Dietary habits are associated with dementia risk in patients with Alzheimer’s pathology

1. Greater adherence to a dietary pattern with lower inflammatory potential was associated with lower dementia risk among individuals with Alzheimer’s pathology and broader neurobiological risk.

Evidence Rating Level: 2 (Good)

Alzheimer’s disease (AD) is a leading cause of dementia. Evidence suggests that nutrients, foods, and dietary patterns may mitigate AD. However, it is unclear whether higher diet quality slows dementia onset in individuals with AD pathology. This study thus examined the relationship between diet quality and dementia risk among older adults with AD or broader neurodegenerative and glial processes. This cohort study included adults aged >60 years without dementia from a prospective Swedish Study. Adherence to 3 dietary patterns was assessed using specific scoring systems: the Alternate Mediterranean Diet (AMED), Alternative Healthy Eating Index (AHEI), and reversed Empirical Dietary Inflammatory Index (rEDII). Higher dietary pattern adherence scores indicated higher diet quality. Baseline data on blood-based biomarkers reflecting AD-related pathology (phosphorylated tau at threonine 217 [p-tau217]) and neurobiological risk (neurofilament light chain [NFL], glial fibrillary acidic protein [GFAP]) were included. The primary outcome was all-cause dementia. Among the 1865 participants in the study cohort (mean [SD] age at baseline, 70.5 [9.3] years; 1125 female [60.3%]), 240 participants developed dementia over a mean follow-up of 8.4 years (range, <0.1 to 15.9 years). Higher adherence to rEDII was associated with lower dementia risk among those with higher levels of p-tau217 (hazard ratio [HR], 0.71; 95% CI, 0.58-0.88), NFL (HR, 0.79; 95% CI, 0.66-0.95), and GFAP levels (HR, 0.73; 95% CI, 0.60-0.89). Higher adherence to AMED and AHEI was associated with lower dementia risk among participants with lower biomarker levels, but not among those with higher levels. Overall, this study found that greater adherence to a dietary pattern with lower inflammatory potential was associated with lower dementia risk among individuals with AD pathology and broader neurobiological risk. These findings underscore the importance of dietary interventions for dementia prevention for both the general population and those already at a higher disease risk.

Click here to read this study in JAMA Network Open

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