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Special Issue "Lifestyle Strategies in Cognitive Decline: Focus on Nutrition"

A special issue of Nutrients (ISSN 2072-6643).

Deadline for manuscript submissions: closed (30 November 2018)

Special Issue Editor

Guest Editor
Prof. M. Cristina Polidori MD PhD FRCP

Geriatrician and Gerontologist, Ageing Clinical Research, Senior Consultant Physician, Dpt. Medicine II, University Hospital of Cologne, Germany
Website | E-Mail
Phone: +49 221 478-0 Page *1101

Special Issue Information

Dear Colleagues,

Preventive lifestyle interventions are known to be effective in a variety of age-related diseases and conditions, including cognitive decline. However, due to the heterogeneity of aging and the broad spectrum of interventions used across studies, the definite structure of lifestyle strategies to maintain cognitive integrity or prevent deterioration is still under debate. In this issue, the state-of-the-art of interventions aimed at reducing the burden of cognitive impairment with and without dementia will be presented to the readers, with particular attention to nutritional strategies.

Prof. M. Cristina Polidori MD PhD FRCP

Guest Editor

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Keywords

  • Cognitive decline
  • Dementia
  • Nutrition
  • Lifestyle
  • Physical exercise
  • Prevention

Published Papers (12 papers)

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Research

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Open AccessFeature PaperArticle Hypovitaminosis D: A Disease Marker in Hospitalized Very Old Persons at Risk of Malnutrition
Nutrients 2019, 11(1), 128; https://doi.org/10.3390/nu11010128
Received: 5 December 2018 / Revised: 3 January 2019 / Accepted: 7 January 2019 / Published: 9 January 2019
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Abstract
Background: Hypovitaminosis D is a frequent condition in elderly subjects. Vitamin D adequacy is best determined by measurement of the 25-hydroxyvitamin D-25(OH)D-concentration in the serum. An inverse association exists between 25(OH)D and cardiovascular, infectious, glucose metabolism, cognitive disorders, and all-cause mortality. Whether 25(OH)D [...] Read more.
Background: Hypovitaminosis D is a frequent condition in elderly subjects. Vitamin D adequacy is best determined by measurement of the 25-hydroxyvitamin D-25(OH)D-concentration in the serum. An inverse association exists between 25(OH)D and cardiovascular, infectious, glucose metabolism, cognitive disorders, and all-cause mortality. Whether 25(OH)D is a marker of organ diseases is still under debate. We aimed to investigate whether comorbidities were associated with serum 25(OH)D levels in geriatric inpatients. Methods: This is a retrospective study, including 237 subjects consecutively admitted to an acute care geriatric unit, with available data of 25(OH)D serum concentrations. 25(OH)D serum levels were defined according to the following cutoffs: 50–30 ng/mL (125–75 nmol/L): optimal range; 30–20 ng/mL (75–50 nmol/L): insufficiency; 20–10 ng/mL (5–25 nmol/L): deficiency; and <10 ng/mL (<25 nmol/L): severe deficiency. Comorbidity was assessed using the Cumulative Illness Rating Scale-Geriatric (CIRS-G). Two summary measures were obtained, the Illness Severity Index (CIRS-SI) and the Comorbidity Index (CIRS-CI). Results: 177 (74.68%) women and 60 (25.32%) men with mean age of 85 ± 6 years old were enrolled. The majority of subjects (68.6%) were at risk of malnutrition. Overall, the burden of comorbidity was 1.87 ± 1.33 for CIRS-CI and 1.18 ± 0.40 for CIRS-SI. 25(OH)D serum concentrations were 10.58 ± 7.68 ng/mL, with 98.7% of subjects having vitamin D below 30 ng/mL and 56.6% with severe deficiency. An inverse correlation was found between 25(OH)D and both CIRS-SI (r: −0.312; p < 0.0001) and CIRS-CI (r: −0.306; p < 0.0001). Independent of multiple covariates an inverse association between both CIRS-SI (p < 0.0001) and CIRS-CI (p < 0.0001) and 25(OH)D was confirmed. Both CIRS-SI (r = 0.251, p < 0.0001) and CIRS-CI (r = 0.137, p = 0.016) were positively correlated with the length of hospital stay. An inverse correlation was confirmed between serum 25(OH)D concentrations and CRP (r = −0.142; p = 0.041). CRP, in turn, positively correlated with CIRS-SI (r = 0.209, p = 0.003) and CIRS-CI (r = 0.158, p = 0.023). Both CIRS-SI (r = 0.251, p < 0.0001) and CIRS-CI (r = 0.137, p = 0.016) were positively correlated with the length of hospital stay. Conclusions: In hospitalized very old subjects, a higher comorbidity burden is associated with lower 25(OH)D serum levels. Hypovitaminosis D was correlated with higher inflammatory status, which, together with the comorbidities burden, negatively influenced the length of hospital stay. Full article
