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This Article Free via Open Access: OA OA Full Text Full Text (PDF) OA All Versions of this Article: 90/2/392    most recent ajcn.2009.27580v1 Purchase Article View Shopping Cart Alert me when this article is cited Alert me if a correction is posted Citation Map Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Google Scholar Articles by Albanese, E. Articles by Prince, M. J PubMed PubMed Citation Articles by Albanese, E. Articles by Prince, M. J Agricola Articles by Albanese, E. Articles by Prince, M. J

Dietary fish and meat intake and dementia in Latin America, China, and India: a 10/66 Dementia Research Group population-based study^1,2,3

¹ From King's College London, Section of Epidemiology, Health Services and Population Research Department, De Crespigny Park, London, United Kingdom (EA, CF, RS, and MJP); the Nutrition and Public Health Intervention Research Unit, London School of Hygiene & Tropical Medicine, London, United Kingdom (ADD); the Public Health Nutrition Division, Instituto Nutricion y Tecnologia de Alimentos, Universidad de Chile, Santiago, Chile (RU); Universidad Nacional Pedro Henriquez Ureña, Internal Medicine Department, Geriatric Section, Santo Domingo, Dominican Republic (DA); the Psychogeriatric Unit, National Institute of Mental Health "Honorio Delgado Hideyo Noguchi," Lima, Perú (MG and SSGG); Peking University, Institute of Mental Health, Beijing, China (YH); Christian Medical College, Vellore, India (KSJ); the Facultad de Medicina Finley-Albarran, Medical University of Havana, Havana, Cuba (JLdR); the Community Mental Health Centre, Mariano, Cuba (LHN); the Medicine Department, Caracas University Hospital, Faculty of Medicine, Universidad Central de Venezuela, Caracas, Venezuela (AS); the Cognition and Behavior Unit, National Institute of Neurology and Neurosurgery of Mexico, Mexico City, Mexico (ALS); and the Department of Community Health, Voluntary Health Services, Chennai, India (JW).

² The 10/66 Dementia Research Group was supported by the Wellcome Trust Health Consequences of Population Change Programme (GR066133 for Cuba and Brazil and GR08002 for Peru, Mexico, Argentina, Cuba, Dominican Republic, and China), the World Health Organization (India, Dominican Republic, and China), the US Alzheimer's Association (IIRG-04-1286 for Peru, Mexico, and Argentina), and Fondo Nacional de Ciencia y Tecnologia and Universidad Central de Venezuela (Venezuela). The 10/66 Dementia Research Group works closely with Alzheimer's Disease International (ADI), the nonprofit federation of 77 Alzheimer associations worldwide; ADI provided support for networking and infrastructure and partially funds EA's research and dissemination activities. The study design, data collection and analysis, and interpretation of findings were independent of all sponsors.

³ Address reprint requests and correspondence to E Albanese, King's College London, Health Service & Population Research Department, De Crespigny Park, SE5 8AF London, United Kingdom. E-mail: emiliano.albanese{at}iop.kcl.ac.uk.

Background: Evidence of an association between fish and meat consumption and risk of dementia is inconsistent and nonexistent in populations in developing countries.

Objective: The objective was to investigate associations between fish and meat consumption with dementia in low- and middle-income countries.

Design: One-phase cross-sectional surveys were conducted in all residents aged 65 y in 11 catchment areas in China, India, Cuba, the Dominican Republic, Venezuela, Mexico, and Peru. A total of 14,960 residents were assessed by using the 10/66 standardized protocol, which includes face-to-face interviews for dietary habits and a cross-culturally validated dementia diagnosis.

Results: Dietary intakes and the prevalence of dementia varied between sites. We combined site-specific Poisson regression prevalence ratios (PRs) for the association between fish and meat consumption and dementia in 2 fixed-effect model meta-analyses adjusted for sociodemographic and health characteristics and fish and meat consumption as appropriate. We found a dose-dependent inverse association between fish consumption and dementia (PR: 0.81; 95% CI: 0.72, 0.91) that was consistent across all sites except India and a less-consistent, dose-dependent, direct association between meat consumption and prevalence of dementia (PR: 1.19; 95% CI: 1.07, 1.31).

Conclusions: Our results extend findings on the associations of fish and meat consumption with dementia risk to populations in low- and middle-income countries and are consistent with mechanistic data on the neuroprotective actions of omega-3 (n–3) long-chain polyunsaturated fatty acids commonly found in fish. The inverse association between fish and prevalent dementia is unlikely to result from poorer dietary habits among demented individuals (reverse causality) because meat consumption was higher in those with a diagnosis of dementia.