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Dietary Intake and Cognitive Function in a Group of Elderly People

CITATION:  Ortega, R.M., Requejo, A.M., et al.  (1997)  Dietary Intake and Cognitive Function in a Group of Elderly People.  Am J Clin Nutr; 66;803.

ABSTRACT:  Associations between dietary intake and cognitive performance were examined in 260 elderly people aged 65-90 y who were free of significant cognitive impairment. Dietary intake was monitored with a weighed-food record for 7 consecutive days. The subjects’ cognitive capacity was tested by using Folstein et al’s Mini-Mental State Examination (MMSE) and Pfeiffer’s Mental Status Questionnaire (PMSQ). Subjects with adequate MMSE results (28 points) had lower intakes of monounsaturated fatty acids, saturated fatty acids, and cholesterol, and higher intakes of total food, fruit, carbohydrate, thiamine, folate, and vitamin C compared with those with less satisfactory results.

Subjects who made no errors on the PMSQ had greater intakes of total food, vegetables, fruit, carbohydrate, fiber, folate, vitamin C, a-carotene, iron, and zinc, and lower intakes of saturated fatty acids compared with those who made errors. Our results agree with those of other authors indicating that intakes of different nutrients or the consumption of a more satisfactory global diet is associated
with better cognitive function in the elderly. However, more research is required to determine whether differences in intake of a particular nutrient are the result of or a conditioning factor for incipient impaired cognition. Unmeasured confounding factors may also affect both dietary intake and risk of cognitive impairment. A diet with less fat, saturated fat, and cholesterol, and more carbohydrate, fiber, vitamins (especially folate, vitamins C and E, and j3-caotenes), and minerals (iron and zinc) may be advisable not only to improve the general health of the elderly but also to improve cognitive function.

References

1. Jama JW, Launer U, Witteman JCM, et al. Dietary antioxidants and
cognitive function in a population-based sample of older persons. The
Rotterdam Study. Am J Epidemiol l996;l44:275-80.

2. Johnson LE. Vitamin disorders in the elderly. In: Morley JE, Glick Z,
Rubenstein 12, eds. Geriatric nutrition. New York: Raven Press,
1990:117-47.

3. La Rue A, Koehler KM. Wayne SJ, Chiulli SJ, Haaland KY, Garry PJ.
Nutritional status and cognitive functioning in a normally aging sampie:
a 6-y reassessment. Am J Clin Nutr 1997;65:20-9.

4. Beard J. One person’s view of iron deficiency, development, and
cognitive function. Am J Clin Nutr 1995;62:709-lO.

5. Bohnen H, Jolles J, Degenaar CP. Lower blood levels of vitamin B12
are related to decreased performance of healthy subjects in the Stroop
Color-Word Test. Neurosci Res Commun l992;l 1:53-66.

6. Bottiglieri T, Crellin RF, Reynolds EH. Folate and neuropsychiatry.
In: Bailey LB. ed. Folate in health and disease. New York: Marcel
Dekker, 1995:435-62.

7. Cook JD, Skikne BS, Baynes RD. Iron deficiency: the global perspective.
Adv Exp Med Biol l994;356:219-28.

8. Connor JR. Iron acquisition and expression of iron regulatory proteins
in the developing brain: manipulation by ethanol exposure, iron
deprivation and cellular dysfunction. Dev Neurosci 1994;l6:233-47.

9. Ham RH. Thiamin and the brain. Annu Rev Nutr l988;8:483-5l5.

10. Goodwin JS, Goodwin JM, Garry PJ. Association between nutritional
status and cognitive functioning in a healthy elderly population. JAMA
l983;249:29l7-21.

1 1. Lauque 5, Wegner A, Oussett PJ, et al. Nutritional intake and neurocognitive
functions. Age Nutr 1995:6:68-72.

12. Masaki KH, White LR, Petrovitch H, et al. The influence of prior and
concurrent use of aspirin and vitamins on cognitive function scores in
elderly Japanese-American men. Neurobiol Aging l994;l5(suppl 1):
574 (abstr).

13. Ortega RM, Andr#{233P}.s L#{243}pez-Sobaler AM, et al. The role of folates in
different biochemical processes that control mental function. Nutr
Hosp l994;9:251-6.

14. Ortega RM, Redondo MR. Jim#{233}neLzM, Andr#{233P}s. Ortega A. Influence
of folate status on mental function in the elderly. Rev Esp Geriatr
Gerontol l995;30:219-22.

15. Ortega RM, RodrIguez L, Andr#{233}sP. et al. Functional and psychic
deterioration in elderly people may be aggravated by folate deficiency.
J Nutr 1996;126:l992-9.

16. Riggs KM, Spiro A III, Tucker K, Rush D. Relations of vitamin B-l2,
vitamin B-6, folate, and homocysteine to cognitive performance in the
Normative Aging Study. Am J Clin Nutr 1996;63:306-l4.

17. Rosenberg IH, Miller flY. Nutritional factors in physical and cognitive
functions of elderly people. Am J Clin Nutr 1992;55(suppl):
12375-435.

18. Soewondo S. The effect of iron deficiency and mental stimulation on
Indonesian children’s cognitive performance and development. Kobe
J Med Sci l995;4l:l-17.

19. Tucker DM, Penland JG, Sandstead HH, Mime DB, Heck DO, Klevay
Downloaded from www.ajcn.org by on May 1, 2006
LM. Nutrition status and brain function in aging. Am J Clin Nutr
l990;52:93-l02.

20. Ortega RM, Collado MA, Moreiras 0. Dietetic evaluation of nutritional
status of two groups of institutionalized elderly people of
different socioeconomic levels. Nutr Clin l992;12:43-9.