(This article belongs to the Special Issue Lifestyle Strategies in Cognitive Decline: Focus on Nutrition)
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Open AccessCommunication Mapping the Literature on Nutritional Interventions in Cognitive Health: A Data-Driven Approach
Nutrients 2019, 11(1), 38; https://doi.org/10.3390/nu11010038
Received: 20 November 2018 / Revised: 11 December 2018 / Accepted: 19 December 2018 / Published: 24 December 2018
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Abstract
Manual review of the extensive literature covering nutrition-based lifestyle interventions to promote healthy cognitive ageing has proved educational, however, data-driven techniques can better account for the large size of the literature (tens of thousands of potentially relevant publications to date) and interdisciplinary nature, [...] Read more.
Manual review of the extensive literature covering nutrition-based lifestyle interventions to promote healthy cognitive ageing has proved educational, however, data-driven techniques can better account for the large size of the literature (tens of thousands of potentially relevant publications to date) and interdisciplinary nature, where relevant publications may be found. In this study, we present a new way to map the literature landscape, focusing on nutrition-based lifestyle interventions to promote healthy cognitive ageing. We applied a combination of citation network analysis and text mining to map out the existing literature on nutritional interventions and cognitive health. Results indicated five overarching clusters of publications, which could be further deconstructed into a total of 35 clusters. These could be broadly distinguished by the focus on lifespan stages (e.g., infancy versus older age), and specificity regarding nutrition (e.g., a narrow focus on iodine deficiency versus a broad focus on weight gain). Rather than concentrating into a single cluster, interventions were present throughout the majority of the research. We conclude that a data-driven map of the nutritional intervention literature can benefit the design of future interventions, by highlighting topics and themes that could be synthesized across currently disconnected clusters of publications. Full article
(This article belongs to the Special Issue Lifestyle Strategies in Cognitive Decline: Focus on Nutrition)
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Open AccessArticle Adherence to a Mediterranean Diet Protects from Cognitive Decline in the Invecchiare in Chianti Study of Aging
Nutrients 2018, 10(12), 2007; https://doi.org/10.3390/nu10122007
Received: 15 November 2018 / Revised: 10 December 2018 / Accepted: 17 December 2018 / Published: 19 December 2018
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Abstract
Following a Mediterranean diet high in plant-based foods and fish, low in meat and dairy foods, and with moderate alcohol intake has been shown to promote healthy aging. Therefore, we examined the association between a Mediterranean diet and trajectories of cognitive performance in [...] Read more.
Following a Mediterranean diet high in plant-based foods and fish, low in meat and dairy foods, and with moderate alcohol intake has been shown to promote healthy aging. Therefore, we examined the association between a Mediterranean diet and trajectories of cognitive performance in the InCHIANTI study. Subjects (N = 832) were examined every 2–3 years up to 18 years with an average follow-up period of 10.1 years. Cognitive performance was assessed using the Mini Mental State Examination (MMSE) at every visit. Dietary habits were assessed using a validated food frequency questionnaire and adherence to Mediterranean diet was computed on a scale of 0-9 and categorized into three groups of low (≤3), medium (4–5), and high (≥6). Those in the highest adherence group (OR = 0.48, 95% CI: 0.29–0.79) and medium adherence group (OR = 0.64, 95% CI: 0.41–0.99) were less likely to experience cognitive decline. The annual average decline in MMSE scores was 0.4 units, for those in the high and medium adherence group this decline was attenuated by 0.34 units (p < 0.001) and 0.16 units (p = 0.03), respectively. Our findings suggest that adherence to a Mediterranean diet can have long-lasting protective effects on cognitive decline and may be an effective strategy for the prevent or delay dementia. Full article
