Variables Associated with Cognitive Function in Elderly California Seventh day Adventists

Abstract

From a cohort of white, non-Hispanic California Seventh-day Adventists, 99 subjects over age 75 years in 1991 were randomly selected. Dietary habits and educational status had been measured in 1976. Subjects completed the Mini-Mental State Examination (MMSE) in 1991, and at that time, they or caregivers also gave information on current medical problems and drug therapy. Those who ate more calories in 1976 had lower MMSE scores in 1991 (p = 0.03), an association strengthened by excluding those with previous stroke or Parkinson's disease by 1991. This raises the possibility that higher consumption of calories in middle age may accelerate the decline in cognitive function seen with aging, as apparently occurs in some animals. Less-educated subjects had lower MMSE scores, especially among the very elderly. The statistical model predicts that the negative association between use of psychotropic drugs and MMSE score (p = 0.004) is particularly potent in those cognitively impaired for other reasons. If causal, this suggests that physicians should use these agents very cautiously in such subjects.Keywords caloric intake; dementia; education; psychotropic drugs; Seventh-day Adventists In different cross-sectional studies, the reported prevalence of dementia ranges from 10 to 50 percent in elderly subjects over age 85 years (1). The increasing number of elderly in both the United States and developing nations over the last 2 decades will undoubtedly further increase the social burden of dementia in the future. While age and family history of a dementing illness are the only unequivocally identified risk factors, the wide international variation in the rates of dementia suggests a possible etiologic role for environmental factors as well (1, 2). Previous studies of Alzheimer's disease and other dementias have identified associations with education, smoking, alcohol use, head trauma, meat consumption, aluminum, comorbid psychiatric disorders, hypertension, diabetes mellitus, and hypothyroidism (2-7). However, these factors need further confirmation as etiologic agents. A higher prevalence of vascular dementia has been observed in populations with a high prevalence of risk factors for vascular disease (8-11). The identification of modifiable risk factors may allow not only the reduction of excess morbidity due to the dementia itself but also the reduction of other problems associated with dementia such as decreased functional capacity (12, 13) and adverse drug effects (14).

Mortality in British vegetarians

“…Giem and colleagues found a positive association between meat eating and dementia in a matched analysis of 272 subjects, but there was no significant difference in the incidence of dementia between vegetarians and meat eaters in a larger group of nearly 3000 unmatched subjects from this study 20 . In a separate study of 90 elderly members of the cohort there was no association between vegetarian status and cognitive function 21 . Nevertheless, we believe that our finding merits further investigation.…”

Nutrition and cognitive impairment in the elderly

“…A high energy intake in middle age has been associated with lower cognitive function in old age (Fraser et al 1996), as apparently occurs in some animals. This suggests that a lower consumption of energy in middle age may decelerate the decline in cognitive function seen with ageing.…”

“…The number of years of education, age (Callahan et al 1995;Gale et al 1996;Fraser et al 1996;Haller et al 1996), intelligence quotient (Haller et al 1996), and lifestyle habits (Gale et al 1996) correlated with test scores and cognitive function. Subjects with a higher educational level seem to have healthier eating habits than those with a lower educational level (Lappalainen et al 1998).…”

Dietary patterns and cognitive function in elderly men in Finland, Italy and the Netherlands

“…Also, a relation has been suggested between sugar intake (especially glucose) and enhanced memory, particularly in elderly individuals (White & Wolraich, 1995). A high caloric intake in middle age was associated with lower cognitive function at old age (Fraser et al, 1996). No associations between macronutrient intake and cognitive impairments were observed in a study in a free-living elderly population aged 65 years or more in France (Pradignac et al, 1995).…”