Little is known about the role of change in protein intake in affecting cognitive function among older adults. Therefore, we aimed to investigate the associations between the change in protein intake from various food groups and cognitive impairment among older adults in a prospective cohort study. A total of 6951 participants without cognitive impairment or dementia were included in this study. The frequency of protein intake from various food groups was measured by a food frequency questionnaire at baseline and follow-up. Multivariable Cox hazard models with time as the underlying time metric applied to calculate the hazard ratios (HRs) and 95% confidence intervals (CIs). During the 37,535 person-years of follow-up, 1202 (17.3%) participants developed cognitive impairment. The improvement in overall protein intake was negatively associated with cognitive impairment with multivariable-adjusted HR of 0.98 (95% CI = 0.97–0.99). Compared with participants with stable change, those with an extreme decline in animal-based protein intake had a 48% higher risk of cognitive impairment. The associations of changes in protein from six food groups with cognitive impairment were in a similar direction to the main result. Protective associations between improving protein intake and a reduced risk of cognitive impairment were observed.
BackgroundOlder adults with mild cognitive impairment (MCI) have the possibility of reverting to normal cognitive function. Leisure activity engagement (LAE) plays a critical role in the progress of the cognitive function. A better understanding of the dynamic relationship between LAE and MCI reversion would inform the implementation of preclinical dementia interventions. This study aimed to investigate the association between change patterns of LAE and MCI reversion among older adults using the Chinese Longitudinal Healthy Longevity Survey (CLHLS) database.Study designLongitudinal population-based study.MethodsOlder adults with MCI at the baseline were enrolled in this study. Information about cognitive function, overall, cognitively stimulating, physically active/demanding, and socially engaged LAE was collected at baseline and follow-up. Adjusted hazard ratios (HRs) for reversion and 95% confidence intervals (CIs) were calculated by Cox hazard models with time as the underlying time metric. We also assessed potential effect modifications by creating a cross-product of the stratifying variable with LAE change patterns in the fully adjusted model.ResultsThe restricted cubic spline showed that the association between LAE change scores and MCI reversion rate was statistically significant and nonlinear (p<0.01). Taking participants in the low–low group as a reference, participants in the low–medium, low–high, medium–medium, medium–high, high–medium, and high–high groups had increased possibilities of MCI reversion with HRs (95% CI) of 2.19 (1.57–3.06), 2.97 (2.13–4.13), 0.87 (0.64–1.19), 2.28 (1.71–3.03), 2.78 (2.10–3.69), 1.93 (1.43–2.59), and 2.74 (2.09–3.60), respectively. Further stratified models showed that the impact of LAE change patterns on MCI reversion varied in different ages (nonagenarian, octogenarian, and younger elderly) and gender.ConclusionsParticipants who maintained the highest LAE had the greatest possibility of MCI reversion. Meanwhile, a higher level of LAE maintenance was associated with the increased possibility of MCI reversion. These results provide a practical message to older adults about how dynamic changes in LAE are associated with improved cognitive function.
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