Diet and risk of dementia: Does fat matter?

The Rotterdam Study

M. J. Engelhart, MD PhD, M. I. Geerlings, PhD, A. Ruitenberg, MD PhD, J. C. van Swieten, MD PhD, A. Hofman, MD PhD, J. C.M. Witteman, PhD and M. M.B. Breteler, MD PhD

From the Departments of Epidemiology and Biostatistics (Drs. Engelhart, Geerlings, Ruitenberg, Hofman, Witteman, and Breteler) and Neurology (Drs. Ruitenberg and van Swieten), Erasmus Medical Center, Rotterdam; and the Julius Center for Health Sciences and Primary Care (Dr. Geerlings), University Medical Center Utrecht, the Netherlands.

Address correspondence and reprint requests to Dr. M.M.B. Breteler, Department of Epidemiology and Biostatistics, Erasmus Medical Center, P.O. Box 1738, 3000 DR Rotterdam, the Netherlands; e-mail: breteler@epib.fgg.eur.nl

Objective: To examine whether high intake of total fat, saturated fatty acids (saturated fat), trans fatty acids (trans fat), and cholesterol and low intake of monounsaturated fatty acids (MUFA), polyunsaturated fatty acids (PUFA), n-6 PUFA, and n-3 PUFA are associated with increased risk of dementia and its subtypes.

Method: Data from the Rotterdam Study, a prospective cohort study among elderly, were used. At baseline (1990 to 1993), 5,395 subjects had normal cognition, were noninstitutionalized, and underwent complete dietary assessment by a semiquantitative food-frequency questionnaire. The cohort was continuously monitored for incident dementia, and re-examinations were performed in 1993 to 1994 and 1997 to 1999. The association between fat intake and incident dementia was examined by Cox’s proportional hazards models.

Results: After a mean follow-up of 6.0 years, 197 subjects developed dementia (146 AD, 29 vascular dementia). High intake of total, saturated, trans fat, and cholesterol and low intake of MUFA, PUFA, n-6 PUFA, and n-3 PUFA were not associated with increased risk of dementia or its subtypes. Rate ratios of dementia per standard deviation increase in intake were for total fat 0.93 (95% CI 0.81 to 1.07), for saturated fat 0.91 (95% CI 0.79 to 1.05), for trans fat 0.90 (95% CI 0.77 to 1.06), for cholesterol 0.93 (95% CI 0.80 to 1.08), for MUFA 0.96 (95% CI 0.84 to 1.10), for PUFA 1.05 (95% CI 0.80 to 1.38), for n-6 PUFA 1.03 (95% CI 0.77 to 1.36), and for n-3 PUFA 1.07 (95% CI 0.94 to 1.22).

Conclusion: High intake of total, saturated, and trans fat and cholesterol and low intake of MUFA, PUFA, n-6 PUFA, and n-3 PUFA were not associated with increased risk of dementia or its subtypes.

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