Consumption of dietary nuts in midlife and risk of cognitive impairment in late-life: the Singapore Chinese Health Study.
Ontology highlight
ABSTRACT: Background
evidence from prospective studies investigating the association between consumption of nuts in midlife and risk of cognitive impairment in late life is limited.Methods
this study analysed data from 16,737 participants in a population-based cohort, the Singapore Chinese Health Study. Intake of nuts was assessed using a validated food-frequency questionnaire at baseline (1993-1998), when participants were 45-74 years old (mean age = 53.5 years). Cognitive function was tested using the Singapore modified Mini-Mental State Examination during the third follow-up visit (2014-2016), when participants were 61-96 years old (mean age = 73.2 years). Cognitive impairment was defined using education-specific cut-off points. Logistic regression models were used to estimate the odds ratio (OR) and the 95% confidence interval (CI) for the association between intake and risk of cognitive impairment.Results
cognitive impairment was identified in 2,397 (14.3%) participants. Compared with those who consumed <1 serving/month of nuts, participants who consumed 1-3 servings/month, 1 serving/week and ≥2 servings/week had 12% (95% CI 2-20%), 19% (95% CI 4-31%) and 21% (2-36%) lower risk of cognitive impairment, respectively (P-trend = 0.01). Further adjustment for intake of unsaturated fatty acids attenuated the association to non-significance. Mediation analysis showed that the 50.8% of the association between nuts and risk of cognitive impairment was mediated by the intake of total unsaturated fatty acids (P < 0.001).Conclusion
higher intake of nuts in midlife was related to a lower risk of cognitive impairment in late life, which was partly mediated by unsaturated fatty acids.
SUBMITTER: Jiang YW
PROVIDER: S-EPMC8522726 | biostudies-literature |
REPOSITORIES: biostudies-literature
Similar Datasets
Project description:BACKGROUND:Dietary intakes of B vitamins (eg, folate) are related to cognitive function according to epidemiological studies in western countries. But prospective studies in Asian populations are scarce. This study evaluated the relationships of dietary intakes of six B vitamins in midlife with cognitive impairment in old age in a Chinese population living in Singapore. METHODS:This study included 16,948 participants from the Singapore Chinese Health Study, a population-based prospective cohort. Baseline dietary intakes of B vitamins were assessed using a validated 165-item food frequency questionnaire when the participants were aged 45-74 years (1993-1998). After an average follow-up of 20 years, cognitive function was examined using a Singapore-modified version of Mini-Mental State Examination scale in 2014-2016, and cognitive impairment was defined using education-specific cutoffs. Logistic regression models were applied to estimate the association between B vitamins and cognitive impairment. All the six B vitamins were mutually adjusted in the final model. RESULTS:In the 2014-2016 interview, 2,443 participants were defined as cognitive impairment. Riboflavin and folate were significantly and independently associated with cognitive impairment in a dose-dependent manner: the odds ratio (95% confidence interval) comparing the highest with the lowest quartile was 0.82 (0.69, 0.97) for riboflavin and 0.83 (0.70, 0.98) for folate (both p-trend <.05). Dietary intakes of thiamine, niacin, vitamin B-6, and B-12 were not significantly associated with risk of cognitive impairment. CONCLUSIONS:Higher dietary intakes of riboflavin and folate in midlife were associated with a lower risk of cognitive impairment in late-life in the Chinese population.
