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Mediterranean diet, stroke, cognitive impairment, and depression: A meta-analysis
Psaltopoulou T, Sergentanis TN, Panagiotakos DB, Sergentanis IN, Kosti R, Scarmeas N.. Annals of neurology, 2013-09-16
Topic: Risk, prevention and care in population studies
Objective This meta-analysis aims to quantitatively synthesize all studies that examine the association between adherence to a Mediterranean diet and risk of stroke, depression, cognitive impairment, and Parkinson disease. Methods Potentially eligible publications were those providing effect estimates of relative risk (RR) for the association between Mediterranean diet and the aforementioned outcomes. Studies were sought in PubMed up to October 31, 2012. Maximally adjusted effect estimates were extracted; separate analyses were performed for high and moderate adherence. Results Twenty-two eligible studies were included (11 covered stroke, 9 covered depression, and 8 covered cognitive impairment; only 1 pertained to Parkinson's disease). High adherence to Mediterranean diet was consistently associated with reduced risk for stroke (RR = 0.71, 95% confidence interval [CI] = 0.57-0.89), depression (RR = 0.68, 95% CI = 0.54-0.86), and cognitive impairment (RR = 0.60, 95% CI = 0.43-0.83). Moderate adherence was similarly associated with reduced risk for depression and cognitive impairment, whereas the protective trend concerning stroke was only marginal. Subgroup analyses highlighted the protective actions of high adherence in terms of reduced risk for ischemic stroke, mild cognitive impairment, dementia, and particularly Alzheimer disease. Meta-regression analysis indicated that the protective effects of Mediterranean diet in stroke prevention seemed more sizeable among males. Concerning depression, the protective effects of high adherence seemed independent of age, whereas the favorable actions of moderate adherence seemed to fade away with more advanced age. Interpretation Adherence to a Mediterranean diet may contribute to the prevention of a series of brain diseases; this may be of special value given the aging of Western societies.
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
APA 7th
Psaltopoulou, T., Sergentanis, T. N., Panagiotakos, D. B., Sergentanis, I. N., Kosti, R., & Scarmeas, N. (2013). Mediterranean diet, stroke, cognitive impairment, and depression: A meta-analysis. Annals of neurology. https://doi.org/10.1002/ana.23944
Vancouver
Psaltopoulou T, Sergentanis TN, Panagiotakos DB, Sergentanis IN, Kosti R, Scarmeas N. Mediterranean diet, stroke, cognitive impairment, and depression: A meta-analysis. Annals of neurology. 2013. doi:10.1002/ana.23944. PMID: 23720230.
BibTeX
@article{psaltopoulou2013-23720230,
author = {Psaltopoulou, T. and Sergentanis, T. N. and Panagiotakos, D. B. and Sergentanis, I. N. and Kosti, R. and Scarmeas, N.},
title = {{Mediterranean diet, stroke, cognitive impairment, and depression: A meta-analysis}},
journal = {Annals of neurology},
year = {2013},
doi = {10.1002/ana.23944},
pmid = {23720230},
url = {https://doi.org/10.1002/ana.23944}
}
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Key findings
- Results Twenty-two eligible studies were included (11 covered stroke, 9 covered depression, and 8 covered cognitive impairment; only 1 pertained to Parkinson's disease).
- High adherence to Mediterranean diet was consistently associated with reduced risk for stroke (RR = 0.71, 95% confidence interval [CI] = 0.57-0.89), depression (RR = 0.68, 95% CI = 0.54-0.86), and cognitive impairment (RR = 0.60, 95% CI = 0.43-0.83).
- Moderate adherence was similarly associated with reduced risk for depression and cognitive impairment, whereas the protective trend concerning stroke was only marginal.
- Meta-regression analysis indicated that the protective effects of Mediterranean diet in stroke prevention seemed more sizeable among males.
Why it matters
This meta-analysis found that high adherence to a Mediterranean diet was associated with reduced risk for cognitive impairment, and subgroup analyses highlighted reduced risk for dementia and particularly Alzheimer's disease. It reports associations from observational studies, not a proven treatment or cure.
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Study details
- Study designmeta-analysis
- Effect sizeRR = 0.71; RR = 0.68; RR = 0.60
- Evidence strengthHigh
How this study scored 75/100
Published in a leading specialty journal, and it is a meta-analysis pooling many studies. Scored zero for sample size and studied in people because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 9 / 10 | Tier 2 — leading specialty journal (Annals of neurology) |
| Journal's citation record | 3 / 4 | Annals of Neurology: journal h-index 437 (OpenAlex, 2026-10-29) |
| Study design | 12 / 12 | A meta-analysis pooling many studies |
| Strength of evidence | 5 / 5 | Rated “high” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 1 / 5 | 2013 — within 20 year(s) of the newest study here |
| Sample size | 0 / 4 | Participant count not stated — scores zero (not stated in the record — scored 0) |
| Effect reported | 3 / 3 | Effect reported with a statistic (interval, p-value, ratio or similar) |
| Studied in people | 0 / 3 | Not stated whether this was studied in people — scores zero (not stated in the record — scored 0) |
| Randomised / blinded | 0 / 2 | A review of other studies — randomisation is not credited here |
| Times cited | 6 / 7 | Cited 798 times (OpenAlex, 2026-10-10) |
| Citations per year | 5 / 5 | 53.2 citations a year over 15 year(s) since 2013 |
| Impact for its field and year | 6 / 6 | Cited 52.5× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 3 / 6 | Cited by 28 other studies in this library |
| Still being cited | 3 / 4 | Cited 140 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 3 / 4 | Last-listed author Nikolaos Scarmeas: h-index 90 (OpenAlex, whole career) |
| Institution's track record | 2 / 3 | Columbia University: institution h-index 1,824 (OpenAlex) |
| Multi-centre collaboration | 2 / 3 | OpenAlex lists 4 institution(s) in 3 countries |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 23720230) |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Total | 75 / 100 | — |
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