Li and Feng. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Xinhong Feng, Department of Neurology, Beijing Tsinghua Changgeng Hospital, Tsinghua University, Beijing, China
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