| S-EPMC7243584 | biostudies-literature
Project description:BackgroundProspective studies linking dietary pattern and cognitive function in the elderly are limited in Asian populations.ObjectiveWe examined the associations between various healthful dietary patterns and risk of cognitive impairment in Chinese adults.MethodsWe used data from the Singapore Chinese Health Study of 16,948 men and women who were aged 45-74 y at baseline (1993-1998) and reinterviewed at the third follow-up visit (2014-2016), ∼20 y later. Diet quality at baseline was assessed according to the alternate Mediterranean diet (aMED), the Dietary Approaches to Stop Hypertension (DASH) diet, the alternative Healthy Eating Index (AHEI)-2010, overall plant-based diet index (PDI), and healthful plant-based diet index (hPDI). Cognitive function was evaluated using a Singapore-modified Mini-Mental State Examination during the third follow-up visit when subjects were aged 61-96 y. Multivariable logistic regression models were used to compute ORs and 95% CIs associated with the risk of cognitive impairment defined using education-specific cut-offs.ResultsCognitive impairment was present in 2443 (14.4%) participants. The OR (95% CI) for cognitive impairment comparing the highest with the lowest quartile of diet quality scores was 0.67 (0.59, 0.77) for aMED, 0.71 (0.62, 0.81) for DASH, 0.75 (0.66, 0.85) for AHEI-2010, 0.82 (0.71, 0.94) for PDI, and 0.78 (0.68, 0.90) for hPDI (all P values for trend <0.001). Each SD increment in different diet quality scores was associated with 7-16% lower risk of cognitive impairment.ConclusionsThese results provide evidence that adherence to healthy dietary patterns in midlife is associated with a lower risk of cognitive impairment in late life in Chinese adults.
| S-EPMC6766457 | biostudies-literature
Project description:Background:the relations of cigarette smoking and alcohol drinking with risk of cognitive impairment remain inconsistent. Methods:to examine the independent and joint relations of smoking and alcohol drinking with cognitive impairment, we used data from 16,948 men and women, who had been followed-up for 16-23 (mean of 20) years as participants of the Singapore Chinese Health Study, a population-based prospective cohort. Data on smoking and alcohol drinking were collected at baseline (1993-98), when participants were aged 45-74 (mean 53) years. Cognition was assessed using a 30-item Mini-Mental State Examination during follow-up three visits (2014-16), when participants were aged 61-96 (mean 73) years. Multivariable logistic regression models were used to estimate the odd ratios (ORs) and 95% confidence intervals (CIs). Results:cognitive impairment was present in 2,443 (14.4%) participants. Compared with non-current smokers, current smokers had 20% increased risk (OR = 1.20, 95% CI = 1.04-1.39). Compared with those who drank less than weekly, regular alcohol drinking (at least weekly) had 17% increased risk (OR = 1.17, 95% CI = 1.01-1.36). Compared with those who were neither smokers nor drinkers, those who were either current smokers or regular drinkers alone had no significantly increased risk, while the risk was highest in those who were both current smokers and regular drinkers (OR = 1.77, 95% CI = 1.39-2.26, Pinteraction = 0.003). Conclusions:co-existence of smoking and regular alcohol drinking at midlife had a much stronger impact than the individual factors on risk of cognitive impairment in late life.
| S-EPMC6322505 | biostudies-literature
Project description:PurposeIt is unclear if midlife consumption of dairy and soy food intake, and their components of calcium and isoflavones (in soy), is related to cognitive impairment in elderly.MethodsWe used baseline data on lifestyle and habitual diet of 16,948 participants collected during their recruitment into the Singapore Chinese Health Study from 1993 to 1998, and data on their cognitive function, measured using a 30-item Singapore modified Mini-Mental State Examination, during follow-up interviews from 2014 to 2016. We used multivariable logistic regression models to estimate the odds ratios (ORs) and 95% confidence intervals (CIs) for developing cognitive impairment.ResultsHigher dairy intake was associated with a lower risk of cognitive impairment in a dose-dependent manner (P for trend = 0.009). Compared to the lowest quartile of dairy intake, ORs (95% CIs) were 0.93 (0.81-1.07) for the second, 0.88 (0.76-1.01) for the third, and 0.82 (0.72-0.94) for the fourth quartiles of intake. Similar results were found for dairy calcium intake (P for trend = 0.008). However, there was no statistically significant association for intake of soy (OR comparing extreme quartiles 0.99, 95% CI 0.87-1.14, P for trend = 0.92), isoflavones (OR 1.01, 95% CI 0.88-1.15, P for trend = 0.90) or non-dairy calcium (OR 1.06, 95% CI 0.86-1.30, P for trend = 0.81) with risk of cognitive impairment.ConclusionsDairy intake at midlife could have a protective association against cognitive impairment that may not be attributed to its calcium content alone, while soy or isoflavone intake was not associated with the cognition of elderly in our study.
