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Open AccessArticle

Mediterranean Lifestyle in Relation to Cognitive Health: Results from the HELIAD Study

Department of Neurology, Aiginition Hospital, National and Kapodistrian University of Athens Medical School, 11528 Athens, Greece
Department of Nutrition and Dietetics, Harokopio University, 17671 Athens, Greece
Laboratory of Cognitive Neuroscience, School of Psychology, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
Department of Neurology, Faculty of Medicine, University of Thessaly, 41500 Larissa, Greece
Department of Neurology, Medical School, University of Cyprus, 2408 Nicosia, Cyprus
Athens Association of Alzheimer’s Disease and Related Disorders, 11636 Marousi, Greece
Taub Institute for Research in Alzheimer’s Disease and the Aging Brain, The Gertrude H. Sergievsky Center, Department of Neurology, Columbia University, New York, NY 10032, USA
Independent Researcher, 34100 Chalkida, Greece
Author to whom correspondence should be addressed.
Nutrients 2018, 10(10), 1557;
Received: 26 September 2018 / Revised: 11 October 2018 / Accepted: 16 October 2018 / Published: 20 October 2018
(This article belongs to the Special Issue Lifestyle Strategies in Cognitive Decline: Focus on Nutrition)
Many lifestyle factors have been linked to cognitive function but little is known about their combined effect. An overall lifestyle pattern for people living in the Mediterranean basin has been proposed, including diet, but also physical activity, sleep and daily living activities with social/intellectual aspects. We aimed to examine the associations between a combination of these lifestyle factors and detailed cognitive performance. A total of 1716 participants from the Hellenic Longitudinal Investigation of Ageing and Diet (HELIAD), a population-based study of participants ≥65 years, were included in this analysis. Lifestyle factors were evaluated using standard, validated questionnaires and a Total Lifestyle Index (TLI) was constructed. Cognitive outcomes included mild cognitive impairment (MCI) diagnosis, a composite z-score (either continuous or with a threshold at the 25th percentile) and z-scores for five cognitive domains. A higher TLI was associated with 65% reduced odds for MCI in the non-demented individuals and 43% reduced odds for low global cognition when MCI participants were excluded, a risk reduction equivalent to 9 and 2.7 fewer years of ageing, respectively. Each lifestyle factor was differentially associated with domain-specific cognitive performance. Our results suggest that a TLI, more so than single lifestyle parameters, may be related to cognitive performance. View Full-Text
Keywords: brain health; cognition; dietary patterns; instrumental activities of daily living; lifestyle; nutrition brain health; cognition; dietary patterns; instrumental activities of daily living; lifestyle; nutrition
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Anastasiou, C.A.; Yannakoulia, M.; Kontogianni, M.D.; Kosmidis, M.H.; Mamalaki, E.; Dardiotis, E.; Hadjigeorgiou, G.; Sakka, P.; Tsapanou, A.; Lykou, A.; Scarmeas, N. Mediterranean Lifestyle in Relation to Cognitive Health: Results from the HELIAD Study. Nutrients 2018, 10, 1557.

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