(This article belongs to the Special Issue Lifestyle Strategies in Cognitive Decline: Focus on Nutrition)
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Open AccessArticle Healthy Dietary Changes in Midlife Are Associated with Reduced Dementia Risk Later in Life
Nutrients 2018, 10(11), 1649; https://doi.org/10.3390/nu10111649
Received: 30 September 2018 / Revised: 28 October 2018 / Accepted: 29 October 2018 / Published: 3 November 2018
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Abstract
Diet is an important modifiable lifestyle factor related to dementia risk. Yet, the role of midlife dietary changes is unclear. The goal is to investigate whether midlife healthy dietary changes are associated with late-life dementia risk. Data were collected within the Cardiovascular Risk [...] Read more.
Diet is an important modifiable lifestyle factor related to dementia risk. Yet, the role of midlife dietary changes is unclear. The goal is to investigate whether midlife healthy dietary changes are associated with late-life dementia risk. Data were collected within the Cardiovascular Risk Factors, Aging, and Dementia (CAIDE) population-based cohort study (n = 2000) (mean baseline age = 56 years). Participants returned for two late-life re-examinations (mean age = 70 and 78 years). Self-reported midlife diet was measured in a sub-sample (n = 341) (mean total follow-up = 16.8 years). Changes in specific dietary components (fats, vegetables, sugar, salt) were measured in midlife. Dementia diagnoses were ascertained with detailed examinations. Analyses adjusted for potential confounders. Total midlife healthy dietary changes (improving quality of fats, increasing vegetables, decreasing sugar and salt) were associated with a reduced risk of dementia (fully adjusted odds ratio (OR) 0.41, 95% confidence interval (CI) = 0.20–0.85). In contrast, when each factor was assessed individually, associations were not significant. This study is the first to show that beneficial midlife dietary changes are associated with a reduced dementia risk later in life. The results highlight the importance of targeting dietary patterns, where various food items may have synergistic effects. Full article
(This article belongs to the Special Issue Lifestyle Strategies in Cognitive Decline: Focus on Nutrition)
Open AccessArticle Mediterranean Lifestyle in Relation to Cognitive Health: Results from the HELIAD Study
Nutrients 2018, 10(10), 1557; https://doi.org/10.3390/nu10101557
Received: 26 September 2018 / Revised: 11 October 2018 / Accepted: 16 October 2018 / Published: 20 October 2018
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Abstract
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 [...] Read more.
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. Full article
(This article belongs to the Special Issue Lifestyle Strategies in Cognitive Decline: Focus on Nutrition)
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Open AccessFeature PaperArticle An Active Lifestyle Reinforces the Effect of a Healthy Diet on Cognitive Function: A Population-Based Longitudinal Study
Nutrients 2018, 10(9), 1297; https://doi.org/10.3390/nu10091297
Received: 17 August 2018 / Revised: 10 September 2018 / Accepted: 11 September 2018 / Published: 13 September 2018
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Abstract
The joint effect of diet and leisure activity on cognitive function remains unknown. We aimed to verify the hypothesis that an active lifestyle reinforces the effect of the Nordic Prudent Dietary Pattern (NPDP) on cognitive function. A total of 2223 dementia-free Swedish adults [...] Read more.
The joint effect of diet and leisure activity on cognitive function remains unknown. We aimed to verify the hypothesis that an active lifestyle reinforces the effect of the Nordic Prudent Dietary Pattern (NPDP) on cognitive function. A total of 2223 dementia-free Swedish adults aged ≥60 with Mini-Mental State Examination (MMSE) scores ≥27 were followed for an average of 6 years. MMSE was tested during follow-ups. Diet was assessed by food frequency questionnaire. The NPDP index was calculated and tertiled (low, moderate, and high adherence). Participation in physical, mental and social activities was trichotomised (low, moderate, and intense). An active lifestyle was defined based on the participation in each activity. Data were analyzed using mixed-effects models. Moderate-to-high adherence to NPDP was associated with a reduced decline in the MMSE score (β: 0.19, 95% Confidence Interval (CI): 0.14–0.24). This association became stronger when combined with moderate-to-intense physical (β: 0.34, 95% CI: 0.2–0.45), mental (β: 0.29, 95% CI: 0.21–0.37), or social (β: 0.27, 95% CI: 0.19–0.34) activities. An active lifestyle strengthened the effect of NPDP on cognitive function by two times, and further lowered risk of MMSE decline by 30%. Thus, an active lifestyle reinforces the effect of a healthy diet on preserved cognitive function, and further decreases the risk of cognitive decline. Full article
