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ARS Home » Northeast Area » Boston, Massachusetts » Jean Mayer Human Nutrition Research Center On Aging » Research » Publications at this Location » Publication #239615
Title: Validity of dietary eicosapentaenoic acid and docosahexaenoic acid intakes determined by interviewer-administrated food frequency questionnaire among older adults with mild-to-moderate cognitive impairment or dementia

Author
item ARSENAULT, LISA - Jean Mayer Human Nutrition Research Center On Aging At Tufts University
item MATTHAN, NIRUPA - Jean Mayer Human Nutrition Research Center On Aging At Tufts University
item SCOTT, TAMMY - Tufts - New England Medical Center
item Dallal, Gerald
item Lichtenstein, Alice
item FOLSTEIN, MARSHAL - Tufts - New England Medical Center
item Rosenberg, Irwin
item Tucker, Katherine

Submitted to: American Journal of Epidemiology
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 3/17/2009
Publication Date: 7/1/2009
Citation: Arsenault, L.N., Matthan, N., Scott, T.M., Dallal, G., Lichtenstein, A.H., Folstein, M.F., Rosenberg, I., Tucker, K. 2009. Validity of dietary eicosapentaenoic acid and docosahexaenoic acid intakes determined by interviewer-administrated food frequency questionnaire among older adults with mild-to-moderate cognitive impairment or dementia. American Journal of Epidemiology. 170(1):95-103.

Interpretive Summary: The primary challenge in collecting self-reported dietary data in any age group is reliance on the ability of subjects to accurately recall and report past intake. However, nearly 25% of community dwelling elders have some degree of cognitive impairment, and 4.5% of individuals over 65 have Alzheimer’s disease. Thus, the elderly represent a population where memory is a critical issue for accurately collecting self-reported data. Because dietary intake is an important modifiable risk factor to decrease chronic disease risk, it is essential to understand the influence cognitive function may have on the validity of self-reported intake in impaired or demented groups. The food frequency questionnaire (FFQ) would seem to be the most valid method for use in the elderly because it involves recognition of general patterns of intake, or generic memory, rather than on short-term or episodic memory of specific details. The latter cognitive processes are known to decline with age. Numerous studies of FFQ’s in older adults have validated their use, but no studies have utilized biomarkers of nutrient intake. The very long-chain omega-3 fatty acids, specifically EPA and DHA, are increasingly becoming nutritional exposures of interest in observational research of chronic disease risk. Unlike many micronutrients, the direct biochemical measurement of fatty acid status may not be feasible in many research settings or for larger study populations. EPA and DHA are therefore important nutrients of focus for validation studies of dietary assessment methods. The purpose of this study was to evaluate the effect of cognitive function on the validity of interviewer-administered FFQ estimates of EPA+DHA intake in a population of 273 community-dwelling elders, aged 60-103 years, receiving home care services in Boston, MA. The fatty acid composition of plasma phospholipids was used as a biomarker of long-term intake. Mini Mental-State Examination scores were used to assess cognitive function, and clinical consensus diagnoses were used to identify cases of mild cognitive impairment and dementia. With interviewer-administration, this FFQ seemed to be a valid dietary assessment method for EPA+DHA intake, in older adults with mild to moderate cognitive impairments.

Technical Abstract: Epidemiological research is increasingly focused on elderly populations, many of whom exhibit mild to moderate cognitive impairments. This presents a challenge for collection and interpretation of self-reported dietary data. There are few reports on the impact of cognitive function and dementia on the validity of self-reported intake. Using plasma phospholipid fatty acid profiles as a biomarker of intake, we assessed the validity of an interviewer-administered food frequency questionnaire (FFQ) to estimate intake of the marine-based omega-3 fatty acids, EPA and DHA, in 273 community dwelling adults, aged 60-103 years, participating in the Nutrition, Aging, and Memory in the Elderly study. Age and energy-adjusted Pearson correlation coefficients between dietary intake and plasma phospholipids were consistent across categories of high and low cognitive function (r=0.48), based on Mini Mental-State Examination score; and were similar across clinically diagnosed categories of normal (r=0.49), mild cognitive impairment (r=0.45), and dementia (r=0.52). The FFQ was able to rank 78% of subjects to within +/-1 quartile of their plasma phospholipid EPA+DHA quartile. This frequency was consistently high across all cognitive categories. With interviewer-administration, this FFQ seems to be a valid dietary assessment method for EPA+DHA intake, in older adults with mild to moderate cognitive impairments.