. Association of Midlife Diet With Subsequent Risk for Dementia. JAMA. 2019 Mar 12;321(10):957-968. PubMed.


Please login to recommend the paper.


  1. These results from the recent report from the Whitehall study suggest a null association between midlife dietary patterns and later-life cognitive performance/dementia incidence. Findings are quite disappointing, raising questions and concerns as to whether a true underlying biological association between nutrition and cognition/dementia really exists. The trajectories of dietary habits with aging, leading to an increasing divergence/separation of adherence with advancing age among subjects who become demented versus those who remain cognitively unimpaired add additional concerns since they support the idea of reverse causality (i.e., dietary habits may be altered as subjects approach clinical dementia onset).

    On the other hand, healthy dietary patterns are not all the same. More extensively explored dietary patterns in this field, such as the Mediterranean diet, are briefly investigated in supplementary analyses and only in relation to incident dementia (i.e., not in relation to the more sensitive measures of cognitive decline). Additionally, although there are clear advantages to the dietary pattern approach, it would be interesting to know whether particular elements of these patterns and specific foods or nutrients had notable associations with cognition and dementia.

    Similar to the current study, some previous reports exploring the role of diet and cognition/dementia at middle age also have been negative. But others have been supportive. Actually, in recently published findings from the CARDIA study, adherence to specific healthy dietary patterns (a Mediterranean-style diet and an A Priori Diet Quality Score) in early adulthood was associated with better cognitive health in midlife (McEvoy et al., 2019; Bowman and Scarmeas, 2019). Beyond the difference in age epochs examined, another major difference with the present study and CARDIA is that the latter was racially diverse. Different ethnicities may suggest different genetic susceptibilities and different cognition-related pathologies and hence different responses to nutritional factors. Overall, the literature on nutrition, particularly at middle or earlier age, and cognitive performance is quite conflicting. Underlying clinical, epidemiological, and biological links remain to be explored.


    . Dietary patterns during adulthood and cognitive performance in midlife: The CARDIA study. Neurology. 2019 Mar 6; PubMed.

    . Dietary patterns in early life pay dividends for midlife cognitive performance. Neurology. 2019 Apr 2;92(14):645-646. Epub 2019 Mar 6 PubMed.

    View all comments by Nikolaos Scarmeas

Make a Comment

To make a comment you must login or register.

This paper appears in the following:


  1. In New Study, Diet During Midlife Not Linked to Dementia