Undernutrition, cognitive decline and dementia: The collaborative PROMED-COG pooled cohorts study

Marianna Noale, Federica Prinelli*, Silvia Conti, Giuseppe Sergi, Stefania Maggi, Lorraine Brennan, Lisette Cpgm de Groot, Dorothee Volkert, Claire T. McEvoy, Caterina Trevisan, E. Scafato, G. Farchi, L. Galluzzo, C. Gandin, A. Capurso, F. Panza, V. Solfrizzi, V. Lepore, P. Livrea, L. MottaG. Carnazzo, M. Motta, P. Bentivegna, S. Bonaiuto, G. Cruciani, D. Postacchini, D. Inzitari, L. Amaducci, A. Di Carlo, M. Baldereschi, C. Gandolfo, M. Conti, N. Canal, M. Franceschi, G. Scarlato, L. Candelise, E. Scapini, F. Rengo, P. Abete, F. Cacciatore, G. Enzi, L. Battistin, G. Sergi, G. Crepaldi, S. Maggi, N. Minicuci, M. Noale, F. Grigoletto, E. Perissinotto, P. Carbonin, PROMED-COG Consortium

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

2 Citations (Scopus)
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Abstract

Background & aims
Undernutrition may negatively impact cognitive function, but evidence of this relationship is not yet consolidated. Under the “PROtein enriched MEDiterranean diet to combat undernutrition and promote healthy neuroCOGnitive ageing” (PROMED-COG) project, we evaluated the association between undernutrition, and cognitive decline and incident dementia in older adults.

Methods
Retrospective data harmonization was performed on three Italian population-based studies: the Italian Longitudinal Study of Ageing (ILSA), the Progetto Veneto Anziani (Pro.V.A.), and the Bollate Eye Study-Follow-Up (BEST-FU). The associations between undernutrition, operationalized using the Global Leadership Initiative on Malnutrition (GLIM) criteria, and decline on the Mini-Mental State Examination (MMSE) or dementia incidence follow-up were evaluated with Cox proportional hazard regression models.

Results
The pooled cohort comprised 9071 individuals (52% females) aged between 42 and 101 years. The prevalence of undernutrition at the baseline was 14.3%, significantly higher among females (15.4% vs 13%) and in older age, ranging from 3.5% in those aged <60 years to 28.8% in those 85+ years. Undernutrition was associated with both cognitive decline over a median 8.3-year follow-up (Hazard Ratio (HR) 1.20, 95% Confidence Interval (CI) 1.02–1.41, p = 0.028) and incidence of dementia over a median 8.6-year follow-up (HR = 1.57, 95%CI 1.01–2.43, p = 0.046). For cognitive decline, the association with undernutrition was more marked in males than females (HR = 1.36, 95%CI 1.05–1.77, p = 0.019 vs HR = 1.10, 95% CI 0.89–1.36, p = 0.375).

Conclusion
Undernutrition is prevalent among older people and is associated with an increased risk of experiencing cognitive decline and dementia. The prevention and early identification of undernutrition could be an important nonpharmacologic strategy to counteract neurodegeneration.
Original languageEnglish
Pages (from-to)2372-2380
Number of pages9
JournalClinical Nutrition
Volume43
Issue number10
Early online date11 Sept 2024
DOIs
Publication statusPublished - Oct 2024

Keywords

  • Dementia
  • Mediterranean diet
  • Neurocognitive ageing
  • Pooled cohorts
  • Undernutrition

ASJC Scopus subject areas

  • Nutrition and Dietetics
  • Critical Care and Intensive Care Medicine

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