Coffee, tea, coffee + tea can reduce the risk of stroke and dementia! From PLOS Medicine

The following is the Coffee, tea, coffee + tea can reduce the risk of stroke and dementia! From PLOS Medicine recommended by recordtrend.com. And this article belongs to the classification: Life data.

With the aggravation of the aging trend of the population, dementia has become a global health problem of increasing concern, and has brought a heavy economic and social burden.

In 2019, more than 50 million people worldwide suffered from dementia. This figure is expected to increase to 152 million by 2050. In view of the limited therapeutic value of drugs currently used to treat dementia, identifying preventable risk factors for dementia is a top priority.

Stroke accounts for 10 per cent of total global deaths and is the leading cause of all disability adjusted life years. Although the incidence rate and mortality rate of age standardized stroke in the past 20 years have decreased, the absolute number of stroke cases and deaths has increased. Stroke and dementia pose risks to each other and share some of the same, modifiable risk and protective factors.

A population-based longitudinal study found that stroke and dementia share about 60% of the risk and protective factors. In principle, 90% of strokes and 35% of dementia are estimated to be preventable.

Coffee and tea are one of the most widely consumed beverages in the world. Coffee contains caffeine and is a rich source of antioxidants and bioactive compounds. It is reported that tea sets containing caffeine, catechin polyphenols and flavonoids have neuroprotective effects, such as antioxidant stress, anti-inflammatory, inhibition of amyloid beta polymerization and anti apoptosis. Coffee consumption is closely related to tea consumption. A prospective cohort study showed that about 70% of participants drank coffee and tea at the same time. Epidemiological and clinical studies have shown that coffee and tea are beneficial to the prevention of dementia, respectively. However, little is known about the association between the combination of coffee and tea and the risk of dementia. Therefore, the aim of this study was to explore the association between the combination of coffee and tea, which may be a multiplicative or additive effect, and the risk of stroke and dementia.

This prospective cohort study included 365682 participants (aged 50 to 74) from the UK Biobank. Participants participated in the study from 2006 to 2010 and were tracked until 2020. Among the 365682 participants, the average age was 60.4 ± 5.1 years, and 167060 (45.7%) were men. Of the 365682 participants, 59558 (16.29%) reported drinking 0.5 to 1 cup of coffee and ≥ 4 cups of tea per day, accounting for the largest proportion; The second was 50015 people (13.68%), who reported drinking 0 cups of coffee and ≥ 4 cups of tea every day. In addition, 44868 participants (12.27%) reported that they drank 2 to 3 cups of coffee and 2 to 3 cups of tea every day. Table 1 shows the baseline characteristics of participants.

Compared with participants who did not drink coffee, coffee drinkers were more likely to be men, whites, former smokers, existing drinkers, people with college degrees and high incomes. Similarly, compared with non tea drinkers, tea drinkers are more likely to be male, never smoke, and current drinkers, have a university degree and frequent physical activity. In addition, compared with participants who did not drink coffee or tea, participants who drank both drinks were more likely to be elderly, male, white, former smokers, existing drinkers, have a university degree and have a high income.

Coffee intake (cup / day) was related to tea intake (r = + 0.337, P < 0.001). Coffee and tea drinking were related to gender, age, race, qualifications, income, body mass index, physical activity, alcohol status, smoking status, consumption of sugar drinks, low density lipoprotein, cancer, diabetes and CAD, but not with HDL. At the median follow-up of 11.35 years, 10053 participants (2.8%) had strokes (5630 ischemic strokes and 1815 hemorrhagic strokes) and 5079 participants (1.4%) had dementia (2128 had Alzheimer's disease and 1223 had vascular dementia).

