Depression, physical function, and risk of mortality: National Diet and Nutrition Survey in adults older than 65 years. What do review papers conclude about food and dietary patterns? Dietary pattern and depressive symptoms in middle age. Adherence to a Mediterranean diet, cognitive decline, and risk of dementia. A Prospective Cohort Study to Examine the Association between Dietary Patterns and Depressive Symptoms in Older Chinese People in Hong Kong Dietary quality is related to frailty in community-dwelling older adults. A prospective study of variety of healthy foods and mortality in women. Adherence to a DASH-style diet and risk of coronary heart disease and stroke in women. Lifestyle behaviours and quality-adjusted life years in middle and older age. A prospective study of diet quality and mortality in women. Modified Mediterranean diet and survival: EPIC-elderly prospective cohort study Mediterranean diet and mobility decline in older persons Long-term risks of death and institutionalization of elderly people in relation to deficit accumulation at age 70. Comprehensive geriatric assessment predicts mortality and adverse outcomes in hospitalized older adults Prospective study of Dietary Approaches to Stop Hypertension- and Mediterranean-style dietary patterns and age-related cognitive change: the Cache County Study on Memory, Health and Aging. Adherence to dietary guidelines positively affects quality of life and functional status of older adults. Diet quality is associated with better cognitive test performance among aging men and women. Mediterranean diet and risk of frailty in community-dwelling older adults. Mediterranean diet and cognitive decline in women with cardiovascular disease or risk factors.
OBJECTIVE the authors used an objective assessment of physical function and a range of sociodemographic , dietary , and health behaviors to explore the possible factors that could explain the association between depression and mortality in community-dwelling elderly participants aged 65 years and older . DESIGN prospect i ve follow-up of the National Diet and Nutrition Survey in older adults . SETTING community sample . PARTICIPANTS a total of 1,007 participants ( 522 men , 485 women ; mean age : 76.4 ± 7.3 years ) . MEASUREMENTS : Depression was assessed from the 15 item Geriatric Depression Scale ( GDS ) and physical function using h and grip strength . Participants were followed up for death over an average of 9.2 years . RESULTS : At baseline , 20.9 % of participants demonstrated depression ( GDS-15 score ≥ 5 ) . Depressed participants were at a higher relative risk of all cause mortality during follow-up ( age- and sex-adjusted hazard ratio = 1.24 , 95 % confidence interval : 1.04 - 1.49 ) . Other risk factors for depression also related to mortality included smoking , physical inactivity , and low grip strength . These factors collectively explained an estimated 54 % of the association between depression and mortality . Low- grade inflammation and low plasma vitamin C were also independently associated with depression and mortality but did not explain any of the association between depression and mortality . CONCLUSION late-life depression is associated with a higher risk of mortality . Physical inactivity and physical dysfunction might partly mediate this association , although further longitudinal studies are required to fully eluci date these mechanisms Nutrients and other bioactive constituents of foods may interact with each other and the surrounding food matrix in complex ways . Therefore , associations between single nutrients and chronic disease may be difficult to identify and interpret , but when dietary patterns ( DPs ) are examined the combination of many food factors will be considered . An explorative literature search of published review articles was conducted to obtain a fuller underst and ing of current DPs in epidemiological research , to discuss pros and cons of DPs in nutrition research , and to identify results of studies linking DPs to chronic disease risk in adults . R and omized feeding trials providing the experimental diets to study participants have repeatedly demonstrated that diets based on current dietary recommendations are associated with important health benefits . Systematic review s of feeding trials and prospect i ve population studies of DPs and chronic disease risk reach similar conclusions regardless of the methodology used to construct DPs . However , to date only a few review articles of DP studies have followed a systematic process using independent review ers with strict inclusion , exclusion , and study quality criteria . Diets with plenty of