Fisicaro F, Lanza G, Pennisi M, et al. Moderate mocha coffee consumption is associated with higher cognitive and mood status in a non-demented elderly population with subcortical ischemic vascular disease. Nutrients. February 2021;13(2):536. doi:10.3390/nu13020536.
A progressively aging population worldwide has led to increases of some age-related diseases, including subcortical ischemic vascular disease (SIVD). SIVD is a cognitive deficit due to neurovascular disorders that can also be associated with vascular depression. This type of late-life depression has a complex relationship with white matter lesions in the brain and cognition. Evidence has shown that modifiable vascular and lifestyle-related factors impact cognitive impairment and movement disorders. As of December 2020, early identification and prompt management are the only effective measures for the prevention of cognitive disorders. In the Mediterranean, components of a local diet are considered preventatives for cardiovascular diseases and age-related cognitive disorders. The roasted seeds of coffee (Coffea sp., Rubiaceae) are used to prepare the common beverage, and known to increase alertness, arousal, and mental performance. Studies have investigated the benefits of coffee in neurological and neuropsychiatric disorders. The authors aimed to estimate the association between mocha coffee consumption and cognitive and mood status of non-demented elderly Italian participants with SIVD in a cross-sectional study.
This study took place at the Cerebrovascular Diseases Centre of the "Azienda Ospedaliera Universitaria Policlinico Gaspare Rodolico-San Marco" in Catania, Italy. Three hundred participants were enrolled with the following inclusion criteria: aged ≥ 65 years, a Mini Mental State Examination score (MMSE) ≥ 24, and brain magnetic resonance imaging (MRI)-based evidence of lacunar state or ischemic WMLs. Exclusion criteria included overt dementia, consumption of other coffee preparations different from mocha, any medical condition or drug affecting cognitive functions and/or mood status, alcohol or drug abuse, and any contraindication to MRI. Of the 300 enrolled, 46 were excluded due to mixed coffee consumption.
Clinical and demographic history, blood pressure, hyperlipidemia, diabetes, and a food-frequency questionnaire were assessed. Information on coffee data was collected through a diet record with the following classifications: < 1 cup/day (non-drinkers or occasional consumers) (n = 73), 1 cup/day (light consumers) (n = 69), 2 cups/day (moderate consumers) (n = 87), and ≥ 2 cups/day (heavy consumers) (n = 71). Neuropsychological evaluation included utilization of the MMSE, Stroop Color-Word Interference Test (Stroop T), 17-item Hamilton Depression Rating Scale (HDRS), Activities of Daily Living, and Instrumental Activities of Daily Living. Participants also underwent brain MRI with the T1-, T2-, fluid-attenuated inversion recovery, and proton density-weighted scans to assess the white matter lesions. The Fazekas visual scale was employed to grade the lesions.
Mocha coffee was the drink of interest and is traditionally made with an aluminum or stainless-steel machine where hot water (approx. 70°C) is forced up through the coffee in the pot top. This quick contact time lowers the concentration of lipids compared to boiled coffee, leaving only 2.3 mg of cafestol and kahweol in a cup.
Participants were placed in subgroups based on their coffee consumption. Results were compared in regards to MMSE, HDRS, or Stroop T. Age, sex, education, and smoking were also analyzed for significance.
It was found that different consumption had significant differences on most outcome measures, as well as age and education. General Regression Models was used, and it was found that MMSE, HDRS, and Stroop T scores were significant and independent in the groups and were unaffected by age and education. There was a lower severity for HDRS with the increase of coffee intake (P < 0.000001) and a better MMSE (P < 0.0071) and Stroop T (P < 0.0028). For MMSE, the heavy consumers group showed a significant difference compared to all other groups; however, for HDRS and Stroop T, there was little difference between heavy and moderate consumers.
The authors conclude that coffee consumption, in regards to mocha preparation, was associated with higher cognition and mood status in non-demented elderly participants with VCI. More data are needed with different coffee preparations, populations, and sizes. Limitations include inaccurate drinking habit reports, response bias in measures of cognition, not all cognitive domains being explored, other lifestyle and social factors affecting cognition, and other compounds in coffee that contribute to cognition. More research is needed with multidimensional follow-ups to verify these findings. The authors state no conflict of interest.