Associations of Dietary Pattern and Sleep Duration with Cognitive Decline in Community-Dwelling Older Adults: A Seven-Year Follow-Up Cohort Study

Article type: Research Article

Authors: Shang, Xianwen^{a; *} | Hodge, Allison M.^{b; c} | Hill, Edward^{d; e} | Zhu, Zhuoting^a | He, Mingguang^{a; f; g; *}

Affiliations: [a] Guangdong Eye Institute, Department of Ophthalmology, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China | [b] Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, Australia | [c] Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia | [d] Wicking Dementia Research and Education Centre, University of Tasmania, Hobart, Australia | [e] Department of Medicine, Royal Melbourne Hospital, University of Melbourne, Melbourne, Australia | [f] Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, Melbourne, Australia | [g] State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China

Correspondence: [*] Correspondence to: Xianwen Shang, MPH, PhD, Guangdong Eye Institute, Department of Ophthalmology, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China. E-mail: andy243@126.com; Mingguang He, MD, PhD, Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, Melbourne, Australia. E-mail: mingguang_he@yahoo.com.

Abstract: Background:A few studies have linked dietary patterns and sleep to cognitive decline. Objective:To examine the independent and joint associations of dietary patterns and sleep with cognitive decline. Methods:Our analysis included 2,307 participants aged 55– 89 years at baseline from the China Health and Nutrition Survey. Dietary intake was assessed using weighing methods in combination with 24 h dietary recalls for three consecutive days. Exploratory factor analysis was applied to identify major dietary factors. Cognition was assessed in 1997, 2000, 2004, 2006, and 2015. Results:Five dietary patterns were identified: dairy-fruits-fast foods, grains-vegetables-pork, plant-based food, beans-mushroom, and beverages-nuts patterns. Beans-mushroom pattern and sleep duration of 8 h/day were defined as healthy habits. There was a positive association between the beans-mushroom pattern and change in the global cognitive Z-score over seven years (β (95% CI) for quintile 5 versus quintile 1:0.17 (0.05, 0.30)). Compared to individuals with sleep duration of 8 h/day, those with sleep duration of≤5 h/day (β (95% CI): – 0.23 (– 0.45, – 0.00)) or > 10 h/day (– 0.52 (– 0.73, – 0.32)) had a greater decrease in global cognitive Z-score. Compared to individuals with no healthy patterns, those with a healthy dietary pattern only (β (95% CI): 0.18 (0.08, 0.28)), healthy sleep pattern only (0.13 (0.04, 0.23), and both healthy dietary and sleep patterns (0.19 (0.08, 0.31)) had a relative increase in global cognitive Z-score. Conclusion:Our findings highlight the importance of involving both diet and sleep as intervention priorities for the potential prevention of cognitive decline.

Keywords: Cognitive decline, dietary pattern, sleep duration

DOI: 10.3233/JAD-201329

Journal: Journal of Alzheimer's Disease, vol. 82, no. 4, pp. 1559-1571, 2021