plants foods , fish , and seafood that preferably include vegetable oils and low-fat dairy products are associated with a lower risk of most chronic diseases . In contrast , Western-type DPs with food products low in essential nutrients and high in energy , like sugar-sweetened beverages , sweets , refined cereals and solid fats ( e.g. butter ) , and high in red and processed meats , are associated with adverse health effects . An emphasis on high- quality original research , and systematic review s following a structured process to objective ly select and judge studies , is needed in order to enforce a strong future knowledge base regarding DPs and chronic disease BACKGROUND Studies of diet and depression have focused primarily on individual nutrients . AIMS To examine the association between dietary patterns and depression using an overall diet approach . METHOD Analyses were carried on data from 3486 participants ( 26.2 % women , mean age 55.6 years ) from the Whitehall II prospect i ve cohort , in which two dietary patterns were identified : ' whole food ' ( heavily loaded by vegetables , fruits and fish ) and ' processed food ' ( heavily loaded by sweetened desserts , fried food , processed meat , refined grains and high-fat dairy products ) . Self-reported depression was assessed 5 years later using the Center for Epidemiologic Studies - Depression ( CES-D ) scale . RESULTS After adjusting for potential confounders , participants in the highest tertile of the whole food pattern had lower odds of CES-D depression ( OR = 0.74 , 95 % CI 0.56 - 0.99 ) than those in the lowest tertile . In contrast , high consumption of processed food was associated with an increased odds of CES-D depression ( OR = 1.58 , 95 % CI 1.11 - 2.23 ) . CONCLUSIONS In middle-aged participants , a processed food dietary pattern is a risk factor for CES-D depression 5 years later , whereas a whole food pattern is protective CONTEXT Higher adherence to a Mediterranean-type diet is linked to lower risk for mortality and chronic diseases , but its association with cognitive decline is unclear . OBJECTIVE To investigate the association of a Mediterranean diet with change in cognitive performance and risk for dementia in elderly French persons . DESIGN , SETTING , AND PARTICIPANTS Prospect i ve cohort study of 1410 adults ( > or = 65 years ) from Bordeaux , France , included in the Three-City cohort in 2001 - 2002 and reexamined at least once over 5 years .  Adherence to a Mediterranean diet ( scored as 0 to 9 ) was computed from a food frequency question naire and 24-hour recall . MAIN OUTCOME MEASURES Cognitive performance was assessed on 4 neuropsychological tests : the Mini-Mental State Examination ( MMSE ) , Isaacs Set Test ( IST ) , Benton Visual Retention Test ( BVRT ) , and Free and Cued Selective Reminding Test ( FCSRT ) . Incident cases of dementia ( n = 99 ) were vali date d by an independent expert committee of neurologists . RESULTS Adjusting for age , sex , education , marital status , energy intake , physical activity , depressive symptomatology , taking 5 medications/d or more , apolipoprotein E genotype , cardiovascular risk factors , and stroke , higher Mediterranean diet score was associated with fewer MMSE errors ( beta = -0.006 ; 95 % confidence interval [ CI ] , -0.01 to -0.0003 ; P = .04 for 1 point of the Mediterranean diet score ) . Performance on the IST , BVRT , or FCSRT over time was not significantly associated with Mediterranean diet adherence . Greater adherence as a categorical variable ( score 6 - 9 ) was not significantly associated with fewer MMSE errors and better FCSRT scores in the entire cohort , but among individuals who remained free from dementia over 5 years , the association for the highest compared with the lowest group was significant ( adjusted for all factors , for MMSE : beta = -0.03 ; 95 % CI , -0.05 to -0.001 ; P = .04 ; for FCSRT : beta = 0.21 ; 95 % CI , 0.008 to 0.41 ; P = .04 ) . Mediterranean diet adherence was not associated with the risk for incident dementia ( fully adjusted model : hazard ratio , 1.12 ; 95 % CI , 0.60 to 2.10 ; P = .72 ) , although power to detect a difference was limited . CONCLUSIONS Higher adherence to a Mediterranean diet was associated with slower MMSE cognitive decline but not consistently with other cognitive tests . Higher adherence was not associated with risk for incident dementia Introduction Dietary patterns are culturally specific and there is limited data on the association of dietary patterns with  late-life depression in Chinese . This study examined the associations between dietary patterns and baseline and subsequent depressive symptoms