The Mediating Role of Psychological Balance on the Effects of Dietary Behavior on Cognitive Impairment in Chinese Elderly

Overview

Journal Nutrients

Date 2024 Mar 28

PMID 38542819

Authors

Yating Chen

Lingling Zhang

Xiaotong Wen

Xiaojun Liu

Affiliations

Soon will be listed here.

Abstract

Background: Cognitive impairment, a significant problem in older adults, may be associated with diet. This study aims to examine the association between the dietary diversity score (DDS), dietary pattern (DP), and cognitive impairment in elderly Chinese. This research further explored the role of psychological balance (PB) as a mediator in the relationship between diet and cognitive impairment.

Methods: A total of 14,318 older adults from the Chinese Longitudinal Healthy Longevity Study (CLHLS) in 2018 were included. Latent class analysis (LCA) was used to identify patterns in seven food varieties. Binary logistic regression models were used to determine factors associated with the DDS, DP, and cognitive impairment. The multiple mediation effect model was evaluated using model 6 in the PROCESS version 3.5 program.

Results: Among the participants, 4294 (29.99%) developed cognitive impairment. Compared to people in food variety group two or lower, people with a high dietary diversity score (DDS) had lower odds of cognitive impairment. Compared to DP1, DP2 (OR = 1.24, 95%CI = 1.09 to 1.40) was associated with a higher risk of cognitive impairment, and DP4 (OR = 0.79, 95%CI = 0.69 to 0.89) was associated with a lower risk of cognitive impairment. PB mediated the relationship between DDS, DP, and cognitive impairment, with a mediating effect of 27.24% and 41.00%.

Conclusions: A DP that is rich in fruits, vegetables, red meat, fish, eggs, beans, nuts, and milk was related to a lower risk of cognitive impairment. PB has an indirect impact on cognitive impairment. Our findings underscore the importance of promoting a diverse diet, which may contribute to a lower risk of cognitive impairment in older adults. The PB of the elderly should also be taken into consideration.

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References

Gauthier S, Reisberg B, Zaudig M, Petersen R, Ritchie K, Broich K . Mild cognitive impairment. Lancet. 2006; 367(9518):1262-70. DOI: 10.1016/S0140-6736(06)68542-5. View

Salminen L, Paul R . Oxidative stress and genetic markers of suboptimal antioxidant defense in the aging brain: a theoretical review. Rev Neurosci. 2014; 25(6):805-19. PMC: 6378111. DOI: 10.1515/revneuro-2014-0046. View

Dominguez L, Barbagallo M . The relevance of nutrition for the concept of cognitive frailty. Curr Opin Clin Nutr Metab Care. 2016; 20(1):61-68. DOI: 10.1097/MCO.0000000000000337. View

Zhang X, Han H, Ge X, Liu L, Wang T, Yu H . Effect of n-3 long-chain polyunsaturated fatty acids on mild cognitive impairment: a meta-analysis of randomized clinical trials. Eur J Clin Nutr. 2019; 74(4):548-554. DOI: 10.1038/s41430-019-0544-4. View

Chen H, Zhang X, Feng Q, Zeng Y . The Effects of "Diet-Smoking-Gender" Three-Way Interactions on Cognitive Impairment among Chinese Older Adults. Nutrients. 2022; 14(10). PMC: 9147822. DOI: 10.3390/nu14102144. View

Zheng J, Zhou R, Li F, Chen L, Wu K, Huang J . Association between dietary diversity and cognitive impairment among the oldest-old: Findings from a nationwide cohort study. Clin Nutr. 2021; 40(4):1452-1462. DOI: 10.1016/j.clnu.2021.02.041. View

Chen X, Maguire B, Brodaty H, OLeary F . Dietary Patterns and Cognitive Health in Older Adults: A Systematic Review. J Alzheimers Dis. 2019; 67(2):583-619. DOI: 10.3233/JAD-180468. View

Byrne C, Coetzer R, Addy K . Investigating the discrepancy between subjective and objective cognitive impairment following acquired brain injury: The role of psychological affect. NeuroRehabilitation. 2017; 41(2):501-512. DOI: 10.3233/NRE-162015. View

Yin Z, Brasher M, Kraus V, Lv Y, Shi X, Zeng Y . Dietary Diversity Was Positively Associated with Psychological Resilience among Elders: A Population-Based Study. Nutrients. 2019; 11(3). PMC: 6471509. DOI: 10.3390/nu11030650. View

10.

Shikh E, Nikolaeva N, Molchanova N, Elizarova E . [Correction of gut dysbiosis as a promising direction in the prevention of neuroinflammation and cognitive impairment]. Vopr Pitan. 2024; 92(6):107-119. DOI: 10.33029/0042-8833-2023-92-6-107-119. View

11.

Morris M, Evans D, Tangney C, Bienias J, Wilson R . Associations of vegetable and fruit consumption with age-related cognitive change. Neurology. 2006; 67(8):1370-6. PMC: 3393520. DOI: 10.1212/01.wnl.0000240224.38978.d8. View

12.

Kumawat M, Sharma T, Singh I, Singh N, Singh S, Ghalaut V . Decrease in antioxidant status of plasma and erythrocytes from geriatric population. Dis Markers. 2012; 33(6):303-8. PMC: 3810699. DOI: 10.3233/DMA-2012-00938. View

13.

Folstein M, Folstein S, McHugh P . "Mini-mental state". A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res. 1975; 12(3):189-98. DOI: 10.1016/0022-3956(75)90026-6. View

14.

Connors M, Ames D, Boundy K, Clarnette R, Kurrle S, Mander A . Mortality in Mild Cognitive Impairment: A Longitudinal Study in Memory Clinics. J Alzheimers Dis. 2016; 54(1):149-55. DOI: 10.3233/JAD-160148. View

15.

Munoz-Garach A, Cornejo-Pareja I, Martinez-Gonzalez M, Bullo M, Corella D, Castaner O . Milk and Dairy Products Intake Is Related to Cognitive Impairment at Baseline in Predimed Plus Trial. Mol Nutr Food Res. 2021; 65(7):e2000728. DOI: 10.1002/mnfr.202000728. View

16.

van Gelder B, Tijhuis M, Kalmijn S, Kromhout D . Fish consumption, n-3 fatty acids, and subsequent 5-y cognitive decline in elderly men: the Zutphen Elderly Study. Am J Clin Nutr. 2007; 85(4):1142-7. DOI: 10.1093/ajcn/85.4.1142. View

17.

Hwang J, Lee S, Kim S, Chung H, Kim W . Psychological distress is associated with inadequate dietary intake in Vietnamese marriage immigrant women in Korea. J Am Diet Assoc. 2010; 110(5):779-85. DOI: 10.1016/j.jada.2010.02.004. View

18.

Solfrizzi V, Panza F, Capurso A . The role of diet in cognitive decline. J Neural Transm (Vienna). 2003; 110(1):95-110. DOI: 10.1007/s00702-002-0766-8. View

19.

Qin B, Plassman B, Edwards L, Popkin B, Adair L, Mendez M . Fish intake is associated with slower cognitive decline in Chinese older adults. J Nutr. 2014; 144(10):1579-85. PMC: 4162477. DOI: 10.3945/jn.114.193854. View

20.

Zhang Y, Chen J, Qiu J, Li Y, Wang J, Jiao J . Intakes of fish and polyunsaturated fatty acids and mild-to-severe cognitive impairment risks: a dose-response meta-analysis of 21 cohort studies. Am J Clin Nutr. 2016; 103(2):330-40. DOI: 10.3945/ajcn.115.124081. View