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      Mediterranean Diet, Cognitive Function, and Dementia: A Systematic Review of the Evidence 1 2 3

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          Abstract

          A growing body of evidence suggests that adherence to the Mediterranean diet (MD) may protect against cognitive decline and dementia. Many epidemiologic studies and several randomized controlled trials (RCTs) have found positive effects of the MD on cognitive function, but findings remain inconsistent. The aim of this systematic review was to provide an update on the current knowledge of the effects of the MD on cognitive function, cognitive impairment, Alzheimer disease (AD), and all-type dementia. Five databases were searched—PubMed, Embase, CINAHL, CENTRAL, and PsycINFO (1806 to 25 May 2015)—with the use of prespecified criteria. Human studies that were published in English without any restriction on study type, population assessed, intervention period, follow-up time, or publication date, and that examined the association between adherence to the MD and cognitive function or dementia symptoms (as measured by cognitive function tests), were included. Only primary publication types were included. Thirty-two studies from 25 unique cohorts, including 5 RCTs and 27 observational studies, met the inclusion criteria. The majority of studies showed that the MD was associated with improved cognitive function, a decreased risk of cognitive impairment or decreased risk of dementia, or AD. Three studies found no correlation between the MD and AD, 3 further studies found no association between the MD and cognitive impairment, and 5 studies found no association between the MD and cognitive function. There was large heterogeneity, and studies differed with regard to quality. Based on the findings and the limitations in study design, we conclude that adherence to the MD is associated with better cognitive performance. However, it should be noted that the majority of findings come from epidemiologic studies that provide evidence for a correlation between the MD and cognition but not for a cause-and-effect relation. More controlled trials are required to establish a causational relation.

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          Author and article information

          Journal
          Adv Nutr
          Adv Nutr
          advances in nutrition
          advannut
          Advances in Nutrition
          American Society for Nutrition
          2161-8313
          2156-5376
          7 September 2016
          September 2016
          1 September 2017
          : 7
          : 5
          : 889-904
          Affiliations
          [4 ]Department of Nutrition and Dietetics, Division of Diabetes and Nutritional Sciences, King’s College London, London, United Kingdom; and
          [5 ]Department of Life and Health Sciences, School of Sciences and Engineering, University of Nicosia, Nicosia, Cyprus
          Author notes
          [* ]To whom correspondence should be addressed. E-mail: philippou.e@ 123456unic.ac.cy .
          [1]

          The authors reported no funding received for this study.

          [2]

          Author disclosures: SD Petersson and E Philippou, no conflicts of interest.

          [3]

          Supplemental Methods and Supplemental Tables 1–4 are available from the “Online Supporting Material” link in the online posting of the article and from the same link in the online table of contents at http://advances.nutrition.org.

          Author information
          http://orcid.org/0000-0003-0300-9572
          Article
          PMC5015034 PMC5015034 5015034 012138
          10.3945/an.116.012138
          5015034
          27633105
          c0ad408d-c1e7-4cd1-873e-47029ba95155
          © 2016 American Society for Nutrition
          History
          Page count
          Pages: 16
          Categories
          Reviews

          Mediterranean diet,cognitive impairment,Alzheimer disease,dementia,systematic review,dietary patterns,cognitive function

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