| S-EPMC6888923 | biostudies-literature
Project description:Previous studies with limited follow-up times have suggested that sleep-related traits are associated with an increased risk of incident dementia or cognitive decline. We investigated the association between midlife sleep characteristics and late life cognitive function.A follow-up study with a median follow-up time of 22.5 (range 15.8-25.7) years assessing the association between midlife sleep characteristics and later cognitive function.Questionnaire data from 1981 were used in the assessment of sleep characteristics, use of hypnotics, and covariates at baseline. Between 1999 and 2007, participants were assigned a linear cognitive score with a maximum score of 51 based on a telephone interview (mean score 38.3, SD 6.1). Linear regression analyses were controlled for age, sex, education, ApoE genotype, and follow-up time.2,336 members of the Finnish Twin cohort who were at least 65 years of age.N/A.Baseline short (< 7 h/day) and long (> 8 h/day) sleepers had lower cognitive scores than participants sleeping 7-8 h/ day (? = -0.84, P = 0.014 and ? = -1.66, P < 0.001, respectively). As compared to good sleep quality, poor or rather poor sleep quality was associated with a lower cognitive score (? = -1.00, P = 0.011). Also, the use of hypnotics ? 60 days per year was associated with poorer cognitive function (? = -1.92, P = 0.002).This is the first study indicating that midlife sleep length, sleep quality, and use of hypnotics are associated with late life cognitive function. Further confirmation is needed, but sleep-related characteristics may emerge as new risk factors for cognitive impairment.
| S-EPMC3773203 | biostudies-literature
Project description:BackgroundPrevious studies have shown inconsistent results for the relation between dietary fat intake and cognitive function in the elderly. Furthermore, prospective studies on this topic among the Chinese population are scarce.ObjectivesWe aimed to examine the association between midlife dietary fat intake and risk of cognitive impairment in the elderly.MethodsProspective cohort analysis was conducted among 16,736 participants from the Singapore Chinese Health Study. Dietary information was assessed by a validated FFQ at baseline (1993-1998) when participants aged 45-74 y (mean: 53.5; SD: 6.22). Cognitive impairment was identified using the Singapore modified Mini-Mental State Examination at the third follow-up visit (2014-2016) when participants aged 61-96 y (mean: 73.2; SD: 6.41). Multivariable logistic regression models were used to calculate ORs and 95% CIs.ResultsCognitive impairment was presented in 2397 participants. When substituted for total carbohydrate, dietary fat intake was inversely related to cognitive impairment (OR comparing extreme quartiles: 0.80; 95% CI: 0.67, 0.94; P-trend = 0.003). The OR (95% CI) comparing extreme quartiles of specific dietary fats was 1.08 (0.89, 1.31; P-trend = 0.51) for SFAs, 0.80 (0.64, 0.99; P-trend = 0.02) for MUFAs, 0.84 (0.72, 0.99; P-trend = 0.02) for PUFAs, 0.92 (0.77, 1.09; P-trend = 0.49) for n-3 PUFAs, and 0.83 (0.70, 0.98; P-trend = 0.01) for n-6 PUFAs. An inverse association was found for plant-based fat (OR: 0.84; 95% CI: 0.72, 0.98; P-trend = 0.02), but not for animal-based fat (OR: 0.96; 95% CI: 0.81, 1.15; P-trend = 0.76). When substituted for SFAs, the OR (95% CI) was 0.77 (0.61, 0.97; P-trend = 0.02) for MUFAs and 0.82 (0.70, 0.95; P-trend = 0.003) for PUFAs.ConclusionsWe found that substitution of total carbohydrate or SFAs with MUFAs and PUFAs, particularly n-6 PUFAs, was related to a lower risk of cognitive impairment in elderly Chinese participants. In addition, an inverse association with cognitive impairment was found for plant-based fat.
