Dietary Intakes of Older Adults with and without Dementia Compared to Healthy Eating Recommendations.
Loading...
Date
2014-07
Journal Title
Journal ISSN
Volume Title
Publisher
Abstract
Background: The Alzheimer’s Research Trust (2012) report that 820,000 people are
currently living with dementia in the UK with prevalence increasing in line with the ageing
population and a new case estimated to occur every 3.2 minutes. Whilst there is currently
no cure, early diagnosis and intervention may be essential in reducing the considerable
health, economic and social burden of dementia. Although multifactorial in aetiology, diet
and lifestyle factors have been identified as potentially protective and pathogenic for
dementia development, Staehelin, [1]. The aim of this study was to compare the dietary
intakes of a group of older adults early in their dementia disease to those of healthy
controls in order to inform the development of future dietary intervention studies and
service delivery to delay the onset and slow the progression of cognitive decline.
Methods: Ethical approval was granted from the National Research Ethics Service
Committee London. Participants with a diagnosis of dementia (Alzheimer’s, vascular or
mixed type) were recruited from Memory Clinics across Sussex, with consent obtained
from both the participant and their designated carer. Routine clinical data was extracted from the patient notes and any additional data collected during a 2hr initial interview.
Healthy controls were recruited from community groups in the Brighton area.
Anthropometric measurements were made according to standard age-appropriate
procedures and dietary intakes were assessed using an adapted version of the EPIC Food
Frequency Questionnaire (FFQ) Adamson et al. [2]. FFQ’s were coded and converted into
nutritional information using the FETA software (Mulligan et al, unpublished). Relative
nutrient intakes (expressed as a percentage of the age- and gender-appropriate dietary
reference values (DRV) and adherence to a Mediterranean style diet Trichopoulou et al.
[3] were compared between groups using independent t tests or non-parametric
equivalents as appropriate.
Results: Ninety-six cases and 53 controls had FFQ data available for analysis. Cases
were more likely to be older (mean age 80.7[6.2] and 68.1[6.0] years), female (58% and
28% respectively) (p≤0.001) and of a higher BMI (26.4[3.8] and 25.0[3.2] kg/m2; p=0.02)
than controls. Cases consumed significantly more energy in the form of saturated fat
(13.8[2.6] and 12.2[3.2]% of energy) and significantly less as polyunsaturated fat (5.6[1.6]
and 6.6[1.5]%) and alcohol (2.0[3.2] and 3.8[4.3]%) (p≤0.001). The differences in fat
remained significant even when only healthy weight individuals were analysed (p<0.05).
No significant differences in relative micronutrient intakes were observed, with the
exception of magnesium (p=0.04). Food-based analyses suggested that adults with
dementia were less likely to consume fruit and nuts and seeds (p≤0.007) and more likely
to consume sugars and snacks (p<0.001) than controls. These differences remained
significant, with the exception of fruit, when analysed within healthy weight adults only
(p≤0.005). Controls showed greater adherence to a Mediterraean–style diet (p=0.001) and
specifically higher scores for the fruit, vegetable and meat components of this score
(p≤0.01).
Discussion: The cross-sectional nature of this data limits the ability to draw conclusions
regarding causality however it would appear that the current diet of older adults with
dementia may fail to meet healthy eating recommendations, particularly with regard to the
balance of fats. The cognitive benefits of a Mediterranean diet have been widely
reportedSofrizzi et al, [4] and the food-based analyses would seem to support this theory,
with potentially beneficial foods like fruits, nuts and alcohol underconsumed in a sample of
adults with diagnosed cognitive impairment.
Conclusion: This data would suggest that older adults with cognitive impairment have
sub-optimal dietary intakes not solely explained by their greater age or BMI. Ongoing
follow up of this cohort will confirm the impact of this on disease progression.
Description
Keywords
Dementia, Mediterranean diet, FFQ
Citation
Hart K, Cave E, Conroy B, Farina N, Young J, Rusted J, Tabet N. Dietary Intakes of Older Adults with and without Dementia Compared to Healthy Eating Recommendations. European Journal of Nutrition & Food Safety. 2014 Jul-Sept; 4(3): 247-249.