Interaction of High-Sugar Diet and History of Stroke with Risk of Cognitive Decline in Older Adults.

ABSTRACT

BACKGROUND Cognitive decline has become a public health concern as it causes adverse economic and socio-psychological outcomes. Studies have assessed the effects of history of stroke or high-sugar diet on cognitive decline of older adults, but whether there was interaction between high-sugar diet and history of stroke in affecting cognitive decline was still unclear. The present study explored the interaction between high-sugar diet and history of stroke in affecting the risk of cognitive decline in older adults. MATERIAL AND METHODS This cross-sectional study included 2710 subjects. Univariate analysis was applied to explore the associations of high-sugar diet or history of stroke in affecting cognitive decline. The relative excess risk of interaction (RERI), synergy index (SI), and attributable proportion of interaction (API) were used to assess the interaction of high-sugar diet and history of stroke in risk of cognitive decline. RESULTS An increased risk of cognitive decline was observed in people with history of stroke [odds ratio (OR)=1.826, 95% confidence interval (CI) 1.124-2.968] and high-sugar diet (OR=1.509, 95% CI 1.109-2.052). The confidence intervals of interaction indicators RERI=1.257 (95% CI 0.188-2.326) and API=0.386 (95% CI 0.135-0.638) did not contain 0 and were both >0; the confidence interval of SI=2.261 (95% CI 1.063-4.809) did not contain 1 and were >1. CONCLUSIONS A high-sugar diet and history of stroke interacted synergically in association with cognitive decline in older adults, which might provide a reference for management of cognition in older adults.