| S-EPMC7138666 | biostudies-literature
Project description:Background and objectivesTo evaluate the association between midlife plasma amyloid-β (Aβ1-42, Aβ1-40, Aβ42:Aβ40) and risk of mild cognitive impairment (MCI) and dementia.MethodsPlasma Aβ42 and Aβ40 were retrospectively measured with a fluorometric bead-based immunoassay in a subsample of the Atherosclerosis Risk in Communities cohort study. We investigated the relationship of plasma Aβ42, Aβ40, and Aβ42:Aβ40 ratio measured in midlife and late life and the change from midlife to late life to risk of MCI, dementia, and combined MCI/dementia outcomes in late life (from 2011-2019). We used multinomial logistic regressions estimating relative risk ratios (RRRs) of these cognitive outcomes vs cognitively normal adjusted for age, sex, education, site-race, APOE, hypertension, diabetes, and body mass index.ResultsA total of 2,284 participants were included (midlife mean age 59.2 ± 5.2, 57% female, 22% Black). Each doubling of midlife Aβ42:Aβ40 was associated with 37% lower risk of MCI/dementia (RRR 0.63, 95% confidence interval [CI] 0.46-0.87), but only up to approximately the median (spline model threshold 0.20). Every 1-SD increase in plasma Aβ42 (10 pg/mL) was associated with 13% lower risk of MCI/dementia (RRR 0.87, 95% CI 0.77-0.98), whereas every 1-SD increase in plasma Aβ40 (67 pg/mL) was associated with 15% higher risk of MCI/dementia (RRR 1.15, 95% CI 1.01-1.29). Associations were comparable but slightly weaker statistically when models were repeated using late-life plasma Aβ predictors. Aβ42 and Aβ40 increased from midlife to late life, but changes were not associated with cognitive outcomes.DiscussionMidlife measurement of plasma Aβ may have utility as a blood-based biomarker indicative of risk for future cognitive impairment.
| S-EPMC8456355 | biostudies-literature
Project description:ImportanceHearing impairment (HI) in midlife (45-65 years of age) may be associated with longitudinal neurodegeneration of temporal lobe structures, a biomarker of early Alzheimer disease.ObjectiveTo evaluate the association of midlife HI with brain volume trajectories in later life (≥65 years of age).Design, setting, and participantsThis prospective cohort study used data from the Baltimore Longitudinal Study of Aging to evaluate hearing from November 5, 1990, to October 3, 1994, and late-life volume change from July 10, 2008, to January 29, 2015, using magnetic resonance imaging (MRI) (mean follow-up time, 19.3 years). Data analysis was performed from September 22, 2017, to August 27, 2018. A total of 194 community-dwelling older adults who had midlife measures of peripheral hearing at a mean age of 54.5 years and late-life volume change of up to 6 years between the first and most recent MRI assessment were studied. Excluded were those with baseline cognitive impairment, stroke, head injuries, Parkinson disease, and bipolar disorder.ExposuresHearing as measured with pure tone audiometry in each ear from November 5, 1990, to October 3, 1994, and late-life temporal lobe volume change measured by MRI.Main outcomes and measuresLinear mixed-effects models with random intercepts were used to examine the association of midlife hearing (pure tone average of 0.5-4 kHz tones in the better ear and each ear separately) with longitudinal late-life MRI-based measures of temporal lobe structures (hippocampus, entorhinal cortex, parahippocampal gyrus, and superior, middle, and inferior temporal gyri) in the left and right hemispheres, in addition to global and lobar regions, adjusting for baseline demographic characteristics (age, sex, subsequent cognitive impairment status, and educational level) and intracranial volume.ResultsA total of 194 patients (mean [SD] age at hearing assessment, 54.5 [10.0] years; 106 [54.6%] female; 169 [87.1%] white) participated in the study. After Bonferroni correction, poorer midlife hearing in the better ear was associated with steeper late-life volumetric declines in the right temporal gray matter (β = -0.113; 95% CI, -0.182 to -0.044), right hippocampus (β = -0.008; 95% CI, -0.012 to -0.004), and left entorhinal cortex (β = -0.009; 95% CI, -0.015 to -0.003). Poorer midlife hearing in the right ear was associated with steeper late-life volumetric declines in the right temporal gray matter (β = -0.136; 95% CI, -0.197 to -0.075), right hippocampus (β = -0.008; 95% CI, -0.012 to -0.004), and left entorhinal cortex (β = -0.009; 95% CI, -0.015 to -0.003), whereas there were no associations between poorer midlife hearing in the left ear with late-life volume loss.Conclusions and relevanceThe findings suggest that midlife HI is a risk factor for temporal lobe volume loss. Poorer midlife hearing, particularly in the right ear, was associated with declines in hippocampus and entorhinal cortex.
