Abstract
Background:
Lifestyle factors have been implicated in the long-lasting neurodegenerative process in prodromal PD (pPD). We aimed to investigate the associations between adherence to the Mediterranean diet (MeDi) and longitudinal changes of pPD probability and the development of PD or pPD in a Mediterranean older population.
Methods:
We used data from the Hellenic Longitudinal Investigation of Aging and Diet (HELIAD) cohort (community dwelling individuals, aged ≥65 years). A detailed food frequency questionnaire was used to evaluate dietary intake and calculate MeDi adherence score, ranging from to 55, with higher scores indicating higher adherence. Probability of pPD was calculated according to the updated MDS research criteria.
Results:
1047 non-PD/DLB participants were followed for 3±1 years. MeDi adherence was associated with lower increase in pPD probability over time (b=-0.003, 95CI%: -0.006 to -0.001, P=.010). Forty-nine participants had incident possible/probable pPD (i.e., pPD probability≥30%). Compared to the participants in the lowest quartile of MeDi adherence, those in the higher quartiles had approximately 60-70% lower risk for possible/probable pPD (P-for-trend=.003). MeDi-pPD associations were driven by both motor and non-motor prodromal PD markers and not from risk markers. Also, twenty-one participants were diagnosed with PD/DLB at follow up. For each unit increase in the MeDi score, there was a 9-10% lower risk for PD/DLB [HR: 0.906 (0.823-0.997), P=.044].
Conclusions:
MeDi adherence is associated with lower increase in pPD probability over time and lower possible/probable pPD and PD/DLB incidence in older Mediterranean people. More studies are needed to confirm our results in other populations.
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