The Nordic Prudent Diet Reduces Risk of Cognitive Decline in the Swedish Older Adults: A Population-Based Cohort Study
by
Behnaz Shakersain 1, Debora Rizzuto 1, 
Susanna C. Larsson 2
, Gerd Faxén-Irving 3, Laura Fratiglioni 1,4 and Wei-Li Xu 1,5,*
Behnaz Shakersain 1, Debora Rizzuto 1, Susanna C. Larsson 2, Gerd Faxén-Irving 3, Laura Fratiglioni 1,4 and Wei-Li Xu 1,5,*
1
Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, 113 30 Stockholm, Sweden
2
Unit of Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, 171 77 Stockholm, Sweden
3
Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, 141 57 Huddinge, Sweden
4
Stockholm Gerontology Research Center, 113 30 Stockholm, Sweden
5
Department Epidemiology & Biostatistics, School of Public Health, Tianjin Medical University, Qixiangtai Road 22, Heping District, Tianjin 300070, China
*
Author to whom correspondence should be addressed.
Nutrients 2018, 10(2), 229; https://doi.org/10.3390/nu10020229
Received: 13 December 2017 / Revised: 19 January 2018 / Accepted: 14 February 2018 / Published: 17 February 2018
(This article belongs to the Special Issue Lifestyle Strategies in Cognitive Decline: Focus on Nutrition)
Appropriate dietary pattern for preserving cognitive function in northern Europe remains unknown. We aimed to identify a Nordic dietary pattern index associated with slower cognitive decline compared to the Mediterranean-DASH Intervention for Neurodegenerative Delay, Mediterranean Diet, Dietary Approaches to Stop Hypertension, and Baltic Sea Diet indices. A total of 2223 dementia-free adults aged ≥60 were followed for 6 years. Mini-Mental State Examination was administrated at baseline and follow-ups. Dietary intake was assessed by 98-item food frequency questionnaire, and the Nordic Prudent Dietary Pattern (NPDP) was identified. Data were analysed using mixed-effects and parametric survival models and receiver operating characteristic curves with adjustment for potential confounders. Moderate (β = 0.139, 95% CI 0.077−0.201) and high adherence (β = 0.238, 95% CI 0.175−0.300) to NPDP were associated with less cognitive decline compared to other four indices. High adherence to NPDP was also associated with the lowest risk of MMSE decline to ≤24 (HR = 0.176, 95% CI 0.080−0.386) and had the greatest ability to predict such decline (area under the curve = 0.70). Moderate-to-high adherence to the NPDP may predict a better-preserved cognitive function among older adults in Nordic countries. Regional dietary habits should be considered in developing dietary guidelines for the prevention of cognitive impairment and dementia.
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Keywords:
the Nordic Prudent Dietary Pattern; cognitive function; Population-based cohort study; Nordic countries
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MDPI and ACS Style
Shakersain, B.; Rizzuto, D.; Larsson, S.C.; Faxén-Irving, G.; Fratiglioni, L.; Xu, W.-L. The Nordic Prudent Diet Reduces Risk of Cognitive Decline in the Swedish Older Adults: A Population-Based Cohort Study. Nutrients 2018, 10, 229.
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