Adherence to Dietary Patterns and Risk of Incident Dementia: Findings from the Atherosclerosis Risk in Communities Study

Emily A. Hu, Aozhou Wu, Jennifer L. Dearborn, Rebecca F. Gottesman, A. Richey Sharrett, Lyn M. Steffen, Josef Coresh, Casey M. Rebholz

Research output: Contribution to journalArticlepeer-review

1 Scopus citations


Background: Previous studies have suggested that adherence to healthy dietary patterns during late life may be associated with improved cognition. However, few studies have examined the association between healthy dietary patterns during midlife and incident dementia. Objective: Our study aimed to determine the association between adherence to healthy dietary patterns at midlife and incident dementia. Methods: We included 13,630 adults from the Atherosclerosis Risk in Communities (ARIC) Study in our prospective analysis. We used food frequency questionnaire responses to calculate four dietary scores: Healthy Eating Index-2015 (HEI-2015), Alternative Healthy Eating Index-2010 (AHEI-2010), alternate Mediterranean (aMed) diet, and Dietary Approaches to Stop Hypertension (DASH). Participants were followed until the end of 2017 for incident dementia. Cox regression models adjusted for covariates were used to estimate risk of incident dementia by quintile of dietary scores. Results: Over a median of 27 years, there were 2,352 cases of incident dementia documented. Compared with participants in quintile 1 of HEI-2015, participants in quintile 5 (healthiest) had a 14% lower risk of incident dementia (hazard ratio, HR: 0.86, 95% confidence interval, CI: 0.74-0.99). There were no significant associations of incident dementia with the AHEI-2010, aMed, or DASH scores. There were no significant interactions by sex, age, race, education, physical activity, hypertension, or obesity. Conclusion: Adherence to the HEI-2015, but not the other dietary scores, during midlife was associated with lower risk of incident dementia. Further research is needed to elucidate whether timing of a healthy diet may influence dementia risk.

Original languageEnglish (US)
Pages (from-to)827-835
Number of pages9
JournalJournal of Alzheimer's Disease
Issue number2
StatePublished - 2020

Bibliographical note

Funding Information:
Ms. Hu is supported by a grant from the National Institutes of Health (NIH)/National Heart, Lung, and Blood Institute (training grant T32 HL007024). Dr. Gottesman is supported by K24 AG052573. Dr. Reb-holz is supported by a mentored research scientist development award from the National Institute of Diabetes and Digestive and Kidney Diseases (K01 DK107782) and a grant from the National Heart, Lung, and Blood Institute (R21 HL143089). The Atherosclerosis Risk in Communities Study is carried out as a collaborative study supported by National Heart, Lung, and Blood Institute contracts (HHSN 268201700001I, HHSN268201700002I, HHSN268 201700003I, HHSN268201700005I, HHSN268201 700004I). Neurocognitive data is collected by U012 U01HL096812, 2U01HL096814, 2U01HL096899, 2U01HL096902, 2U01HL096917 from the NIH (NH LBI, NINDS, NIA and NIDCD), and with previous brain MRI examinations funded by R01-HL70825 from the NHLBI. The authors thank the staff and participants of the ARIC study for their important contributions.

Publisher Copyright:
© 2020 - IOS Press and the authors. All rights reserved.


  • AHEI-2010
  • DASH
  • HEI-2015
  • Mediterranean diet
  • cognition
  • dementia
  • dietary pattern

PubMed: MeSH publication types

  • Journal Article
  • Research Support, N.I.H., Extramural


Dive into the research topics of 'Adherence to Dietary Patterns and Risk of Incident Dementia: Findings from the Atherosclerosis Risk in Communities Study'. Together they form a unique fingerprint.

Cite this