MARIA ENCARNACIÓN ANDREU REINÓN¹, MARIA DOLORES CHIRLAQUE¹, SANDRA MILENA COLORADO YOHAR¹, Fernando Navarro Mateu¹, Carmen Navarro Sánchez¹, José María Huerta Castaño¹

(1) INVESTIGACIÓN EN EPIDEMIOLOGÍA Y SALUD PÚBLICA, IMIB-Arrixaca, España

The Mediterranean diet (MD) has demonstrated to be beneficial for different health outcomes. Over the past few years there is raising interest on its potential protective effect on cognitive health. The objective was to evaluate the relationship between adherence to a MD pattern and the risk of dementia and subtypes in the EPIC-Spain Dementia Cohort.

The EPIC-Spain Dementia Cohort consists of 25,015 healthy participants recruited from three Spanish regions (Murcia, Navarra, Gipuzkoa) between 1992-1996 and followed-up for over 20 years. Incident cases of dementia and subtypes were ascertained through medical records. Dietary information was collected through a validated diet history questionnaire and adherence to the MD pattern was assessed by means of the relative Mediterranean Diet (rMED) score. Hazard ratios (HR) of dementia and subtypes were estimated using proportional hazards Cox models, stratified by center and age and adjusted by different variables for tertile categories of the rMED and the score as a continuous variable. Time-dependent effects were evaluated using flexible parametric Royston-Parmar (RP) multivariate survival models. Participants with major chronic pathologies, and energy misreporters were excluded from the analyses, with a final sample of 16,160 participants including 459 incident cases of dementia.

A non-linear inverse association was found between adherence to the rMED score and the risk of dementia. Dementia risk decreased by 9% for each 2-point increment of the rMED score. The protective effect was higher in men for Alzheimer’s disease (AD) and showed a potential dose-response effect. Moreover, the risk of dementia varied depending on follow-up time and cumulative number of cases. Education was found to be a potential modifying factor.

MD had a protective effect on dementia and AD in the EPIC-Spain Dementia cohort. The protective effect was higher in male for AD and higher in female for non-AD with a potential dose-response effect. Funding: The EPIC study received financial support from the International Agency for Research on Cancer (AEP/93/06), the European Commission (SO-97-200302-05F02, SP23-CT-2005-006438), the Health Research Fund (FIS) of the Spanish Ministry of Health, the CIBER de Epidemiología y Salud Pública (CIBERESP), and the participating Regional Governments of Basque Country, Murcia (no. 6236), and Navarra. The present project received partial funding from the Fundación Séneca (19487/PI/14).