in community-dwelling Chinese older people in Hong Kong . Methods Participants aged ≥65 year participating in a cohort study examining the risk factors for osteoporosis completed a vali date d food frequency question naire at baseline between 2001 and 2003 . Factor analysis was used to identify three dietary patterns : “ vegetables-fruits ” pattern , “ snacks-drinks-milk products ” pattern , and “ meat-fish ” pattern . Depressive symptoms were measured at baseline and 4-year using the vali date d Geriatric Depression Scale . Multiple logistic regression was used for cross-sectional analysis ( n = 2,902 ) to assess the associations between dietary patterns and the presence of depressive symptoms , and for longitudinal analysis ( n = 2,211 ) on their associations with 4-year depressive symptoms , with adjustment for socio-demographic and lifestyle factors . Results The highest quartile of “ vegetables-fruits ” pattern score was associated with reduced likelihood of depressive symptoms [ Adjusted OR = 0.55 ( 95 % CI : 0.36–0.83 ) , ptrend = 0.017 ] compared to the lowest quartile at baseline . Similar inverse trend was observed for the highest quartile of “ snacks-drinks-milk products ” pattern score [ Adjusted OR = 0.41 ( 95 % CI : 0.26–0.65 ) , ptrend<0.001 ] compared to the lowest quartile . There was no association of “ meat-fish ” pattern with the presence of depressive symptoms at baseline . None of the dietary patterns were associated with subsequent depressive symptoms at 4-year . Conclusion Higher “ vegetables-fruits ” and “ snacks-drinks-milk products ” pattern scores were associated with reduced likelihood of baseline depressive symptoms in Chinese older people in Hong Kong . The longitudinal analyses failed to show any causal relationship between dietary patterns  and depressive symptoms in this population BACKGROUND The etiology of the geriatric syndrome frailty is multifactorial . Besides hormonal and inflammatory processes , nutritional influences may be of major relevance . In this cross-sectional study , the association between dietary quality and frailty was investigated . METHODS In 192 community-dwelling older volunteers ( > 75 years ) , an interview-based food frequency question naire was used to assess nutritional data . A Mediterranean diet ( MED ) score ( maximum 9 points ) was used to evaluate dietary quality . Frailty was defined as the presence of at least three and prefrailty as the presence of one or two of the following criteria : weight loss , exhaustion , low physical activity , low h and grip strength , and slow walking speed . Older adults without any of these attributes were defined as " nonfrail " Binomial logistic regression analysis was used to assess the risk of being frail ( vs prefrail and nonfrail ) in each quartile ( vs lowest quartile ) of the MED score . RESULTS The mean ( SD ) age of the participants was 83 ( 4 ) years ; 41.1 % were prefrail and 15.1 % were frail . The risk of being frail was significantly reduced in the highest quartile of the MED score ( OR 0.26 ; 95 % CI 0.07 - 0.98 ) . CONCLUSIONS A healthy dietary pattern is associated with a lower risk of being frail . Larger , prospect i ve and interventional studies are needed to clarify the association between dietary quality and frailty BACKGROUND To assess the overall influence of diet on health and disease in epidemiological studies , the habitual diet of the study participants has to be captured as a pattern rather than individual foods or nutrients . The simplest way to describe dietary preferences is to separate foods considered beneficial to health from foods considered to promote disease , and separate individuals on the basis of their regular consumption of these foods . METHODS We used data from 59 038 women participating in the prospect i ve Mammography Screening Cohort in Sweden to investigate the influence of variety of healthy and less healthy foods on all-cause and cause-specific mortality . RESULTS Women who followed a healthy diet defined as consumption of a high variety of fruits , vegetables , whole grain breads , cereals , fish , and low fat dairy products had a significantly lower mortality than women who consumed few of these foods ( 3710 deaths total ) . Women who reported regularly consuming 16 - 17 healthy foods had a 42 % lower all-cause mortality ( 95 % CI : 32 - 50 % ) compared to women reporting consumption of 0 - 8 healthy foods with any regularity ( P for trend < 0.0001 ) . For each additional healthy food consumed the risk of death was about 5 % lower ( 95 % CI : 4 - 6 % ) . Cardiovascular mortality was particularly low among women who reported consuming a high variety