In unadjusted and multi adjusted models (Figure 1), the combination of coffee and tea was associated with stroke, dementia and post-stroke dementia. In the multiple adjustment model, the association between coffee and tea and stroke and dementia was nonlinear (nonlinear P < 0.001), and coffee intake of 2 to 3 cups / day or tea intake of 3 to 5 cups / day, or coffee and tea intake of 4 to 6 cups / day was associated with the lowest risk ratio (HR) of stroke and dementia. In addition, the combination of tea and coffee was associated with a lower risk of post-stroke dementia: consuming 3 to 6 cups of coffee and tea per day had the lowest risk of post-stroke dementia (HR, 0.52, 95% CI, 0.32 to 0.83: P  = 0.007）。

To analyze the association between coffee and tea intake and new onset outcomes, we defined coffee and tea intake as the following categories: 0, 0.5 to 1, 2 to 3, and ≥ 4 cups / day. We investigated the association of intake of each coffee and tea with stroke and its subtypes (Figure 2). In the unadjusted Cox model, coffee and tea intake was associated with a lower risk of stroke. After multivariable adjustment, coffee intake was associated with a reduced risk of stroke. Compared with non coffee drinkers, the HR of coffee intake of 0.5 to 1, 2 to 3 and ≥ 4 cups / day were 0.90 (95% CI, 0.85-0.95: P < 0.001),   0.88 (95% CI, 0.84 -0.94: P < 0.001) and 0.92 (95% CI, 0.86 – 0.98: P = 0.009). Similarly, after adjusting for confounding factors, tea intake was associated with a reduced risk of stroke. The HR of 0.5 to 1, 2 to 3 and ≥ 4 cups / day were 0.97 (95% CI, 0.89 - 1.04, P = 0.386), 0.84 (95% CI, 0.79 - 0.90; P < 0.001) and 0.84 (95% CI, 0.79 - 0.90: P < 0.001), respectively. In addition, both coffee and tea were associated with a low risk of ischemic stroke, but not hemorrhagic stroke (P > 0.05).

In addition, we examined the combined association of coffee and tea intake with stroke and its subtypes (Fig. 2). In unadjusted and multi adjusted models, the combination of coffee and tea was associated with a lower risk of stroke and ischemic stroke. In the multiple adjustment model, the HR of stroke and ischemic stroke after drinking 2 to 3 cups of coffee and 2 to 3 cups of tea per day were 0.68 (95% CI, 0.59-0.79: P  < 0.001) and 0.62 (95% CI, 0.51 -0.75: P  < 0.001）。 However, coffee and tea were not found to be associated with hemorrhagic stroke. There was a statistical interaction between tea and coffee intake during stroke (P  < 0.001）。

Subsequently, this study assessed the association of each coffee and tea with dementia and its subtypes (Fig. 3). In the unadjusted Cox model, the intake of coffee and tea and their combination were associated with reducing the risk of dementia and vascular dementia, but not Alzheimer’s disease. After adjusting for mixed factors, coffee intake was associated with a reduced risk of dementia and vascular dementia, but not Alzheimer’s disease. Similarly, tea intake was associated with reducing the risk of dementia and vascular dementia, but not Alzheimer’s disease.

Next, the combined association of coffee and tea intake with dementia and its subtypes was evaluated. We found that drinking 0.5 to 1 cup of coffee and ≥ 4 cups of tea per day had the lowest risk of dementia. The HR of drinking 0.5 to 1 cup of coffee and ≥ 4 cups of tea per day was 0.70 (95% CI, 0.58-0.86: P  < 0.001), the HR for drinking 2 to 3 cups of coffee and 2 to 3 cups of tea per day was 0.72 (95% CI, 0.59 – 0.89: P  = 0.002）。 Tea and coffee intake were associated with dementia and vascular dementia (P  = 0.0127). In addition, the combination of coffee and tea intake was associated with a lower risk of vascular dementia, but not Alzheimer's disease.

In addition, we assessed the HR of participants who drank both coffee and tea and those who drank only coffee or tea. After adjusting for confounding factors, participants who drank both coffee and tea had a stroke compared with participants who drank only coffee or tea (HR 0.89:95% CI, 0.86 to 0.93: P  < 0.001), ischemic stroke (HR 0.89:95% CI, 0.84 to 0.94: P  < 0.001), dementia (HR, 0.92:95% CI, 0.87 to 0.98: P  = 0.001) and vascular dementia (HR, 0.82; 95% CI, 0.72 to 0.92; P  < 0.001).

