An Active Lifestyle Reinforces the Effect of a Healthy Diet on Cognitive Function: A Population-Based Longitudinal Study

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 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.

Leisure activity and social integration mitigate the risk of dementia related to cardiometabolic diseases: A population‐based longitudinal study

“…Response alternatives for physical activities were daily, weekly, monthly, less frequently, or never. Based on the previous studies, the activities were categorized as physical, mental, or social.…”

“…Education was categorized as elementary school, professional school, high school, or university. 14 The body mass index (BMI) was calculated as weight in kilograms divided by squared height in meters (kg/m 2 ) and was categorized as underweight (<20.0), normal weight (20)(21)(22)(23)(24)(25), overweight (25)(26)(27)(28)(29)(30), or obese (≥30). Smoking was dichotomized as never smoked versus former/current smoker.…”

“…Response alternatives for physical activities were daily, weekly, monthly, less frequently, or never. Based on the previous studies, 22,23 Finally, the engagement level in these three types of activities was summed into a continuous variable ranging between 0 and 6, which was used as a leisure activity index that categorized participation in leisure activities as low (score 0-1), moderate (score 2-3), or high (score 4-6). 24…”

The Association of Poor Oral Health Parameters with Malnutrition in Older Adults: A Review Considering the Potential Implications for Cognitive Impairment

“…Decreased consumption of fibre and micronutrients and increased consumption of softer, easy-to-chew foods rich in saturated fats and cholesterol may be associated with cognitive impairment either through micronutrient deficiencies (i.e., vitamin B12, thiamine) or by adopting unhealthy diets, increasing the risk of stroke and dementia [ 17 ]. It should be noted that adherence to the Mediterranean diet has been associated with reduced risk for mild cognitive impairment, dementia, and particularly Alzheimer’s disease [ 20 ], but other diets, adapted to regional cultures, are also being investigated, showing promising results [ 21 ]. Moreover, mastication might be a protective factor for cognitive decline, as it is related to increased blood flow in specific brain areas (the cerebral cortex, cerebellum, thalamus, and hippocampus) [ 19 , 22 ].…”

Neurodegenerative Dementias: Improving Brain Health to Decrease Risk

“…Sensory loss may promote social isolation, which is independently associated with an increased risk of dementia (though cause and effect determinations cannot be drawn from epidemiological studies) (31,32). Physical activity is associated with lower risks of dementia and depression (33)(34)(35). Poor sleep quality, a common complaint across the lifespan, has multiple detrimental effects on brain health (36).…”