of healthy foods . A less healthy diet defined as consumption of a high variety of red meats , refined carbohydrates and sugars , and foods high in saturated or trans fats was not directly associated with a higher overall mortality . However , women who reported consuming many less healthy foods were significantly more likely to die from cancer than those who consumed few less healthy foods . CONCLUSIONS A healthy diet can affect longevity . It appears more important to increase the number of healthy foods regularly consumed than to reduce the number of less healthy foods regularly consumed BACKGROUND The Dietary Approaches to Stop Hypertension ( DASH ) diet has been shown to lower blood pressure , but little is known about its long-term effect on cardiovascular end points . Our objective was to assess the association between a DASH-style diet adherence score and risk of coronary heart disease ( CHD ) and stroke in women . METHODS In this prospect i ve cohort study , diet was assessed 7 times during 24 years of follow-up ( 1980 - 2004 ) with vali date d food frequency question naires . A DASH score based on 8 food and nutrient components ( fruits , vegetables , whole grains , nuts and legumes , low-fat dairy , red and processed meats , sweetened beverages , and sodium ) was calculated . Lifestyle and medical information was collected biennially with a question naire . The Cox proportional hazard model was used to adjust for potential confounders . The study population comprised 88,517 female nurses aged 34 to 59 years without a history of cardiovascular disease or diabetes in 1980 . The main outcome measures were the numbers of confirmed incident cases of nonfatal myocardial infa rct ion , CHD death , and stroke . RESULTS We documented 2129 cases of incident nonfatal myocardial infa rct ion , 976 CHD deaths , and 2317 [ corrected ] cases of stroke . After adjustment for age , smoking , and other cardiovascular risk factors , the relative risks of CHD across quintiles of the DASH score were 1.0 , 0.99 , 0.86 , 0.87 , and 0.76 ( 95 % confidence interval , 0.67 - 0.85 ) ( P<.001 for trend ) . The magnitude of risk difference was similar for nonfatal myocardial infa rct ion and fatal CHD . The DASH score was also significantly associated with lower risk of stroke ( multivariate relative risks across quintiles of the DASH score were 1.0 , 0.92 , 0.91 , 0.89 , and 0.82 ) ( P=.002 for trend ) . Cross-sectional analysis in a subgroup of women with blood sample s showed that the DASH score was significantly associated with lower plasma levels of C-reactive protein ( P=.008 for trend ) and interleukin 6 ( P=.04 for trend ) . CONCLUSION Adherence to the DASH-style diet is associated with a lower risk of CHD and stroke among middle-aged women during 24 years of follow-up OBJECTIVE to examine the relationship between combined lifestyle behaviours  and quality -adjusted life years ( QALYs ) in a general population . METHODS a population -based study was conducted in 13,358 men and women who participated in the European Prospect i ve Investigation into Cancer (EPIC)-Norfolk ( baseline 1993 - 97 ) . A score of 1 was given to each of non-smoking , physically not inactive , moderate alcohol consumption ( 1 - 14 units ) and consumption of at least five portions of fruit and vegetables ( vitamin C level ≥50 µmol/l ) . Short-Form Six-Dimension ( SF-6D ) health utility index scores were derived from the SF-36 . QALYs were estimated up to follow-up ( July 2007 ) . RESULTS a total of 13,358 men and women were eligible to be included in the study ( aged 40 - 79 years at baseline ) . A total of 12,921 people were alive at follow-up ( 117 , 784 person-years  ) . Mean follow-up period was ∼11.5 years . 437 ( 4.4 % of men and 2.4 % of women ) died . The death rate was 6.5 times higher in people with health behaviour score 0 compared with those who scored 4 ( 8.4 versus 1.3 % ) . People with higher scores had significantly higher QALYs . CONCLUSION our findings support the view that modifiable lifestyle factors are an important component in health improvement CONTEXT Most studies of diet and health care have focused on the role of single nutrients , foods , or food groups in disease prevention or promotion . Few studies have addressed the health effects of dietary patterns , which include complex mixtures of foods containing multiple nutrients and nonnutrients . OBJECTIVE To examine the association of mortality with a multifactorial diet quality index . DESIGN AND SETTING Data from phase 2 ( 1987 - 1989 ) of a prospect i ve cohort study of breast cancer screening , the Breast Cancer Detection Demonstration Project , with a median follow-up of 5.6 years . PARTICIPANTS A total of 42,254 women ( mean age , 61.1 years ) who completed the food frequency question naire portion of the survey .  