(This article belongs to the Special Issue Lifestyle Strategies in Cognitive Decline: Focus on Nutrition)
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Open AccessArticle Oxidative Stress Levels in the Brain Are Determined by Post-Mortem Interval and Ante-Mortem Vitamin C State but Not Alzheimer’s Disease Status
Nutrients 2018, 10(7), 883; https://doi.org/10.3390/nu10070883
Received: 31 May 2018 / Revised: 27 June 2018 / Accepted: 6 July 2018 / Published: 9 July 2018
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Abstract
The current study highlighted several changes in measures of oxidative stress and antioxidant status that take place in the mouse brain over the course of 24 h post-mortem. Ascorbic acid (vitamin C) and glutathione both decreased significantly in cortex in as little as [...] Read more.
The current study highlighted several changes in measures of oxidative stress and antioxidant status that take place in the mouse brain over the course of 24 h post-mortem. Ascorbic acid (vitamin C) and glutathione both decreased significantly in cortex in as little as 2 h and malondialdehyde levels increased. Further change from baseline was observed up to 24 h, including carbonyl and sulfhydryl formation. The greatest changes were observed in brains that began with low ascorbic acid levels (gulo−/− mice) compared to wild-type or 5XFAD mice. Cortical samples from nine Alzheimer’s Disease cases and five controls were also assayed under the same conditions. Post mortem intervals ranged from 6 to 47 h and all samples had low ascorbic acid levels at time of measurement. Malondialdehyde levels were lower in Alzheimer’s Disease cases. Despite a strong positive correlation between ascorbic acid and glutathione levels, no other correlations among oxidative stress measures or post mortem interval were observed. Together the data suggest that molecular changes occurring within the first hours of death may mask differences between patient groups. Care must be taken interpreting studies in human brain tissue where ante-mortem nutrient status is not known to avoid bias or confounding of results. Full article
(This article belongs to the Special Issue Lifestyle Strategies in Cognitive Decline: Focus on Nutrition)
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Open AccessArticle Early Life Vitamin C Deficiency Does Not Alter Morphology of Hippocampal CA1 Pyramidal Neurons or Markers of Synaptic Plasticity in a Guinea Pig Model
Nutrients 2018, 10(6), 749; https://doi.org/10.3390/nu10060749
Received: 12 May 2018 / Revised: 28 May 2018 / Accepted: 7 June 2018 / Published: 8 June 2018
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Approximately 15% of the Western world population, including pregnant women and their children, is characterized as vitamin C (vitC) deficient. In guinea pigs, early life vitC deficiency causes spatial memory deficits, decreased hippocampal volume and neuron numbers, in otherwise clinically healthy animals. We [...] Read more.
Approximately 15% of the Western world population, including pregnant women and their children, is characterized as vitamin C (vitC) deficient. In guinea pigs, early life vitC deficiency causes spatial memory deficits, decreased hippocampal volume and neuron numbers, in otherwise clinically healthy animals. We hypothesized that vitC deficiency leads to decreased brain-derived neurotrophic factor and synaptic plasticity markers in selected brain areas (frontal cortex, hippocampus and striatum) and cause morphological changes in cornu ammonis 1 pyramidal neurons of the hippocampus either through a direct effect or indirectly by increased oxidative stress. Fifty-seven female guinea pigs were allocated to three groups receiving either 1390, 100 or 0–50 mg vitC/kg feed for 11 weeks. Dietary vitC levels were reflected in the plasma, cortical and adrenal gland levels, however, redox imbalance was only present in the adrenal glands allowing for the investigation of a direct influence of vitC deficiency on the chosen parameters in the brain. Synaptic plasticity markers were not affected in the investigated brain areas and no differences in isolated pyramidal neuron morphology was recorded. Based on our findings, it appears that vitC deficiency may primarily elicit impaired neuronal function through increased levels of oxidative stress. Full article
