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American Journal of Epidemiology Advance Access originally published online on May 11, 2009
American Journal of Epidemiology 2009 170(1):95-103; doi:10.1093/aje/kwp089
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American Journal of Epidemiology © The Author 2009. Published by the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oxfordjournals.org.

PRACTICE OF EPIDEMIOLOGY

Validity of Estimated Dietary Eicosapentaenoic Acid and Docosahexaenoic Acid Intakes Determined by Interviewer-Administered Food Frequency Questionnaire Among Older Adults With Mild-to-Moderate Cognitive Impairment or Dementia

Lisa N. Arsenault, Nirupa Matthan, Tammy M. Scott, Gerard Dallal, Alice H. Lichtenstein, Marshal F. Folstein, Irwin Rosenberg and Katherine L. Tucker

Correspondence to Dr. Katherine L. Tucker, Dietary Assessment and Epidemiology Research Program, Human Nutrition Research Center on Aging, Tufts University, 711 Washington Street, Boston, MA 02124 (e-mail: katherine.tucker{at}tufts.edu).

Received for publication November 24, 2008. Accepted for publication March 17, 2009.

Epidemiologic research is increasingly being focused on elderly persons, many of whom exhibit mild-to-moderate cognitive impairment. This presents a challenge for collection and interpretation of self-reported dietary data. There are few reports on the impact of cognitive function and dementia on the validity of self-reported dietary intakes. Using plasma phospholipid fatty acid profiles as a biomarker of intake, the authors assessed the validity of an interviewer-administered food frequency questionnaire (FFQ) to estimate intakes of 2 marine-based omega-3 fatty acids, eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), among 273 community-dwelling adults aged ≥60 years participating in the Nutrition, Aging, and Memory in Elders Study (Boston, Massachusetts, 2002–2008). Age- and energy-adjusted Pearson correlation coefficients for correlations between dietary intakes and plasma phospholipids were consistent across categories of high and low cognitive function (r = 0.48), based on Mini-Mental State Examination score, and were similar across clinically diagnosed categories of normal functioning (r = 0.49), mild cognitive impairment (r = 0.45), and dementia (r = 0.52). The FFQ ranked 78% of subjects to within 1 quartile of their plasma phospholipid EPA + DHA quartile. This frequency was consistently high across all cognitive categories. With interviewer administration, this FFQ seems to be a valid method of assessing dietary EPA + DHA intake in older adults with mild-to-moderate cognitive impairment.

aged; aged, 80 and over; dementia; epidemiologic methods; fatty acids, omega-3; mental recall; nutrition assessment; questionnaires

Abbreviations: DHA, docosahexaenoic acid; DPA, docosapentaenoic acid; EPA, eicosapentaenoic acid; FFQ, food frequency questionnaire; IQR, interquartile range; MMSE, Mini-Mental State Examination; MRI, magnetic resonance imaging; NAME, Nutrition, Aging, and Memory in Elders; SD, standard deviation


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