MAIN OUTCOME MEASURE All-cause mortality by quartile of Recommended Food Score ( RFS ; the sum of the number of foods recommended by current dietary guidelines [ fruits , vegetables , whole grains , low-fat dairy , and lean meats and poultry ] that were reported on the question naire to be consumed at least once a week , for a maximum score of 23 ) . RESULTS There were 2065 deaths due to all causes in the cohort . The RFS was inversely associated with all-cause mortality . Compared with those in the lowest quartile , subjects in the upper quartiles of the RFS had relative risks for all-cause mortality of 0.82 ( 95 % confidence interval [ CI ] , 0.73 - 0.92 ) for quartile 2 , 0.71 ( 95 % CI , 0.62 - 0.81 ) for quartile 3 , and 0.69 ( 95 % CI , 0.61 - 0.78 ) for quartile 4 adjusted for education , ethnicity , age , body mass index , smoking status , alcohol use , level of physical activity , menopausal hormone use , and history of disease ( chi2 for trend = 35.64 , P<.001 for trend ) . CONCLUSIONS These data suggest that a dietary pattern characterized by consumption of foods recommended in current dietary guidelines is associated with decreased risk of mortality in women Abstract Objective To examine whether adherence to the modified Mediterranean diet , in which unsaturates were substituted for monounsaturates , is associated with longer life expectancy among elderly Europeans . Design Multicentre , prospect i ve cohort study . Setting Nine European countries ( Denmark , France , Germany , Greece , Italy , the Netherl and s , Spain , Sweden , United Kingdom ) . Participants 74 607 men and women , aged 60 or more , without coronary heart disease , stroke , or cancer at enrolment and with complete information about dietary intake and potentially confounding variables . Main outcome measures Extent of adherence to a modified Mediterranean diet  using a scoring system on a 10 point scale , and death from any cause by time of occurrence , modelled through Cox regression . Results An increase in the modified Mediterranean diet score was associated with lower overall mortality , a two unit increment corresponding to a statistically significant reduction of 8 % ( 95 % confidence interval 3 % to 12 % ) . No statistically significant evidence of heterogeneity was found among countries in the association of the score with overall mortality even though the association was stronger in Greece and Spain . When dietary exposures were calibrated across countries , the reduction in mortality was 7 % ( 1 % to 12 % ) . Conclusion The Mediterranean diet , modified so as to apply across Europe , was associated with increased survival among older people We examined whether adherence to a Mediterranean-style diet has positive effects on mobility assessed over a 9-year follow-up in a representative sample of older adults . This research is part of the InCHIANTI Study , a prospect i ve population -based study of older persons in Tuscany , Italy . The sample for this analysis included 935 women and men aged 65 years and older .  Adherence to the Mediterranean diet was assessed at baseline by the st and ard 10-unit Mediterranean diet score ( MDS ) . Lower extremity function was measured at baseline , and at the 3- , 6- and 9-year follow-up visits using the short physical performance battery ( SPPB ) . At baseline , higher adherence to Mediterranean diet was associated with better lower body performance . Participants with higher adherence experienced less decline in SPPB score , which was of 0.9 points higher ( p<.0001 ) at the 3-year-follow , 1.1 points higher ( p=0.0004 ) at the 6-year follow-up and 0.9 points higher ( p=0.04 ) at the 9-year follow-up compared to those with lower adherence . Among participants free of mobility disability at baseline , those with higher adherence had a lower risk ( HR=0.71 , 95 % CI=0.51 - 0.98 , p=0.04 ) of developing new mobility disability . High adherence to a Mediterranean-style diet is associated with a slower decline of mobility over time in community-dwelling older persons . If replicated , this observation is highly relevant in terms of public health OBJECTIVES To measure relative fitness and frailty in older people without specific frailty instruments and to relate that measurement to long-term health outcomes . DESIGN Retrospective cohort studies . SETTING Two population -based studies of people aged approximately 70 at baseline and followed up to 10 years ( in the Canadian Study of Health and Aging ( CSHA ) ) or 26 