Year: 2023
Type: article
Abstract: Background Healthy diet reduces cognitive decline and dementia. Vascular risk factors are associated with increased atherosclerosis, but associations between dietary pattern and atherosclerosis in older brains are unclear. This study investigates associations between diet pattern and risk of atherosclerosis in individuals with preexisting hypertension (HTN) or myocardial infarction (MI). Method Study includes 677 autopsied participants (mean age at death = 91.1±6.1, 71% women) of the Rush Memory and Aging Project, a longitudinal clinical neuropathological cohort study, with complete dietary and neuropathology data. The mean MIND and Mediterranean diet (MedDiet) scores (assessed annually using a 144‐item Food Frequency Questionnaire) were computed (mean interval to death = 5.85±3.92 years). HTN and MI history was self‐reported. Large vessel atherosclerosis was evaluated at the circle of Willis, and severity of intracranial atherosclerosis was assessed based on the number of atherosclerotic plaques, extent of involvement in each vessel, and the degree of vessel occlusion to create a 4 level grading system (0‐3). All regression models were adjusted for age, sex, education, caloric intake, and APOE4. Result Of the 677 subjects, 362 (53%) had mild, 142 (21%) had moderate, and 29 (5%) had severe atherosclerosis. There was no direct relationship between diet and atherosclerosis. Both MI (β = 3.031 (p = 0.003)) and HTN (β = 2.063(p = 0.015)) were associated with intracranial atherosclerosis. The interaction models indicated significant interaction of hypertension with MedDiet (β = ‐0.077, p = 0.029) and a qualitatively similar interaction with MIND diet (β = ‐0.212, p = 0.055) for intracranial atherosclerosis. Interaction of MI with MIND (p = 0.007) and MedDiet(p = 0.006) was also significant for intracranial atherosclerosis. In stratified analysis, among individuals with preexisting MI (N = 130), those with better diet have lesser odds of intracranial atherosclerosis (MedDiet: OR(95% CI) = 0.88 (0.81, 0.97)); (MIND: OR(95% CI) = 0.77 (0.59, 1.01)). Conclusion In older adults with a history of hypertension or myocardial infarction, a healthy dietary pattern is associated with less severe intracranial large vessel atherosclerosis. These data suggest that healthy diets may be more effective in maintaining brain vascular health in persons with a history of vascular risk or disease. In‐vivo studies of dietary habits and brain health, specifically in those at high vascular risk are needed.
Source: Alzheimer s & Dementia
DOI: 10.1002/alz.083143
Authors: Laurel J Cherian, Puja Agarwal, Sonal Agrawal, Bryan D James, Sue E. Leurgans, David A. A Bennett, Neelum T. Aggarwal, Julie A Schneider
Institutions: Rush University Medical Center, Rush University
Language: English
Topic: Nutritional Studies and Diet
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W4390191686