(This article belongs to the Special Issue Lifestyle Strategies in Cognitive Decline: Focus on Nutrition)
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Open AccessArticle Neurocognitive Disorders and Dehydration in Older Patients: Clinical Experience Supports the Hydromolecular Hypothesis of Dementia
Nutrients 2018, 10(5), 562; https://doi.org/10.3390/nu10050562
Received: 16 March 2018 / Revised: 11 April 2018 / Accepted: 27 April 2018 / Published: 3 May 2018
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Abstract
Abnormalities of water homeostasis can be early expressions of neuronal dysfunction, brain atrophy, chronic cerebrovasculopathy and neurodegenerative disease. The aim of this study was to analyze the serum osmolality of subjects with cognitive impairment. One thousand and ninety-one consecutive patients attending the Alzheimer’s [...] Read more.
Abnormalities of water homeostasis can be early expressions of neuronal dysfunction, brain atrophy, chronic cerebrovasculopathy and neurodegenerative disease. The aim of this study was to analyze the serum osmolality of subjects with cognitive impairment. One thousand and ninety-one consecutive patients attending the Alzheimer’s Evaluation Unit were evaluated with the Mini-Mental State Examination (MMSE), 21-Item Hamilton Depression Rating Scale (HDRS-21), Activities of Daily Living (ADL), Instrumental-ADL (IADL), Mini Nutritional Assessment (MNA), Exton-Smith Scale (ESS), and Cumulative Illness Rating Scale (CIRS). For each patient, the equation for serum osmolality developed by Khajuria and Krahn was applied. Five hundred and seventy-one patients had cognitive decline and/or depression mood (CD-DM) and 520 did not have CD-DM (control group). Patients with CD-DM were less likely to be male (p < 0.001), and were more likely to be older (p < 0.001), have a significant clear cognitive impairment (MMSE: p < 0.001), show the presence of a depressive mood (HDRS-21: p < 0.001) and have major impairments in ADL (p < 0.001), IADL (p < 0.001), MNA (p < 0.001), and ESS (p < 0.001), compared to the control group. CD-DM patients had a higher electrolyte concentration (Na+: p < 0.001; K+: p < 0.001; Cl: p < 0.001), risk of dehydration (osmolality p < 0.001), and kidney damage (eGFR: p = 0.021), than the control group. Alzheimer’s disease (AD) patients showed a major risk for current dehydration (p ≤ 0.001), and dehydration was associated with the risk of developing a type of dementia, like AD or vascular dementia (VaD) (OR = 2.016, p < 0.001). In the multivariate analysis, the presence of dehydration state was associated with ADL (p < 0.001) and IADL (p < 0.001), but independently associated with age (r2 = 0.0046, p = 0.77), ESS (r2 = 0.0052, p = 0.54) and MNA (r2 = 0.0004, p = 0.48). Moreover, younger patients with dementia were significantly more dehydrated than patients without dementia (65–75 years, p = 0.001; 76–85 years, p = 0.001; ≥86 years, p = 0.293). The hydromolecular hypothesis intends to explain the relationship between dehydration and cognitive impairment in older patients as the result of protein misfolding and aggregation, in the presence of a low interstitial fluid volume, which is a defect of the microcirculation. Defective proteins were shown to impair the amount of information in brain biomolecular mechanisms, with consequent neuronal and synaptic damage. Full article
(This article belongs to the Special Issue Lifestyle Strategies in Cognitive Decline: Focus on Nutrition)
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Open AccessArticle The Nordic Prudent Diet Reduces Risk of Cognitive Decline in the Swedish Older Adults: A Population-Based Cohort Study
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
Cited by 4 | PDF Full-text (2113 KB) | HTML Full-text | XML Full-text | Supplementary Files
Abstract
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 [...] Read more.
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. Full article
(This article belongs to the Special Issue Lifestyle Strategies in Cognitive Decline: Focus on Nutrition)
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Review