years in the Gothenburg H-70 cohort study . PARTICIPANTS Nine hundred sixty-two men and 1,178 women . MEASUREMENTS  Deficit accumulation ( the exposure ) was counted using self-reported ( CSHA ) or clinical ly design ated ( H-70 ) symptoms , signs , diseases , and disabilities . Relative fitness and frailty were measured in relation to the degree of deficit accumulation evaluated in four quartiles , representing those most fit to those most frail . The items that made up the frailty index were selected r and omly without replacement in 1,000 iterations . The outcomes were risks of death or residential long-term care . RESULTS Worse frailty , however measured , was associated with worse survival ; the Kaplan-Meier curves of r and om iterations of the frailty definition showed virtually no interquartile overlap for mortality . For any given level of frailty , men died younger than women . Worse frailty was also associated with a higher risk of institutionalization . CONCLUSION Frailty appears to be a robust concept that is readily operationalized , with the risk of adverse outcomes being largely established by age 70 Background Comprehensive Geriatric Assessment ( CGA ) provides detailed information on clinical , functional and cognitive aspects of older patients and is especially useful for assessing frail individuals . Although a large proportion of hospitalized older adults demonstrate a high level of complexity , CGA was not developed specifically for this setting . Our aim was to evaluate the application of a CGA model for the clinical characterization and prognostic prediction of hospitalized older adults . Methods This was a prospect i ve observational study including 746 patients aged 60 years and over who were admitted to a geriatric ward of a university hospital between January 2009 and December 2011 , in Sao Paulo , Brazil . The proposed CGA was applied to evaluate all patients at admission . The primary outcome was in-hospital death , and the secondary outcomes were delirium , nosocomial infections , functional decline and length of stay .  Multivariate binary logistic regression was performed to assess independent factors associated with these outcomes , including socio-demographic , clinical , functional , cognitive , and laboratory variables . Impairment in ten CGA components was particularly investigated : polypharmacy , activities of daily living ( ADL ) dependency , instrumental activities of daily living ( IADL ) dependency , depression , dementia , delirium , urinary incontinence , falls , malnutrition , and poor social support . Results The studied patients were mostly women ( 67.4 % ) , and the mean age was 80.5±7.9 years . Multivariate logistic regression analysis revealed the following independent factors associated with in-hospital death : IADL dependency ( OR=4.02 ; CI=1.52 - 10.58 ; p=.005 ) ; ADL dependency ( OR=2.39 ; CI=1.25 - 4.56 ; p=.008 ) ; malnutrition ( OR=2.80 ; CI=1.63 - 4.83 ; p<.001 ) ; poor social support  ( OR=5.42 ; CI=2.93 - 11.36 ; p<.001 ) ; acute kidney injury ( OR=3.05 ; CI=1.78 - 5.27 ; p<.001 ) ; and the presence of pressure ulcers ( OR=2.29 ; CI=1.04 - 5.07 ; p=.041 ) . ADL dependency was independently associated with both delirium incidence and nosocomial infections ( respectively : OR=3.78 ; CI=2.30 - 6.20 ; p<.001 and OR=2.30 ; CI=1.49 - 3.49 ; p<.001 ) . The number of impaired CGA components was also found to be associated with in-hospital death ( p<.001 ) , delirium incidence ( p<.001 ) and nosocomial infections ( p=.005 ) . Additionally , IADL dependency , malnutrition and history of falls predicted longer hospitalizations . There were no significant changes in overall functional status during the hospital stay . Conclusions CGA identified patients at higher risk of in-hospital death and adverse outcomes , of which those with functional dependence , malnutrition and poor social support were foremost BACKGROUND Healthy dietary patterns may protect against age-related  cognitive decline , but results of studies have been inconsistent . OBJECTIVE We examined associations between Dietary Approaches to Stop Hypertension (DASH)- and Mediterranean-style dietary patterns and age-related cognitive change in a prospect i ve , population -based study . DESIGN Participants included 3831 men and women ≥65 y of age who were residents of Cache County , UT , in 1995 . Cognitive function was assessed by using the Modified Mini-Mental State Examination ( 3MS ) ≤4 times over 11 y. Diet-adherence scores were computed by summing across the energy-adjusted rank-order of individual food and nutrient components and categorizing participants into quintiles of the distribution