Objective:There is evidence from a population-based study of an inverse relationship between monounsaturated fatty acids (MUFA) energy intake and age-related cognitive decline (ARCD), while high polyunsaturated fatty acids (PUFA) intake was positively associated with cognitive impairment in elderly subjects. After a median follow-up of 8.5 years, we investigated the possible role of MUFA and PUFA in protecting against age-related cognitive changes and all-cause mortality. Design:Randomized, cohort study with a median period of 8.5-year follow-up. Materials and Methods: The subjects were 278, 186, and 95 nondemented elderly subjects (65-84 years) evaluated at the 1st (1992-1993), 2nd (1995-1996), and 3rd survey (2000-2001), respectively, from the randomized cohort of Casamassima, Bari, Italy (n=704), one of the eight centers of the Italian Longitudinal Study on Aging (ILSA). A standardized test assessing global cognitive functions (Mental State Examination, MMSE) and a semi-quantitative food frequency questionnaire evaluating macronutrient energy intakes were performed. Analyses were by Random-effects regression models. Results:The average predicted MMSE scores rose between T0 and T3.5 (by 1.19 at any given age and education categories), then it decreased between T3.5 and T8.5 (by 3.20) associated to PUFA intake >220 kJ/die, while the average predicted MMSE scores rose between T0 and T3.5 (by 1.16) then it decreased between T3.5 and T8.5 (by 1.90) associated to MUFA intake > 2000 kJ/die. Although average predicted MMSE performance associated to high MUFA and PUFA intakes showed a negative trend over time, they resulted significantly better than those associated to low MUFA and PUFA intakes. Finally survival analysis showed a protective role of MUFA intake >1600 kJ/die compared to <1600 kJ/die on all-cause mortality, while no effect about PUFA intake was found. Conclusion:The MMSE performance over 9 years follow-up associated with high PUFA and MUFA intakes were better than that due to low PUFA and MUFA intakes, in all subjects and completers. Moreover >1600 kJ/die MUFA intake increased survival; no effect about PUFA intake was found. These findings confirm that in the Mediterranean region, where large amounts of olive oil are consumed with high intakes of MUFA, rates of coronary artery disease and total mortality are low. Furthermore, a recent study suggested an inverse association of MUFA and a positive association of PUFA with the risk of breast cancer, while a MUFA but not a PUFA diet, along with a slight reduction in SFA intake, markedly lowers daily antihypertensive dosage requirement, and olive oil may have a protective effect on the development of colorectal cancer. Although these promising findings, further investigations are needed in larger samples of elderly subjects to determine the role of unsaturated fatty acids intake in protecting against ARCD in relation to other environmental and genetic factors.
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