MD, PhD, MAE, FMedSci, FRCP, FRCPEd.

This prospective cohort study investigated associations of coffee and tea intake with dementia risk and cognitive function. It included female participants from the Nurses’ Health Study (NHS; n = 86 606 with data from 1980-2023) and male participants from the Health Professionals Follow-up Study (HPFS; n = 45 215 with data from 1986-2023) who did not have cancer, Parkinson disease, or dementia at study entry (baseline) in the US.

The primary exposures were intakes of caffeinated coffee, decaffeinated coffee, and tea. Dietary intake was collected every 2 to 4 years using validated food frequency questionnaires. The primary outcome was dementia, which was identified via death records and physician diagnoses. The secondary outcomes included subjective cognitive decline assessed by a questionnaire-based score (range, 0-7; higher scores indicate greater perceived decline; cases defined as those with a score ≥3) and objective cognitive function assessed only in the NHS cohort using telephone-based neuropsychological tests such as the Telephone Interview for Cognitive Status (TICS) score (range, 0-41) and a measure of global cognition (a standardized mean z score for all 6 administered cognitive tests).

Among 131 821 participants (mean age at baseline, 46.2 [SD, 7.2] years in the NHS cohort and 53.8 [SD, 9.7] years in the HPFS cohort; 65.7% were female) during up to 43 years of follow-up (median, 36.8 years; IQR, 28-42 years), there were 11 033 cases of incident dementia. After adjusting for potential confounders and pooling results across cohorts, higher caffeinated coffee intake was significantly associated with lower dementia risk (141 vs 330 cases per 100 000 person-years comparing the fourth [highest] quartile of consumption with the first [lowest] quartile; hazard ratio, 0.82 [95% CI, 0.76 to 0.89]) and lower prevalence of subjective cognitive decline (7.8% vs 9.5%, respectively; prevalence ratio, 0.85 [95% CI, 0.78 to 0.93]). In the NHS cohort, higher caffeinated coffee intake was also associated with better objective cognitive performance. Compared with participants in the lowest quartile, those in the highest quartile had a higher mean TICS score (mean difference, 0.11 [95% CI, 0.01 to 0.21]) and a higher mean global cognition score (mean difference, 0.02 [95% CI, −0.01 to 0.04]); however, the association with global cognition was not statistically significant (P = .06). Higher intake of tea showed similar associations with these cognitive outcomes, whereas decaffeinated coffee intake was not associated with lower dementia risk or better cognitive performance. A dose-response analysis showed nonlinear inverse associations of caffeinated coffee and tea intake levels with dementia risk and subjective cognitive decline. The most pronounced associated differences were observed with intake of approximately 2 to 3 cups per day of caffeinated coffee or 1 to 2 cups per day of tea.

The authors concluded that “greater consumption of caffeinated coffee and tea was associated with lower risk of dementia and modestly better cognitive function, with the most pronounced association at moderate intake levels”.

Prior to this new study, observational evidence from prospective cohort studies and meta-analyses had already suggested that moderate coffee and tea consumption—typically 1–5 caffeinated cups per day—was associated with a modestly lower risk of dementia and slower cognitive decline, often with J- or U-shaped dose responses favoring moderate intake. Yet, findings had been inconsistent across cohorts – stronger for tea in some Asian studies, mixed for coffee, and varying by sex or vascular risk factors. Caffeine was hypothesized to protect via adenosine antagonism and amyloid reduction, while polyphenols offered antioxidant and vascular benefits. The limitations of this body of evidence included confounding by lifestyle, self-reported exposures, reverse causation, and lack of randomized trials confirming causality. The new study seems to settle at least some of the uncertainties and makes a causal link more likely. 

One Response to Does Coffee and Tea Consumption Reduce the Dementia Risk and Improve Cognitive Function?

  • This is the kind of Study, I love!
    1-5 cups of coffee works!

    Peter Attia will fume! (Or probably sell incredible expensive caffeine capsules in adequate doses) 🤭🤭🤭)

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