Managing blood pressure through a healthy diet isn’t just important for heart health. It may also lead to better cognition in the future, particularly in women, according to a recent study.

The research conducted by scientists from NYU Grossman School of Medicine found that women following the DASH diet (Dietary Approaches to Stop Hypertension) in mid-life were 17% less likely to note loss of memory and other clues of cognitive decline years later. This is important as women make up over two-thirds of individuals diagnosed with Alzheimer’s disease, the most common type of dementia.

The results were published recently in the journal Alzheimer's & Dementia and may impact nearly 6.5 million Americans diagnosed in 2022 with Alzheimer’s disease over the age of 65. The number of people with Alzheimer’s is expected to be more than 13 million by 2060.

According to Yu Chen, PhD, MPH, professor in the Department of Population Health and senior author of the study, "Subjective complaints about daily cognitive performance are early predictors of more serious neurocognitive disorders such as Alzheimer's. With more than 30 years follow-up, we found that the stronger the adherence to a DASH diet in midlife, the less likely women are to report cognitive issues much later in life."

Plant-based foods high in potassium, calcium, and magnesium that limit saturated fat, cholesterol, sugar, and sodium make up The DASH diet. Previous research studies find that poorly controlled blood pressure, especially in mid-life, is a risk factor for dementia and decline in cognition.

How the Research was Done

Data from 5,116 of the over 14,000 women participating in the NYU Women's Health Study, was evaluated by the researchers. This is one of the longest studies to analyze the impact of lifestyle and other risks on the development of common cancers and other chronic diseases in women.

Subjects in the study were asked about their diets through questionnaires from 1985 to 1991 at the start of the study when the subjects were an average of 49 years old. The subjects were then followed for over 30 years (average age 79) and asked to note any complaints of cognitive changes. Those who did not return the surveys were reached by phone.

A questionnaire using six validated standard questions that suggest later mild cognitive impairment was used to assess self-reported cognitive complaints. Questions included trouble recalling recent events or shopping lists, comprehending spoken instructions or group conversations, or finding familiar streets.

Thirty-three percent of women reported having more than one of the six cognitive complaints. Those who followed the DASH diet the closest had a 17 percent reduction in the chances of reporting more than one cognitive complaint.

Yixiao Song, a lead author of the study noted, "Our data suggest that it is important to start a healthy diet in midlife to prevent cognitive impairment in older age."

"Following the DASH diet may not only prevent high blood pressure but also cognitive issues," said Fen Wu, PhD, a senior associate research scientist who co-led the study.

More research is advised on multiple racial and ethnic groups to examine the generalization of the results, according to the researchers. The National Institutes of Health, grant U01 CA182934 supported this study.

Below are 10 tips to manage blood pressure and reduce the risk of dementia.

1.    Follow your doctor’s advice regarding medication and lifestyle for high blood pressure.

2.    Have a plant with all meals and snacks. Add veggies to omelets or pair apples with unsalted nuts.

3.    Include low-fat dairy products like Greek yogurt or milk in your coffee for calcium and vitamin D.

4.    Choose whole grains such as whole wheat pasta, brown rice, quinoa or farro for magnesium.

5.    Use leaner cuts of meat such as ground turkey or chicken when possible.

6.    Add fish to your diet twice per week.

7.    Enjoy meatless sources of protein such as beans, lentils, or soy-based products a few times per week.

8.    Include leafy greens in your diet daily. This has been found to reduce the risk of cognitive decline.2

9.    Stay active. Regular exercise manages weight, reduces stress, and improves blood flow to your brain.

10.  Avoid highly processed fast foods and desserts high in fat, sodium, and sugar, respectively.

Lisa Andrews, MEd, RD, LD

References:

1. Yixiao Song, Fen Wu, Sneha Sharma, Tess V. Clendenen, Sandra India‐Aldana, Yelena Afanasyeva, Yian Gu, Karen L. Koenig, Anne Zeleniuch‐Jacquotte, Yu Chen. Mid‐life adherence to the Dietary Approaches to Stop Hypertension (DASH) diet and late‐life subjective cognitive complaints in women. Alzheimer's & Dementia, 2023; DOI: 10.1002/alz.13468

2. Morris MC, et al. Nutrients and bioactives in green leafy vegetables and cognitive decline. Neurology. 2017 90:e214-e222. Research supported by NIA grants R01 AG031553 and R01 AG17917.