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Open AccessFeature PaperReview The Association of Poor Oral Health Parameters with Malnutrition in Older Adults: A Review Considering the Potential Implications for Cognitive Impairment
Nutrients 2018, 10(11), 1709; https://doi.org/10.3390/nu10111709
Received: 4 October 2018 / Revised: 30 October 2018 / Accepted: 6 November 2018 / Published: 8 November 2018
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Abstract
Poor dental status and chewing deficiencies have been associated with cognitive decline. Altered dietary habits and malnutrition have been suggested as linking mechanisms. The aim of the present review was thus to investigate if poor oral health, and in particular tooth loss and [...] Read more.
Poor dental status and chewing deficiencies have been associated with cognitive decline. Altered dietary habits and malnutrition have been suggested as linking mechanisms. The aim of the present review was thus to investigate if poor oral health, and in particular tooth loss and impaired masticatory function, may affect dietary selection and nutritional intake in older adults, and moreover, to assess if prosthodontic dental care may improve nutritional status. Extensive tooth loss may impair masticatory function. Several studies in older populations have shown that severe tooth loss and masticatory impairment are associated with limited consumption of various food types (especially fruits and vegetables), increased consumption of sugary and easy-to-chew foods, and lower dietary intake of fibre and vitamins. However, these findings are not consistently reported, due to methodological variation among studies, potential adverse causalities, and the multifactorial nature of food choices. On the other hand, a few interventional studies revealed that prosthetic rehabilitation of missing teeth, when accompanied by dietary counselling, may improve dietary habits and nutritional intake. Further research is required to improve current knowledge of these associations. Under the limitations of the current study, a functional dental arch of natural or artificial teeth is important for maintaining adequate chewing efficiency and ability, but this only partly contributes to food choices and nutritional status. The multifactorial nature of food choices necessitates the interprofessional collaboration of dental professionals, dietetics practitioners, and primary care providers to improve dietary habits and nutritional intake. Full article
(This article belongs to the Special Issue Lifestyle Strategies in Cognitive Decline: Focus on Nutrition)
Open AccessReview Multidomain Lifestyle Intervention Strategies for the Delay of Cognitive Impairment in Healthy Aging
Nutrients 2018, 10(10), 1560; https://doi.org/10.3390/nu10101560
Received: 17 September 2018 / Revised: 10 October 2018 / Accepted: 19 October 2018 / Published: 21 October 2018
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Abstract
Present demographic changes demonstrate that the number of elderly people is growing at a frenetic pace. This shift in population consequently results in many social and economic problems, which burden the social and economic systems of countries. The aging process is associated with [...] Read more.
Present demographic changes demonstrate that the number of elderly people is growing at a frenetic pace. This shift in population consequently results in many social and economic problems, which burden the social and economic systems of countries. The aging process is associated with age-related diseases, the most common of which are dementia and Alzheimer’s disease, whose main symptom is a decline in cognitive function, especially memory loss. Unfortunately, it cannot be cured. Therefore, alternative approaches, which are cost-effective, safe, and easy to implement, are being sought in order to delay and prevent cognitive impairment. The purpose of this review was to explore the effect of multidomain lifestyle intervention strategies on the delay and/or prevention of cognitive impairment in healthy older individuals. The methods are based on a literature review of available sources found on the research topic in three acknowledged databases: Web of Science, Scopus, and PubMed. The results of the identified original studies reveal that multidomain lifestyle interventions generate significant effects. In addition, these interventions seem feasible, cost-effective, and engaging. Thus, there is a call for the implementation of effective lifestyle prevention programs, which would involve goal-setting and would focus on the prevention of crucial risk factors threatening the target group of elderly people, who are at risk of cognitive decline and dementia. Full article
(This article belongs to the Special Issue Lifestyle Strategies in Cognitive Decline: Focus on Nutrition)
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