21. Instituto de Nutrici#{243}n.Spanish food composition tables. Madrid: Instituto
de Nutrici#{243}n, 1994.

22. Moreiras 0, Carbajal A, Cabrera ML. Tablas de composici#{243}n de
alimentos. (Food composition tables.) Madrid: Ediciones Piramide SA,
1995 (in Spanish).

23. World Health Organization. Energy and protein requirements. Report
of a joint FAO/WHOIUNU expert consultation. World Health Organ
Tech Rep 5cr 1985;724:7l-80.

24. Departamento de NutriciOn. Tables of recommended intakes of energy
and nutrients for the Spanish population. Madrid: Departamento de
NutriciOn, 1994.

25. Dalloso HM, Morgan K, Bassey El, Ebrahim SBJ, Fentem PH, Arie
THD. Levels of customary physical activity among the old and very
old living at home. J Epidemiol Community Health l988;42:l21-7.

26. Johnson RK, Goran MI, Pohlman ET. Correlates of over- and underreporting
ofenergy intake in healthy older men and women. Am J Clin
Nutr 1994;59: 1286-90.

27. Ortega RM, Redondo MR. Zamora Mi, L#{243}pez-Sobaler A, Andr#{233P}s.
Eating behaviour and energy and nutrient intake in overweight/obese
and normal-weight Spanish elderly. Ann Nutr Metab 1995;39:371-8.

28. World Health Organization. Methodology of nutritional surveillance.
Report of a joint FAOIWHO/UNU expert consultation. World Health
Organ Tech Rep 5cr l976;53:20.

29. Lucas-Mann A. Introduction to sociology. 3rd ed. Pamplona, Spain:
Eunsa SA, 1992:141-6.

30. Folstein MF, Folstein SE, McHugh PR. Mini Mental State. A practical
method for grading the cognitive state of patients for the clinician.
J Psychiatr Res 1975;l2:l89-98.

3 1 . Lobo A, Ezquerra J. The cognoscente Mini-Exam: a simple and
practical test for detecting intellectual alterations in medical patients.
Actas Luso Esp Neurol Psiquiatr 1979;3:l49-53.

32. Pfeiffer E. A short portable mental status questionnaire for the assessment
of organic brain deficit in elderly patients. J Am Geriatr Soc
l975;23:433-9.

33. Gonzalez JL, RodrIguez-Mafias L, Ruiperez I. Evaluation of Pfeiffer’s
Questionnaire and the Red Cross Mental Incapacity Scale in the
detection of mental deterioration in geriatric out-patients. Rev Esp
Geriatr Gerontol 1992;27: 129-33.

34. Wonnacott HW, Wonnacott Ri. Introductory statistics. New York:
John Wiley and Sons, 1977.

35. Ortega RM, Andr#{233}sP, Redondo MR, Zamora MJ, L#{243}pez-Sobaler AM,
Encinas-Sotillos A. Dietary assessment of a group of elderly Spanish
people. mt J Food Sci Nutr 1995;46:l37-44.

36. Ortega RM, Redondo R, Andres P, Eguileor I. Nutritional assessment
of folate and cyanocobalamin status in a Spanish elderly group. mt J
Vitam Nutr Res l993;63:l8-22.

37. Requejo AM, Ortega RM. Correct nutrition for the elderly. Madrid:
Excelentisimo Ayuntamiento de Madrid, Area de Salud y Consumo,
1995.

38. Ortega RM, Andr#{233P},s Mel#{233}ndeAz, et al. The influence of nutrition on
functional capacity in a group of elderly Spanish people. Arch Latinoam
Nutr l992;42:133-45.

39. Breteler MMB, van Swieten JC, Bots ML, et al. Cerebral white matter
lesions, vascular risk factors, and cognitive function in a populationbased
study: the Rotterdam Study. Neurology 1994;44: 1246-52.

40. Elwan 0, Hashem 5, Helmy AA, et al. Cognitive deficits in ischemic
strokes: psychometric, electrophysiological and cranial tomographic
assessment. J Neurol Sci l994;l25:168-74.

41 . Gey KF, Stahelin HB, Eichholzer M. Poor plasma status of carotene
and vitamin C is associated with higher mortality from ischemic heart
disease and stroke. Clin Invest 1993;7l:3-6.

42. White BC, Grossman LI, Krause GS. Brain injury by global ischemia
and reperfusion: a theoretical perspective on membrane damage and
repair. Neurology 1993,43:1656-65.

43. Ames BN, Shigenaga MK, Hagen TM. Oxidants, antioxidants and the
degenerative diseases of aging. Proc NatI Acad Sci U S A
l993;90:79l5-22.

44. Werbach MR. Nutritional influences on illness. A sourcebook of
clinical research. San Francisco: Third Line Press, 1993.

45. Ministerio de Sanidad y Consumo, Sociedad Espa#{241}ola de Cardiologla.
Consensus for the control of cholesterolemia in Spain. Madrid: Mmisterio
de Sanidad y Consumo, Direcci#{243}n General de Planificaci#{243}n
Sanitaria, 1989.

46. Kang 55, Wong PWK, Malinow MR. Hyperhomocyst(e)inemia as a
risk factor for occlusive vascular disease. Annu Rev Nutr
1992; 12:279-98.

47. Pancharuniti N, Lewis CA, Sauberlich HE, et al. Plasma homocyst(
e)ine, folate, and vitamin B-12 concentrations and risk for early-onset
coronary artery disease. Am J Clin Nutr l994;59:940-8.