| S-EPMC6613307 | biostudies-literature
Project description:BackgroundMeasures of cardiac ventricular electrophysiology have been associated with cognitive performance in cross-sectional studies. We sought to evaluate the association of worsening ventricular repolarization in midlife, as measured by incident prolonged QT interval, with cognitive decline in late life.MethodsMidlife QT interval was assessed by electrocardiography during three study visits from 1965/68 to 1971/74 in a cohort of Japanese American men aged 46-68 at Exam 1 from the Honolulu Heart Study. We defined incident prolonged QT as the QT interval in the upper quartile at Exam 2 or 3 after QT interval in lower three quartiles at Exam 1. Cognitive performance was assessed at least once using the Cognitive Abilities Screening Instrument (CASI), scored using item response theory (CASI-IRT), during four subsequent visits from 1991/93 to 1999/2000 among 2,511 of the 4,737 men in the Honolulu-Asia Aging Study otherwise eligible for inclusion in analyses. We used marginal structural modeling to determine the association of incident prolonged QT with cognitive decline, using weighting to account for confounding and attrition.ResultsIncident prolonged QT interval in midlife was not associated with late-life CASI-IRT at cognitive baseline (estimated difference in CASI-IRT: 0.04; 95% CI: -0.28, 0.35; p = 0.81), or change in CASI-IRT over time (estimated difference in annual change in CASI-IRT: -0.002; 95%CI: -0.013, 0.010; p = 0.79). Findings were consistent across sensitivity analyses.ConclusionsAlthough many midlife cardiovascular risk factors and cardiac structure and function measures are associated with late-life cognitive decline, incident prolonged QT interval in midlife was not associated with late-life cognitive performance or cognitive decline.
| S-EPMC7041789 | biostudies-literature
Project description:To evaluate the association of late-life depression with mild cognitive impairment (MCI) and dementia in a multiethnic community cohort.A cohort study was conducted in Northern Manhattan, New York, New York.A total of 2160 community-dwelling Medicare recipients aged 65 years or older were included in the study.Depression was assessed using the 10-item version of the Center for Epidemiological Studies Depression scale (CES-D) and defined by a CES-D score of 4 or more. We used logistic regression for cross-sectional association analyses and proportional hazards regression for longitudinal analyses.Mild cognitive impairment dementia, and progression from MCI to dementia were the main outcome measures. We also used subcategories of MCI (amnestic and nonamnestic), and dementia (probable Alzheimer disease and vascular dementia, including possible Alzheimer disease with stroke).Baseline depression was associated with prevalent MCI (odds ratio, 1.4; 95% CI, 1.1-1.9) and dementia (2.2; 1.6-3.1). Baseline depression was associated with an increased risk of incident dementia (hazard ratio [HR], 1.7; 95% CI, 1.2-2.3) but not with incident MCI (0.9; 0.7-1.2). Persons with MCI and coexisting depression at baseline had a higher risk of progression to dementia (HR, 2.0; 95% CI, 1.2-3.4), especially vascular dementia (4.3; 1.1-17.0), but not Alzheimer disease (1.9; 1.0-3.6).The association of depression with prevalent MCI and with progression from MCI to dementia, but not with incident MCI, suggests that depression accompanies cognitive impairment but does not precede it.
| S-EPMC3694613 | biostudies-literature