Abstract

Background and aims: Investigating modifiable risk factors, such as diet, is crucial in understanding their effects on the relationship between Alzheimer's disease (AD)-related cognitive decline and related conditions. This study assesses whether dietary patterns moderate the relationship between symptoms of depression, anxiety, and cognitive function in older adults. Given that biological and psychosocial differences between sexes may influence dietary behaviours, mental health symptoms, and cognitive outcomes, conducting sex-stratified analyses will allow for identification of differential associations. Method: Cross-sectional data from cognitively unimpaired older adults (n = 1174, age ≥60 years) from the Australian Imaging, Biomarkers and Lifestyle (AIBL) study were included. Participants completed the Cancer Council of Victoria food frequency questionnaire, provided depression and anxiety symptom data, and underwent neuropsychological testing. Composite scores for six cognitive domains were generated from individual test scores (episodic recall, recognition, executive function, language, attention processing, and the AIBL Preclinical Alzheimer Cognitive Composite (PACC)). Dietary pattern scores were calculated for the Mediterranean diet (MeDi), Dietary Approaches to Stop Hypertension (DASH), and Western diet. Moderation analysis explored interactions between dietary patterns, depression, anxiety, and cognitive performance. Results: The MeDi was found to moderate the relationship between depressive symptoms and attention processing in males, where low to moderate MeDi adherence was linked to poorer attention with higher depressive symptoms. The Western diet moderated the relationship between anxiety and the AIBL PACC score in males, with high adherence to the Western diet associated with worse PACC performance in those with greater anxiety. No significant moderating effects were observed in females for the MeDi and Western diet, or in either sex for the DASH diet on the association of depression and anxiety with cognitive function. Conclusion: These findings also emphasise the importance of sex-specific approaches in research on symptoms of depression and anxiety, cognitive health, and diet. Our results highlight the need for further investigation into sex-specific pathways using longitudinal study designs and randomised controlled trials to establish causal relationships.

Keywords

Alzheimer's disease, anxiety, cognition, depression, dietary patterns

Document Type

Journal Article

Date of Publication

8-1-2025

Volume

51

Publisher

Elsevier

School

Centre of Excellence for Alzheimer's Disease Research and Care / School of Medical and Health Sciences

RAS ID

82645

Funding Information

The AIBL Study (www.AIBL.csiro.au) is a consortium between Austin Health, CSIRO, Edith Cowan University, the Florey Institute (The University of Melbourne), and the National Ageing Research Institute. The study has received partial financial support from the Alzheimer’s Association (US), the Alzheimer’s Drug Discovery Foundation, an Anonymous foundation, Science and Industry Endowment Fund, the Dementia Collaborative Research Centres, the Victorian Government’s Operational Infrastructure Support program, the Australian Alzheimer’s Research Foundation, the National Health and Medical Research Council (NHMRC), and The Yulgilbar Foundation. Numerous commercial interactions have supported data collection and analyses. In-kind support has also been provided by Sir Charles Gairdner Hospital, Cogstate Ltd, Hollywood Private Hospital, The University of Melbourne, and St Vincent’s Hospital. H.A. is supported by an Omani Consulate PhD Scholarship. S.R.RS. is supported by a National Health and Medical Research Council (NHMRC) Investigator Grant (GNT1197315).

Funding received from the National Health and Medical Research Council (NHMRC)

GNT1197315

Administering Institution

Edith Cowan University

Creative Commons License

Creative Commons Attribution 4.0 License
This work is licensed under a Creative Commons Attribution 4.0 License.

Comments

Shamsi, H. S. S. A., Gardener, S. L., Sohrabi, H. R., Taddei, K., Masters, C. L., Rainey-Smith, S. R., Martins, R. N., & Fernando, W. M. a. D. B. (2025). The moderating effect of dietary patterns on the association of depression and anxiety with cognitive function. Clinical Nutrition, 51, 278–286. https://doi.org/10.1016/j.clnu.2025.06.013

Recommended Citation

Shamsi, H. S. S. A., Gardener, S. L., Sohrabi, H. R., Taddei, K., Masters, C. L., Rainey-Smith, S. R., Martins, R. N., & Fernando, W. M. a. D. B. (2025). The moderating effect of dietary patterns on the association of depression and anxiety with cognitive function. Clinical Nutrition, 51, 278–286. https://doi.org/10.1016/j.clnu.2025.06.013

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