Relationship Between Diet And Mild Cognitive Impairment Among Elderly In Baodi District Of Tianjin:a Cross-sectional Study

Objective In this study,dietary patterns and dietary inflammation index(DII)were used to comprehensively analyze the relationship between diet and mild cognitive impairment(MCI)in the elderly in Baodi District,Tianjin,in order to provide dietary guidance for the prevention of MCI in the elderly.Method A cross-sectional study was conducted on the elderly who underwent physical examination in Koudong,Hezhang and Baoping Hospitals in Baodi District of Tianjin from March 2019 to July 2019.General health questionnaire was used to investigate the basic information of the subjects,such as age,sex,education level and so on.Dietary frequency questionnaire(FFQ)was used to investigate the dietary intake of the subjects.Mini mental state examination(MMSE)and activities of daily living scale(ADL)were used to evaluate the cognitive function of the elderly.The physical examination information of the subjects was collected,including height,weight,leukocyte count,neutrophil percentage and lymphocyte percentage.SPSS22.0 and SAS9.4 were used to analyze the data.When the data satisfy the normal distribution,the continuous variables are generally described by mean±SD,and the two groups of independent samples t-test are used to compare the differences between groups;if the data do not meet the normal distribution,the geometric mean and its 95% confidence interval(CI)are used to describe the continuous variables,and the rank sum tests of the two groups of independent samples are used to test and compare the differences of components.The adoption rate or constituent ratio of classified variables was expressed,and the chi-square test was used to compare the differences between groups.Factor analysis and reduced rank regression(RRR)were used to extract dietary patterns,and binary logistic regression was used to analyze the relationship between dietary patterns and MCI,DII and MCI,DII and inflammatory indexes.Result 1.The prevalence of MCI: the prevalence rate of MCI among the elderly in Baodi District of Tianjin was 11.3%.The prevalence rate of males(9.3%)was lower than that of females(12.9%)(P<0.05),and the scores of orientation,memory,attention and numeracy,language ability,recall ability and total MMSE scores of males were higher than those of females(P<0.05).The prevalence rate of MCI in the high age group(>70 years old)was higher than that in the low age group(≤ 70 years old)(10.3%)(P<0.05),and the scores of orientation,memory,language ability,recall ability and the total score of MMSE were lower than those in the low age group(P<0.05).2.Comparison of general condition and food intake: the age,the proportion of low education level,the proportion of low income and the ratio of neutrophils to lymphocytes(NLR)in MCI group were higher than those in non-MCI group.The BMI,the amount of physical activity,the proportion of married and living together,and the proportion of people with fixed occupation in the MCI population were lower than those in the non-MCI population(P<0.05).The intake of biscuit dim sum,western-style pastry and fried food in MCI group was higher than that in non-MCI group.The intake of bean,bean products,meat,aquatic products,nuts,potatoes,vegetables,fruits and beverages was lower than that of non-MCI people(P<0.05).3.Relationship between dietary pattern and MCI: four main dietary patterns were obtained by factor analysis,which were named vegetable-fruit model(mainly vegetables,fruits,potatoes,nuts),bean model(mainly beans,bean products,bacteria and algae),animal food model(poultry,meat,animal offal,aquatic products),dessert model(biscuit,western pastry mainly).The results of binary logistic regression analysis showed that in the vegetable-fruit model,the risk of MCI in the highest Q4 group was lower than that in the lowest Q1 group(OR:0.718,95%CI:0.518-0.996,P<0.05),and in the bean model,compared with the lowest Q1 group,the highest Q4 group had a lower risk of MCI(OR:0.851,95%CI:0.622-1.164,P>0.05).In the animal food model,compared with the lowest Q1 group,the risk of MCI in the highest Q4 group was(OR:0.917,95%CI:0.663-1.269,P>0.05).In the dessert model,the risk of MCI in the highest Q4 group was higher than that in the lowest Q1 group(OR:1.676,95%CI:1.220-2.302,P<0.05).RRR was used to extract the inflammatory dietary pattern related to white blood cell count and NLR(mainly animal offal,beverage and pickle intake).Binary logistic regression analysis showed that the risk of MCI in the highest Q4 group was higher than that in the lowest Q1 group(OR:1.656,95%CI:1.198-2.291,P<0.05).4.The relationship between DII and MCI: there was a significant difference in the prevalence of MCI among different levels of DII,and the prevalence of MCI gradually increased with the increase of DII.Binary logistic regression analysis showed that high DII group,that is,pro-inflammatory group was a risk factor for MCI(OR:1.505,95%CI:1.148-1.972,P<0.05).5.Relationship between inflammatory markers and DII: binary logistic regression analysis showed that compared with T1 group with the lowest level of DII,T2 group had a higher risk of white blood cell count(OR:1.141,95%CI:0.969-1.345,P<0.05),and T3 group had a higher risk of white blood cell count(OR:1.170,95%CI:0.993-1.379,P<0.05).Compared with T1 group with the lowest level of DII,T2 group had a higher risk of NLR(OR:1.220,95%CI:1.036-1.438,P<0.05),T3 group had a higher risk of NLR(OR:1.178,95%CI:1.000-1.398,P<0.05).Conclusion 1.The prevalence rate of MCI in the elderly in Baodi District of Tianjin is in the middle level,the prevalence rate of female is higher than that of male,and the prevalence rate of high age group is higher than that of low age 2.The vegetable-fruit dietary pattern based on the intake of vegetables,fruits,nuts and potatoes was the protective factor for MCI,while the dessert pattern dominated by biscuit and western pastry was the risk factor for MCI,suggesting that the dietary pattern dominated by biscuit and western pastry was associated with a higher risk of MCI.The inflammatory dietary pattern,which is related to leukocyte count and NLR,and mainly based on animal viscera,beverage and pickle intake,is the risk factor for the occurrence of MCI,suggesting that diet may affect the occurrence of MCI through inflammation.3.Higher DII,that is,pro-inflammatory diet is associated with a higher risk of MCI,and people with high levels of DII have a higher risk of NLR.It is suggested that diet-related inflammation plays a potential role in the occurrence and development of MCI,and the incidence of MCI can be reduced by increasing the intake of antiinflammatory diet and reducing the intake of pro-inflammatory diet..4.The main foods in the vegetable-fruit model vegetables,fruits,nuts,potatoes are anti-inflammatory foods,intake helps to reduce the risk of MCI;biscuits and pastries in the dessert model,and animal offal,beverages and pickles in the inflammatory diet model are all pro-inflammatory foods,eating more will increase the risk of MCI.