Long - term association of food and nutrient intakes with cognitive and functional 1 decline : a 13 - year follow - up study of elderly

209 23 Text: 3,684 24 Running title: Dietary habits and age-related decline 25 26 Women 33 34 2 ABSTRACT 35 The objective of this study was to determine the potential long-term impact of dietary habits 36 on age-related decline among 4,809 elderly women (born between 1925 and 1930) in the E3N 37 study, a French longitudinal cohort. In 1993, an extensive diet history self-administered 38 questionnaire was sent to all participants, and in 2006 another questionnaire on instrumental 39 activities of daily living (IADL) and recent cognitive change was sent to a close 40 relative/friend of each woman. Logistic models adjusted for sociodemographic, lifestyle and 41 health factors were performed to evaluate associations between habitual dietary intakes and 42 two outcomes of interest based on the informant response: recent cognitive decline and IADL 43 impairment. Recent cognitive decline was associated with lower intakes of poultry, fish, and 44 animal fats, as well as higher intakes of dairy dessert and ice-cream. IADL impairment was 45 associated with lower intake of vegetables. The odds of recent cognitive decline increased 46 significantly with decreasing intake of soluble dietary fibre and n-3 fatty acids but with 47 increasing intake of retinol. The odds of IADL impairment increased significantly with 48 decreasing intake of vitamins B2, B6, and B12. These results are consistent with a possible 49 long-term neuroprotective effect of dietary fibre, n-3 polyunsaturated fats, and B-group 50 vitamins, and support dietary intervention to prevent cognitive decline.