We further investigated the association of coffee and tea with dementia and its subtypes in stroke participants. Of the 13352 stroke patients, 646 participants (4.8%) developed dementia (119 Alzheimer’s disease and 315 vascular dementia) during the median follow-up of 7.07 years. In the unadjusted Cox model, coffee and the combination of coffee and tea were associated with reducing the risk of dementia. After multivariate adjustment, participants who drank 2 to 3 cups of coffee a day were associated with a lower risk of dementia than non coffee drinkers (HR, 0.80:95% CI, 0.64 to 0.99, P  = 0.044）。

Next, we evaluated the coffee and tea intake of dementia and the combination of its subtypes in stroke participants. We found that the combination of coffee and tea was associated with a lower risk of dementia after stroke. Compared with those who did not drink coffee and tea, those who drank 0.5 to 1 cup of coffee and 2 to 3 cups of tea per day had a HR of 0.50 (95% CI, 0.31 to 0.82: P  = 0.006）。 However, no association was found between coffee and tea and Alzheimer’s disease and vascular dementia. There was no interaction between tea and coffee intake and dementia and vascular dementia (P  > 0.05）。

We also assessed the association of coffee type with stroke and dementia. Among the coffee drinkers, 160741 (44.0%), 63363 (17.3%) and 57397 (15.7%) drank instant coffee, ground coffee and decaffeinated coffee respectively. In a multiple adjusted Cox regression model, ground coffee was not associated with stroke and its subtypes compared with instant coffee (HR, 0.98; 95% CI, 0.93 ~ 1.04; P = 0.619). Compared with decaffeinated coffee, instant coffee was not associated with stroke and its subtypes (HR, 0.95; 95% CI, 0.90-1.01; P = 0.074), while ground coffee was associated with lower risk of stroke (HR, 0.90, 95% CI, 0.84-0.97; P = 0.006) and ischemic stroke (HR, 0.90, 95% CI, 0.82-1.00; P = 0.045).

For dementia, ground coffee was associated with a lower risk of dementia than instant coffee in a multi adjusted Cox regression model (HR, 0.83; 95% CI, 0.77 – 0.89; P<   0.001), Alzheimer's disease (HR, 0.77; 95% CI, 0.69 ~ 0.87; P<   0.001), vascular dementia (HR, 0.82; 95% CI, 0.70 to 0.96; P = 0.012). Compared with decaffeinated coffee, instant coffee was associated with lower dementia (HR 0.85; 95% CI, 0.79 ~ 0.92; P<   0.001), Alzheimer's disease (HR, 0.81; 95% CI, 0.72 to 0.91; P < 0.001), vascular dementia (HR, 0.84; 95% CI, 0.72 to 0.99; P = 0.036); Coffee powder was associated with a lower risk of dementia (HR, 0.74; 95% CI, 0.66 to 0.82; P < 0.001), Alzheimer's disease (HR, 0.67; 95% CI, 0.57 to 0.78; P < 0.001), and vascular dementia (HR, 0.74; 95% CI, 0.59 to 0.92; P = 0.008).

In conclusion, this large prospective cohort study found that:

(1) Tea and coffee intake alone and in combination was associated with a lower risk of stroke, ischemic stroke, dementia and vascular dementia;

(2) Participants who reported drinking 2 to 3 cups of coffee and 2 to 3 cups of tea a day had a reduced risk of stroke and dementia by about 30%;

(3) The combination of coffee and tea seemed to have a lower risk of stroke and dementia than drinking only coffee or tea, respectively;

(4) Coffee intake alone or in combination with tea is associated with a lower risk of dementia after stroke.

In conclusion, the results of this study suggest that moderate consumption of coffee and tea, either alone or in combination, is associated with a lower risk of stroke and dementia.

reference material:

Yuan Zhang， et al.Consumption of coffee and tea and risk of developing stroke, dementia, and poststroke dementia: A cohort study in the UK Biobank.

Plos Medicine | https://doi.org/10.1371/journal.pmed.1003830 November 16，2021

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