A Brief Dietary Assessment Predicts Executive Dysfunction in an Elderly Cohort: Results from the Einstein Aging Study.

OBJECTIVES: To examine the association between diet and executive function, episodic memory and global verbal cognition in the Einstein Aging Study (EAS) cohort and determine whether race modifies this relationship.

DESIGN: Cross-sectional.

SETTING: Community.

PARTICIPANTS: EAS participants without dementia who completed the Rapid Eating and Activity Assessment for Patients (REAP) (N = 492).

MEASUREMENTS: The previously validated REAP is based on the 2000 U.S. dietary guidelines. REAP scores were dichotomized as less-healthy (<median) or healthier (≥median) diet. Nine neurocognitive tests underwent principle component analysis, revealing three significant orthogonal components: episodic memory, executive function, and global cognition. Impaired cognitive function in each domain was defined as 2 standard deviations (SD) or more below the mean on any task or a total score of 1.5 SD or more below the mean. Using logistic regression, the association between diet and cognitive impairment was assessed, adjusting for age, education, sex, cardiovascular comorbidities, hypertension, body mass index, diabetes mellitus, depressive symptoms, race, and the interaction between race and diet group.

RESULTS: The sample was 60% female and 74% white and had a mean age of 80. In the entire sample, impaired executive function was associated with the interaction between race and diet group (P = .08), whereas other cognitive domains were not. In race-stratified analyses, healthier diet was associated with lower odds of impaired executive function in whites (odds ratio (OR) = 0.44, 95% confidence interval (CI) = 0.21-0.93, P = .03), as were healthier scores on the saturated fat subscale (OR = 0.34, 95% CI = 0.16-0.71, P = .004). In blacks, REAP scores were not associated with cognitive domains.

CONCLUSION: Healthy diet was associated with lower risk of executive dysfunction in whites. Race differences may be due to greater vascular risk in blacks or differences in generalizability of the REAP.