of the diet accordance score . Mixed-effects repeated- measures models were used to examine 3MS scores over time across increasing quintiles of dietary accordance scores and individual food components that comprised each score . RESULTS The range of rank-order DASH and Mediterranean diet scores was 1661 - 25,596 and 2407 - 26,947 , respectively . Higher DASH and Mediterranean diet scores were associated with higher average 3MS scores . People in quintile 5 of DASH averaged 0.97 points higher than those in quintile 1 ( P = 0.001 ) . The corresponding difference for Mediterranean quintiles was 0.94 ( P = 0.001 ) . These differences were consistent over 11 y. Higher intakes of whole grains and nuts and legumes were also associated with higher average 3MS scores [ mean quintile 5 compared with 1 differences : 1.19 ( P < 0.001 ) , 1.22 ( P < 0.001 ) , respectively ] . CONCLUSIONS Higher levels of accordance with both the DASH and Mediterranean dietary patterns were associated with consistently higher levels of cognitive function in elderly men and women over an 11-y period . Whole grains and nuts and legumes were positively associated with higher cognitive functions and may be core neuroprotective foods common to various healthy plant-centered diets around the globe BACKGROUND Nutritional parameters could influence self-perceived health and functional status of older adults . OBJECTIVE We prospect ively determined the association between diet quality and quality of life and activities of daily living . DESIGN This was an observational cohort study in which total diet scores , reflecting adherence to dietary guidelines , were determined . Dietary intakes were assessed using a food frequency question naire at baseline . Total diet scores were allocated for intake of selected food groups and nutrients for each participant as described in the Australian Guide to Healthy Eating . Higher scores indicated closer adherence to dietary guidelines . PARTICIPANTS / SETTING In Sydney , Australia , 1,305 and 895 participants ( aged ≥ 55 years ) with complete data were examined over 5 and 10 years , respectively . MAIN OUTCOME VARIABLES The 36-Item Short-Form Survey assesses quality of life and has eight subscales representing dimensions of health and well-being ; higher scores reflect better quality of life . Functional status was determined once at the 10-year follow-up by the Older Americans Re sources and Services activities of daily living scale . This scale has 14 items : seven items assess basic activities of daily living ( eg , eating and walking ) and seven items assess instrumental activities of daily living ( eg , shopping or housework ) . STATISTICAL ANALYSES PERFORMED Normalized 36-Item Short-Form Survey component scores were used in analysis of covariance to calculate multivariable adjusted mean scores . Logistic regression analysis was used to calculate adjusted odds ratios and 95 % CIs to demonstrate the association between total diet score with the 5-year incidence of impaired activities of daily living . RESULTS Participants in the highest vs lowest quartile of baseline total diet scores had adjusted mean scores 5.6 , 4.0 , 5.3 , and 2.6 units higher in these 36-Item Short-Form Survey domains 5 years later : physical function ( P trend=0.003 ) , general health ( P trend=0.02 ) , vitality ( P trend=0.001 ) , and physical composite score ( P trend=0.003 ) , respectively . Participants in the highest vs lowest quartile of baseline total diet scores had 50 % reduced risk of impaired instrumental activites of daily living at follow-up ( multivariable-adjusted P trend=0.03 ) . CONCLUSIONS  Higher diet quality was prospect ively associated with better quality of life and functional ability Most studies of association between diet and cognition among the elderly focus on the role of single nutrients or foods and ignore the complexity of dietary patterns and total diet quality . We prospect ively examined associations between an index of diet quality and cognitive function and decline among elderly men and women of the Cache County Study on Memory and Aging in Utah . In 1995 , 3634 resident men and women > or = 65 y of age completed a baseline survey  that included a 142-item FFQ . Cognition was assessed using an adapted version of the  Modified Mini-Mental State Examination  ( 3MS ) at baseline and 3 subsequent interviews spanning approximately 11 y. A recommended food score ( RFS ) and non-RFS were computed by summing the number of recommended foods ( n = 57 ) and nonrecommended foods ( n = 23 ) regularly consumed . Multivariable-mixed models were used to estimate associations between the RFS and non-RFS