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Mediterranean Diet, Alzheimer Disease Biomarkers, and Brain Atrophy in Old Age
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OBJECTIVE: To determine whether following a Mediterranean-like diet (MeDi) relates to cognitive functions and in vivo biomarkers for Alzheimer disease (AD), we analyzed cross-sectional data from the German DZNE-Longitudinal Cognitive Impairment and Dementia Study. METHOD: The sample (n=512, mean age: 69.5±5.9 years) included 169 cognitively normal participants and subjects at higher AD risk (53 with relatives with AD, 209 with subjective cognitive decline, and 81 with mild cognitive impairment). We defined MeDi adherence based on the Food Frequency Questionnaire. Brain volume outcomes were generated via voxel-based morphometry on T1-MRI and cognitive performance with an extensive neuropsychological battery. AD-related biomarkers (Aβ42/40 ratio, pTau181) in cerebrospinal fluid were assessed in n=226 individuals. We analyzed the associations between MeDi and the outcomes with linear regression models controlling for several covariates. Additionally, we applied hypothesis-driven mediation and moderation analysis. RESULTS: Higher MeDi adherence related to larger mediotemporal gray matter volume (p<0.05 FWE corrected), better memory (β±SE = 0.03 ± 0.02; p=0.038), and less amyloid (Aβ42/40 ratio, β±SE = 0.003 ± 0.001; p=0.008) and pTau181 pathology (β±SE = -1.96±0.68; p=0.004). Mediotemporal volume mediated the association between MeDi and memory (40% indirect mediation). Finally, MeDi favorably moderated the associations between Aβ42/40 ratio, pTau181 and mediotemporal atrophy. Results were consistent correcting for ApoE-ε4 status. CONCLUSION: Our findings corroborate the view of MeDi as a protective factor against memory decline and mediotemporal atrophy. Importantly, they suggest that these associations might be explained by a decrease of amyloidosis and tau-pathology. Longitudinal and dietary intervention studies should further examine this conjecture and its treatment implications.
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Metadata
- Authors
- Ballarini, T., Melo van Lent, D., Brunner, J., Schröder, A., Wolfsgruber, S., Altenstein, S., Brosseron, F., Buerger, K., Dechent, P., Dobisch, L., Düzel, E., Ertl-Wagner, B., Fliessbach, K., Freiesleben, S. D., Frommann, I., Glanz, W., Hauser, D., Haynes, J. D., Heneka, M. T., Janowitz, D., Kilimann, I., Laske, C., Maier, F., Metzger, C. D., Munk, M. H., Perneczky, R., Peters, O., Priller, J., Ramirez, A., Rauchmann, B.-S., Roy, N., Scheffler, K., Schneider, A., Spottke, A., Spruth, E. J., Teipel, S. J., Vukovich, R., Wiltfang, J., Jessen, F., Wagner, M., & on behalf of the DELCODE Study Group
- Affiliations
- The University of Texas at San Antonio Health Science Center (US)
- From the German Center for Neurodegenerative Diseases (DZNE) (T.B., D.M.v.L., J.B., A.Schröder, S.W., F.B., K.F., I.F., M.T.H., N.R., A. Schneider, A. Spottke, F.J., M.W.), Bonn, Venusberg-Campus 1, Bonn, Germany; University of Texas Health Science Center at San Antonio (D.M.v.L.); Department of Neurodegeneration and Geriatric Psychiatry (S.W., F.B., K.F., M.T.H., A. Schneider, M.W.), University Hospital Bonn, Venusberg-Campus 1; German Center for Neurodegenerative Diseases (DZNE) (S.A., O.P., J.P.,...
- ORCID
- Ballarini, Tommaso
- Wolfsgruber, Steffen
- Altenstein, Slawek
- Brosseron, Frederic
- Dechent, Peter
- Düzel, Emrah
- Ertl-Wagner, Birgit
- Fliessbach, Klaus
- Freiesleben, Silka Dawn
- Frommann, Ingo
- Glanz, Wenzel
- Haynes, John Dylan
- Heneka, Michael T.
- Janowitz, Daniel
- Kilimann, Ingo
- Laske, Christoph
- Maier, Franziska
- Munk, Matthias H.
- Perneczky, Robert
- Peters, Oliver
- Priller, Josef
- Ramirez, Alfredo
- Rauchmann, Boris-Stephan
- Scheffler, Klaus
- Schneider, Anja
- Spottke, Annika
- Spruth, Eike Jakob
- Teipel, Stefan J.
- Wiltfang, Jens
- Jessen, Frank
- Wagner, Michael
- Venue
- Neurology
- Published
- 2021-06-15
- Volume
- 96
- Issue
- 24
- Pages
- e2920-e2932
- ISSN
- 0028-3878 (ISSN-L)
- 1526-632X
- PMC
- PMC8253566
- OpenAlex
- W3159579165
- Cited by
- 153
- References
- 54
- Citations by year
- 2026: 20 · 2025: 23 · 2024: 39 · 2023: 35 · 2022: 27 · 2021: 9
- FWCI
- 19.71
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Neurology (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Kölner Universitäts PublikationsServer (Universität zu Köln) (publishedVersion)
- Kölner Universitäts PublikationsServer (Universität zu Köln) (acceptedVersion)
- Open Repository and Bibliography (University of Luxembourg) (submittedVersion, other-oa)
- UCL Discovery (University College London) (submittedVersion)
- DZNE Pub (submittedVersion)
- GoeScholar The Publication Server of the Georg-August-Universität Göttingen (Georg-August-Universität Göttingen) (submittedVersion, cc-by)
- Funders
- Bundesministerium für Bildung und Forschung (01EA1809C)
- Deutsches Zentrum für Neurodegenerative Erkrankungen
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Nutritional Studies and Diet
- Life Sciences › Neuroscience › Cellular and Molecular Neuroscience › Alzheimer's disease research and treatments
- Keywords
- Mediterranean diet, Alzheimer's disease, brain atrophy, memory decline, amyloid-beta, tau pathology, cerebrospinal fluid biomarkers, dietary adherence, cognitive impairment, APOE ε4
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