J Nutr Health.  2015 Jun;48(3):221-227. 10.4163/jnh.2015.48.3.221.

Association between compliance with dietary guidelines and Alzheimer's disease in Korean elderly

• Kim JE
• Shin S
• Lee DW
• Park JH
• Hong EJ
• Joung H

• KMID: 2327192
• DOI: http://doi.org/10.4163/jnh.2015.48.3.221

Abstract

PURPOSE
Confronting the growing burden of dementia requires understanding the causes and predictors of dementia in order to develop preventive strategies. In Korea a large proportion (71%) of dementia is Alzheimer's disease, and the risk factors have not yet been elucidated. Dietary factors may be possible risk factors, however research on the relationship between Alzheimer's disease and dietary behaviors has been insufficient. The purpose of this study was to investigate the association between compliance with the "Dietary Guidelines for Elderly (The Ministry of Health and Welfare, 2011)" and Alzheimer's disease among Korean elderly.
METHODS
Elderly persons who visited a University hospital or a dementia center of Seoul and agreed to participate in the examinations were selected. Among 277 subjects, 89 Alzheimer patients were selected with diagnosis and 118 subjects were assigned to the control group. Diagnosis of Alzheimer's disease was based on Alzheimer's disease criteria of Diagnostic and Statistical manual of Mental Disorders, 4th edition (DSM-IV) and criteria of National Institute of Neurological and Communicative Disorders and Stroke-Alzheimer's Disease and related Disorders Association (NINCDS-ADRDA). Information on the general characteristics, health related behaviors and compliance with the dietary guidelines for Korean elderly was collected by face to face interview using a structured questionnaire. Anthropometric variables were measured during the survey.
RESULTS
Total compliance score of dietary guidelines was significantly lower in the Alzheimer's disease group than in the control group (p = 0.0001). The odds ratio of Alzheimer's disease was significantly decreased in the group with the highest dietary guideline compliance score (OR = 0.47, 95 % CI = 0.18~1.09) compared to the group with the lowest compliance score.
CONCLUSION
The results indicate that increasing compliance with the dietary guidelines could be an effective strategy to decrease the risk of Alzheimer's disease among Korean elderly.

Keyword

compliance; dietary guidelines; Alzheimer's disease

MeSH Terms

Aged*
Alzheimer Disease*
Communication Disorders
Compliance*
Dementia
Diagnosis
Diagnostic and Statistical Manual of Mental Disorders
Humans
Korea
Nutrition Policy*
Odds Ratio
Surveys and Questionnaires
Risk Factors
Seoul

Reference

1.Lopez AD., Mathers CD., Ezzati M., Jamison DT., Murray CJ. Global and regional burden of disease and risk factors, 2001: systematic analysis of population health data. Lancet. 2006. 367(9524):1747–1757.

2.Steenland K., MacNeil J., Vega I., Levey A. Recent trends in Alzheimer disease mortality in the United States, 1999 to 2004. Alzheimer Dis Assoc Disord. 2009. 23(2):165–170.

3.Gu Y., Nieves JW., Stern Y., Luchsinger JA., Scarmeas N. Food combination and Alzheimer disease risk: a protective diet. Arch Neurol. 2010. 67(6):699–706.

4.Scarmeas N., Stern Y., Tang MX., Mayeux R., Luchsinger JA. Mediterranean diet and risk for Alzheimer's disease. Ann Neurol. 2006. 59(6):912–921.

5.Scarmeas N., Stern Y., Mayeux R., Manly JJ., Schupf N., Luchsinger JA. Mediterranean diet and mild cognitive impairment. Arch Neurol. 2009. 66(2):216–225.

6.McKhann G., Drachman D., Folstein M., Katzman R., Price D., Stad-lan EM. Clinical diagnosis of Alzheimer's disease: report of the NINCDS-ADRDA Work Group under the auspices of Department of Health and Human Services Task Force on Alzheimer's Disease. Neurology. 1984. 34(7):939–944.

7.Knopman DS., DeKosky ST., Cummings JL., Chui H., Corey-Bloom J., Relkin N., Small GW., Miller B., Stevens JC. Practice parameter: diagnosis of dementia (an evidence-based review). Report of the Quality Standards Subcommittee of the American Academy of Neurology. Neurology. 2001. 56(9):1143–1153.

8.Barnard ND., Bush AI., Ceccarelli A., Cooper J., de Jager CA., Erickson KI., Fraser G., Kesler S., Levin SM., Lucey B., Morris MC., Squitti R. Dietary and lifestyle guidelines for the prevention of Alzheimer's disease. Neurobiol Aging. 2014. 35(Suppl 2):S74-S78.

9.Dai Q., Borenstein AR., Wu Y., Jackson JC., Larson EB. Fruit and vegetable juices and Alzheimer's disease: the Kame Project. Am J Med. 2006. 119(9):751–759.

10.Hughes TF., Andel R., Small BJ., Borenstein AR., Mortimer JA., Wolk A., Johansson B., Fratiglioni L., Pedersen NL., Gatz M. Midlife fruit and vegetable consumption and risk of dementia in later life in Swedish twins. Am J Geriatr Psychiatry. 2010. 18(5):413–420.

11.Eskelinen MH., Ngandu T., Tuomilehto J., Soininen H., Kivipelto M. Midlife healthy-diet index and late-life dementia and Alzheimer's disease. Dement Geriatr Cogn Dis Extra. 2011. 1(1):103–112.

12.Cho KO., Jeong SY. The effects of regular dietary habits on obesity indices and nutrition intakes in adult males. J Korean Diet Assoc. 2007. 13(2):114–122.

13.Gustafson D., Rothenberg E., Blennow K., Steen B., Skoog I. An 18-year follow-up of overweight and risk of Alzheimer disease. Arch Intern Med. 2003. 163(13):1524–1528.

14.Luchsinger JA., Tang MX., Shea S., Mayeux R. Caloric intake and the risk of Alzheimer disease. Arch Neurol. 2002. 59(8):1258–1263.

15.Luchsinger JA., Tang MX., Shea S., Mayeux R. Antioxidant vitamin intake and risk of Alzheimer disease. Arch Neurol. 2003. 60(2):203–208.

16.Luchsinger JA., Tang MX., Siddiqui M., Shea S., Mayeux R. Alcohol intake and risk of dementia. J Am Geriatr Soc. 2004. 52(4):540–546.

17.Larson EB., Wang L., Bowen JD., McCormick WC., Teri L., Crane P., Kukull W. Exercise is associated with reduced risk for incident dementia among persons 65 years of age and older. Ann Intern Med. 2006. 144(2):73–81.

18.Rogers HB., Schroeder T., Secher NH., Mitchell JH. Cerebral blood flow during static exercise in humans. J Appl Physiol (1985). 1990. 68(6):2358–2361.

19.Colcombe S., Kramer AF. Fitness effects on the cognitive function of older adults: a meta-analytic study. Psychol Sci. 2003. 14(2):125–130.

20.Barnes DE., Yaffe K., Satariano WA., Tager IB. A longitudinal study of cardiorespiratory fitness and cognitive function in healthy older adults. J Am Geriatr Soc. 2003. 51(4):459–465.