MIND and Mediterranean diet association with Alzheimer's disease pathology. (31st December 2021)

• Record Type: Journal Article
• Authors: Agarwal, Puja; Wang, Yamin; Aggarwal, Neelum T; Cherian, Laurel J; James, Bryan D; Dhana, Klodian; Leurgans, Sue E; Bennett, David A; Schneider, Julie A
• Is Part Of: Alzheimer's & dementia. Volume 17(2021)Supplement 10
• Page Start: n/a
• Page End: n/a
• Publication Date: 2021-12-31
• Subjects: Alzheimer's disease -- Periodicals; Alzheimer Disease -- Periodicals; Dementia -- Periodicals; Démence; Maladie d'Alzheimer; Périodique électronique (Descripteur de forme); Ressource Internet (Descripteur de forme); 616.83
• DOI: 10.1002/alz.055679
• Languages: English
• ISSNs: 1552-5260

Abstract

Abstract: Background: Healthy dietary patterns, primarily Mediterranean‐DASH Intervention for Neurodegenerative Delay (MIND), and Mediterranean diet (MedDiet) are related to slower cognitive decline and reduced risk for Alzheimer's dementia. However, it is unknown if these diets and its primary food groups are associated with Alzheimer's disease (AD) pathology in postmortem brains. Method: The study was conducted in 459 deceased participants (age at death (91.0±6.3 years), 73% female, 20% with APO‐ε4 allele) of the Rush Memory and Aging Project (a clinicopathologic longitudinal cohort) with completed neuropathological evaluations, dietary data, and without mild cognitive impairment or dementia at first dietary assessments. Mean diet scores were obtained from a validated food frequency questionnaire administered annually over follow‐up years (6.8 ± 3.9 years). Multiple brain regions were assessed for percent cortical area occupied by amyloid‐beta and density of cortical phosphorylated tau (p‐tau) tangles. A global AD pathology score was computed, summarizing three pathologies (neuritic and diffuse plaques and neurofibrillary tangles) based on modified Bielschowsky silver‐staining. Linear regression models adjusted for age, sex, education, APO‐ε4 status, and total calories were used. We also assessed diet interaction with age, sex, education, and APO‐ε4 status. Diet was evaluated as continuous and in tertiles. Result: Healthy diet scores were associated with lower global AD pathology (MIND:β=‐0.028, p=0.02; MedDiet:β=‐0.011, p=0.006) and less amyloid load (MIND:β=‐0.077, p=0.04; MedDiet:β=‐0.040, p=0.001). However, when stratified by APO‐ε4 status, this association was significant only in non‐carriers, and diet was also associated with lower p‐tau tangles. Overall, higher fish (p trend=0.007) and green leafy vegetable (p trend=0.014) intakes were associated with less global AD pathology. Sweets and pastries intake was related to higher amyloid load (β=0.021, p=0.009). Those in the highest tertile of legumes/beans (β=‐0.032, p=0.03), and surprisingly, butter intake had fewer p‐tau tangles (β=‐0.030, p=0.04) compared to the lowest tertile group. Conclusion: Both the MIND and Mediterranean diets are associated with less AD pathology, primarily amyloid plaques. Dietary components, including green leafy vegetables, fish, legumes, butter, and sweets, were also related to AD pathology. These relationships were more significant in those without an APOE‐ε4 allele. Further studies with larger numbers should be explored in those with and without APOE‐ ε4 genotypes.