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Author Affiliations: Taub Institute for
Research on Alzheimer's Disease and the Aging
Brain.
OBJECTIVES: To examine the association
between the Mediterranean diet (MeDi) and
Alzheimer disease (AD) in a different AD
population and to investigate possible mediation
by vascular pathways.
Design, Setting, Patients,
and MAIN OUTCOME MEASURES: A case-control
study nested within a community-based cohort
in New York, NY. Adherence to the MeDi (0-
to 9-point scale with higher scores indicating
higher adherence) was the main predictor
of AD status (194 patients with AD vs 1790
nondemented subjects) in logistic regression
models that were adjusted for cohort, age,
sex, ethnicity, education, apolipoprotein
E genotype, caloric intake, smoking, medical
comorbidity index, and body mass index (calculated
as weight in kilograms divided by height
in meters squared).
We investigated whether
there was attenuation of the association
between MeDi and AD when vascular variables
(stroke, diabetes mellitus, hypertension,
heart disease, lipid levels) were simultaneously
introduced in the models (which would constitute
evidence of mediation).
RESULTS: Higher adherence
to the MeDi was associated with lower risk
for AD (odds ratio, 0.76; 95% confidence
interval, 0.67-0.87; P<.001). Compared
with subjects in the lowest MeDi tertile,
subjects in the middle MeDi tertile had an
odds ratio of 0.47 (95% confidence interval,
0.29-0.76) and those at the highest tertile
an odds ratio of 0.32 (95% confidence interval,
0.17-0.59) for AD (P for trend <.001).
Introduction of the vascular variables in
the model did not change the magnitude of
the association.
CONCLUSIONS: We note once
more that higher adherence to the Mediterranean
Diet is associated with a reduced risk for
AD. The association does not seem to be mediated
by vascular comorbidity. This could be the
result of either other biological mechanisms
(oxidative or inflammatory) being implicated
or measurement error of the vascular variables.Published
online October 9, 2006 (doi:10.1001/archneur.63.12.noc60109).
PMID: 17030648 [PubMed - as supplied by publisher] |
