The Association Between Inflammatory Dietary Pattern and Risk of Cognitive Impairment Among Older Adults with Chronic Diseases and Its Multimorbidity: A Cross-Sectional Study

Lili Wang,1 Le Cheng,1 Chenhui Lv,1 Jie Kou,1 Wenjuan Feng,1 Haoran Xie,1 Ruolin Yan,1 Xi Wang,1 Shuangzhi Chen,1 Xin Song,1 Lushan Xue,1 Cheng Zhang,1 Xuemin Li,2 Haifeng Zhao1,3 1Department of Nutrition and Food Hygiene, School of Public Health, Shanxi Medical University, Taiyuan, People’s Republic of China; 2Center for Disease Control and Prevention in Shanxi Province, Taiyuan, People’s Republic of China; 3MOE Key Laboratory of Coal Environmental Pathogenicity and Prevention (Shanxi Medical University), Ministry of Education, Taiyuan, People’s Republic of ChinaCorrespondence: Haifeng Zhao, Department of Nutrition & Food Hygiene, School of Public Health, Shanxi Medical University, Taiyuan, Shanxi, 030001, People’s Republic of China, Tel/Fax +86-351-4135046, Email [email protected]: The present study aimed to explore the association between the inflammatory potential of diet, assessed by energy-adjusted dietary inflammatory index (E-DII) and reduced rank regression (RRR)-derived inflammatory dietary pattern, and the risk for cognitive impairment (CI) in community-dwelling older adults, especially in older adults with chronic diseases and multimorbidity.Methods: A total of 549 older adults from Taiyuan city were included in the present cross-sectional study. The Chinese Version of the Mini-Mental State Examination (CMMSE) was used for the evaluation of cognitive function. E-DII score was calculated based on semi-quantitative food frequency questionnaire (FFQ). Blood samples, including interleukin (IL)-1β, interleukin (IL)-18, tumor necrosis factor-α (TNF-α) and C-reactive protein (CRP), were tested for calculating RRR-derived inflammatory dietary pattern. Logistic regression was used to assess the association between inflammatory dietary pattern and risk of CI. In addition, patients with diabetes, hypertension, hyperlipidemia and multimorbidity were screened for further analysis among 549 older adults.Results: In those 549 older adults, adjusting for demographic characteristics and chronic disease status, there was no association between E-DII score tertile (ORT3VST1: 1.357, 95%CI:0.813~2.265, Ptrend = 0.267), RRR-derived inflammatory dietary pattern score tertile (ORT3VST1: 1.092, 95%CI:0.679~ 1.758, Ptrend = 0.737) and risk of CI. However, in older adults with diabetes and multimorbidity, the score tertile of E-DII and RRR-derived inflammatory dietary pattern were positively correlated with risk of CI in a dose-responsive manner (All Ptrend < 0.05). There is insufficient evidence to reach similar conclusion in patients with hypertension and hyperlipidemia (All Ptrend > 0.05).Conclusion: In the present study, pro-inflammatory diet contributed to the increased risk of CI in older adults with diabetes and multimorbidity. These results supplemented vital evidence for the prevention and treatment of CI in older adults with chronic diseases.Keywords: chronic diseases, multimorbidity, cognitive impairment, inflammatory dietary pattern, dietary inflammatory index, reduced rank regression