Background: Cognitive decline presents increasing global health challenges, with chronic low-grade inflammation emerging as a key contributing factor. The aim of this study was to explore the association between pro-inflammatory dietary and/or lifestyle patterns with cognitive functioning in the Italian adult population of the Moli-sani Study. Methods: Dietary Inflammation Score (DIS) and Lifestyle Inflammation Score (LIS) were used to reflect dietary/lifestyle contributions to inflammation. Cognitive decline was assessed with the Montreal Cognitive Assessment (MoCA) test. Results: The DIS, LIS, and MoCA scores were available for 2474 individuals (mean age of 66.7 years, 55.2 % women). Approximately 42 % of the sample exhibited normal cognitive function (MoCA score ≥ 26), while 7 % of participants reported substantial cognitive decline (score ≤ 18). In multinomial-multivariable logistic analysis, the odds of having MoCA ≤18 (compared to ≥26) was 1.33 (95 % confidence interval: 1.11–1.59) and 1.16 (0.97–1.39) per 1 standard deviation (SD) increase of DIS and LIS, respectively. These findings remained unchanged even after further adjustment for biomarkers of inflammation. The association between DIS, but not LIS, and MoCA was more pronounced in individuals with a Patient Health Questionnaire-9 (PHQ-9) score ≥ 10 (indicating moderate to severe depressive symptoms; 1-SD DIS OR = 2.36; 95 % CI: 1.36–4.11), compared to those with a PHQ-9 score < 10 (OR = 1.21; 0.99–1.47; P for difference = 0.0014). Conclusion: High dietary inflammatory potential contributes to cognitive decline in Italian adults, particularly when combined with depressive symptoms. These findings underscore the importance of nutrition-based primary prevention strategies against cognitive impairment, especially for individuals with concurrent depressive conditions.
Exploring the correlation between pro-inflammatory dietary and lifestyle patterns and cognitive function: Cross-sectional results from the Moli-sani study
Gialluisi A.;Bonaccio M.;Costanzo S.;De Curtis A.;Panzera T.;Iacoviello L.;
2026-01-01
Abstract
Background: Cognitive decline presents increasing global health challenges, with chronic low-grade inflammation emerging as a key contributing factor. The aim of this study was to explore the association between pro-inflammatory dietary and/or lifestyle patterns with cognitive functioning in the Italian adult population of the Moli-sani Study. Methods: Dietary Inflammation Score (DIS) and Lifestyle Inflammation Score (LIS) were used to reflect dietary/lifestyle contributions to inflammation. Cognitive decline was assessed with the Montreal Cognitive Assessment (MoCA) test. Results: The DIS, LIS, and MoCA scores were available for 2474 individuals (mean age of 66.7 years, 55.2 % women). Approximately 42 % of the sample exhibited normal cognitive function (MoCA score ≥ 26), while 7 % of participants reported substantial cognitive decline (score ≤ 18). In multinomial-multivariable logistic analysis, the odds of having MoCA ≤18 (compared to ≥26) was 1.33 (95 % confidence interval: 1.11–1.59) and 1.16 (0.97–1.39) per 1 standard deviation (SD) increase of DIS and LIS, respectively. These findings remained unchanged even after further adjustment for biomarkers of inflammation. The association between DIS, but not LIS, and MoCA was more pronounced in individuals with a Patient Health Questionnaire-9 (PHQ-9) score ≥ 10 (indicating moderate to severe depressive symptoms; 1-SD DIS OR = 2.36; 95 % CI: 1.36–4.11), compared to those with a PHQ-9 score < 10 (OR = 1.21; 0.99–1.47; P for difference = 0.0014). Conclusion: High dietary inflammatory potential contributes to cognitive decline in Italian adults, particularly when combined with depressive symptoms. These findings underscore the importance of nutrition-based primary prevention strategies against cognitive impairment, especially for individuals with concurrent depressive conditions.
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