Mediterranean diet and age-related cognitive decline: a randomized clinical trial

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• dc.contributor.author Valls Pedret, Cintaca
• dc.contributor.author Sala Vila, Aleixca
• dc.contributor.author Serra-Mir, Mercèca
• dc.contributor.author Corella, Doloresca
• dc.contributor.author Torre Fornell, Rafael de laca
• dc.contributor.author Martínez-González, Miguel Ángel, 1957-ca
• dc.contributor.author Martínez Lapiscina, Elena H.ca
• dc.contributor.author Fitó Colomer, Montserratca
• dc.contributor.author Pérez Heras, Anaca
• dc.contributor.author Salas-Salvadó, Jordica
• dc.contributor.author Estruch, Ramónca
• dc.contributor.author Ros, Emilioca
• dc.date.accessioned 2016-04-25T13:28:36Z
• dc.date.available 2016-08-01T02:00:04Z
• dc.date.issued 2015
• dc.description.abstract IMPORTANCE: Oxidative stress and vascular impairment are believed to partly mediate age-related cognitive decline, a strong risk factor for development of dementia. Epidemiologic studies suggest that a Mediterranean diet, an antioxidant-rich cardioprotective dietary pattern, delays cognitive decline, but clinical trial evidence is lacking. OBJECTIVE: To investigate whether a Mediterranean diet supplemented with antioxidant-rich foods influences cognitive function compared with a control diet. DESIGN, SETTING, AND PARTICIPANTS: Parallel-group randomized clinical trial of 447 cognitively healthy volunteers from Barcelona, Spain (233 women [52.1%]; mean age, 66.9 years), at high cardiovascular risk were enrolled into the Prevención con Dieta Mediterránea nutrition intervention trial from October 1, 2003, through December 31, 2009. All patients underwent neuropsychological assessment at inclusion and were offered retesting at the end of the study. INTERVENTIONS: Participants were randomly assigned to a Mediterranean diet supplemented with extravirgin olive oil (1 L/wk), a Mediterranean diet supplemented with mixed nuts (30 g/d), or a control diet (advice to reduce dietary fat). MAIN OUTCOMES AND MEASURES: Rates of cognitive change over time based on a neuropsychological test battery: Mini-Mental State Examination, Rey Auditory Verbal Learning Test (RAVLT), Animals Semantic Fluency, Digit Span subtest from the Wechsler Adult Intelligence Scale, Verbal Paired Associates from the Wechsler Memory Scale, and the Color Trail Test. We used mean z scores of change in each test to construct 3 cognitive composites: memory, frontal (attention and executive function), and global. RESULTS: Follow-up cognitive tests were available in 334 participants after intervention (median, 4.1 years). In multivariate analyses adjusted for confounders, participants allocated to a Mediterranean diet plus olive oil scored better on the RAVLT (P = .049) and Color Trail Test part 2 (P = .04) compared with controls; no between-group differences were observed for the other cognitive tests. Similarly adjusted cognitive composites (mean z scores with 95% CIs) for changes above baseline of the memory composite were 0.04 (-0.09 to 0.18) for the Mediterranean diet plus olive oil, 0.09 (-0.05 to 0.23; P = .04 vs controls) for the Mediterranean diet plus nuts, and -0.17 (-0.32 to -0.01) for the control diet. Respective changes from baseline of the frontal cognition composite were 0.23 (0.03 to 0.43; P = .003 vs controls), 0.03 (-0.25 to 0.31), and -0.33 (-0.57 to -0.09). Changes from baseline of the global cognition composite were 0.05 (-0.11 to 0.21; P = .005 vs controls) for the Mediterranean diet plus olive oil, -0.05 (-0.27 to 0.18) for the Mediterranean diet plus nuts, and -0.38 (-0.57 to -0.18) for the control diet. All cognitive composites significantly (P < .05) decreased from baseline in controls. CONCLUSIONS AND RELEVANCE: In an older population, a Mediterranean diet supplemented with olive oil or nuts is associated with improved cognitive function. TRIAL REGISTRATION: isrctn.org Identifier: ISRCTN35739639.ca
• dc.description.sponsorship The PREDIMED trial was supported by the official funding agency for biomedical research of the Spanish government, Instituto de Salud Carlos III, through grants provided to research networks specifically developed for the trial: RTICG03/140 (Dr Estruch, principal investigator), RTICRD06/0045 (Dr Martínez-González, principal investigator), and Ciber Fisiopatología de la Obesidad y Nutrición (a network of biomedical research groups; DrsCorella, Martínez-González, Fitó, Salas-Salvadó, Estruch, and Ros, principal investigators).
• dc.format.mimetype application/pdfca
• dc.identifier.citation Valls-Pedret C, Sala-Vila A, Serra-Mir M, Corella D, de la Torre R, Martínez-González MÁ et al. Mediterranean diet and age-related cognitive decline: a randomized clinical trial. JAMA internal medicine. 2015; 175(7): 1094-1103. DOI 10.1001/jamainternmed.2015.1668ca
• dc.identifier.doi http://dx.doi.org/10.1001/jamainternmed.2015.1668
• dc.identifier.issn 2168-6106
• dc.identifier.uri http://hdl.handle.net/10230/26167
• dc.language.iso engca
• dc.publisher American Medical Associationca
• dc.relation.ispartof JAMA internal medicine. 2015; 175(7): 1094-1103
• dc.rights © American Medical Association. All Rights Reserved.ca
• dc.rights.accessRights info:eu-repo/semantics/openAccess
• dc.subject.other Trastorns de la cognicióca
• dc.subject.other Dieta -- Mediterrània, Regió de laca
• dc.subject.other Tests neuropsicològicsca
• dc.title Mediterranean diet and age-related cognitive decline: a randomized clinical trialca
• dc.type info:eu-repo/semantics/articleca
• dc.type.version info:eu-repo/semantics/publishedVersionca