and average 3MS score over time . Those in the highest quartile of RFS scored 1.80 points higher on the baseline 3MS test than did those in the lowest quartile of RFS ( P < 0.001 ) . This effect was strengthened over 11 y of follow-up . Those with the highest RFS declined by 3.41 points over 11 y compared with the 5.2-point decline experienced by those with the lowest RFS ( P = 0.0013 ) . The non-RFS was not associated with cognitive scores . Consuming a diverse diet that includes a variety of recommended foods may help to attenuate age-related cognitive decline among the elderly BACKGROUND AND OBJECTIVE Low intake of certain micronutrients and protein has been associated with higher risk of frailty . However , very few studies have assessed the effect of global dietary patterns on frailty . This study examined the association between adherence to the Mediterranean diet ( MD ) and the risk of  frailty in older adults . DESIGN , SETTING , AND PARTICIPANTS Prospect i ve cohort study with 1815 community-dwelling individuals aged ≥60 years recruited in 2008 - 2010 in Spain . MEASUREMENTS At baseline , the degree of MD adherence was measured with the Mediterranean Diet Adherence Screener ( MEDAS ) score and the Mediterranean Diet Score  , also known as the Trichopoulou index . In 2012 , individuals were reassessed to detect incident frailty , defined as having at least 3 of the following criteria : exhaustion , muscle weakness , low physical activity , slow walking speed , and weight loss . The study associations were summarized with odds ratios ( OR ) and their 95 % confidence interval ( CI ) obtained from logistic regression , with adjustment for the main confounders . RESULTS Over a mean follow-up of 3.5 years , 137 persons with incident frailty were identified . Compared with individuals in the lowest tertile of the MEDAS score ( lowest MD adherence ) , the OR ( 95 % CI ) of frailty was 0.85 ( 0.54 - 1.36 ) in those in the second tertile , and 0.65 ( 0.40 - 1.04 ; P for trend = .07 ) in the third tertile . Corresponding figures for the Mediterranean Diet Score were 0.59 ( 0.37 - 0.95 ) and 0.48 ( 0.30 - 0.77 ; P for trend = .002 ) . Being in the highest tertile of MEDAS was associated with reduced risk of slow walking ( OR 0.53 ; 95 % CI 0.35 - 0.79 ) and of weight loss ( OR 0.53 ; 95 % CI 0.36 - 0.80 ) . Lastly , the risk of frailty was inversely associated with consumption of fish ( OR 0.66 ; 95 % CI 0.45 - 0.97 ) and fruit ( OR 0.59 ; 95 % CI 0.39 - 0.91 ) . CONCLUSIONS Among community-dwelling older adults , an increasing adherence to the MD was associated with decreasing risk of frailty BACKGROUND Cardiovascular disease and vascular risk factors increase rates of cognitive impairment , but very little is known regarding prevention in this high-risk group . The heart-healthy Mediterranean-type dietary pattern may beneficially influence both vascular and cognitive outcomes . OBJECTIVES We examined the association between Mediterranean-style diet and cognitive decline in women with prevalent vascular disease or ≥3 coronary risk factors . DESIGN / PARTICIPANTS / SETTING Prospect i ve cohort study among 2,504 women participants in the Women 's Antioxidant Cardiovascular Study ( WACS ) , a cohort of female health professionals . Adherence to a Mediterranean-style diet was determined at WACS baseline ( 1995 - 1996 ) using a 0- to 9-point scale with higher scores indicating higher adherence . In 1998 - 2000 , participants aged ≥65 years underwent a telephone cognitive battery including five tests of global cognition , verbal memory , and category fluency . Tests were administered three additional times across 5.4 years . STATISTICAL ANALYSES PERFORMED We used multivariable-adjusted generalized linear models for repeated measures to compare the annual rates of cognitive score changes across tertiles of Mediterranean diet score , as assessed at WACS baseline . RESULTS In both basic- and multivariable-adjusted models , consuming a Mediterranean-style diet was not related to cognitive decline . No effect modification was detected by age , education , depression , cardiovascular disease severity at WACS baseline , or level of cognition at initial assessment . CONCLUSIONS In women at higher risk of cognitive decline due to vascular disease or risk factors , adherence to a Mediterranean-style diet was not associated with subsequent 5-year cognitive change
Abstract Purpose Nutrition is a key determinant of chronic disease in later life .
A systematic review was conducted of studies examining dietary patterns  and quality of life , physical  function , cognitive function and mental health among older adults .