Higher adherence to the Mediterranean Diet was associated with lower risk
for Alzheimer Disease.
ArchNeurol.2006;63
doi:10.1001/archneur.63.12.noc60109)
Mediterranean Diet, Alzheimer Disease, and Vascular Mediation
Objectives: To examine the association between the Mediterranean diet
(MeDi) and Alzheimer disease (AD) in a different AD population and to
investigate possible mediation by vascular pathways.
Design, Setting, Patients, and Main Outcome
Measures: A case-control study nested within a community- based cohort in
New York, NY. Adherence to the MeDi (0- to 9-point scale with higher scores
indicating higher adherence) was the main predictor of AD status (194
patients with AD vs 1790 nondemented subjects) in logistic regression
models that were adjusted for cohort, age, sex, ethnicity, education,
apolipoprotein E genotype, caloric intake, smoking, medical comorbidity
index, and body mass index (calculated as weight in kilograms divided by
height in meters squared). We investigated whether there was attenuation of
the association between MeDi and AD when vascular variables (stroke,
diabetes mellitus, hypertension, heart disease, lipid levels) were
simultaneously introduced in the models (which would constitute evidence of
mediation).
Results: Higher adherence to the MeDi was associated with lower risk for AD
(odds ratio, 0.76; 95% confidence interval, 0.67-0.87; P.001). Compared
with subjects in the lowest MeDi tertile, subjects in the middle MeDi
tertile had an odds ratio of 0.47 (95% confidence interval, 0.29-0.76) and
those at the highest tertile an odds ratio of 0.32 (95% confidence
interval, 0.17-0.59) for AD (P for trend .001). Introduction of the
vascular variables in the model did not change the magnitude of the
association.
Conclusions: We note once more that higher adherence to the MeDi is
associated with a reduced risk for AD. The association does not seem to be
mediated by vascular comorbidity. This could be the result of either other
biological mechanisms (oxidative or inflammatory) being implicated or
measurement error of the vascular variables.
hth
Gys
The Mediterranean Diet and Alzheimer Disease 
Linear Mode
