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Original Research | Open Access

Clinical association of habitual breakfast skipping with cognitive decline and neurodegeneration among older adults

Jun Zhanga, Ya-Jun Lia, Shu Yangb, Bing-Hu Lib, Duo-Zi Wangb, Lei Liuc, Jian-Hong Wangb( )
Department of Neurology, Chengdu Xindu District People’s Hospital, Chengdu 610599, Sichuan, China
Department of Neurology, Sichuan Provincial People’s Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu 610072, Sichuan, China
Department of Neurology, Clinical Medical College and The First Affiliated Hospital of Chengdu Medical College, Chengdu 610500, Sichuan, China
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Abstract

Background

Unhealthy lifestyles have a considerable impact on the incidence of dementia. Skipping breakfast disturbs energy homeostasis and impairs brain function. In this study, we investigated the association between breakfast skipping and cognitive performance among community-dwelling adults.

Methods

We recruited 859 community-dwelling adults aged ≥60 years from January 1 to December 31, 2021. Participants’ sociodemographic information and breakfast skipping habits were self-reported. Participants were followed up for 36 months and cognitive function was assessed using the Mini-Mental State Examination (MMSE) with an interval of 18 months. Trajectories of cognitive change were compared between individuals with and without breakfast skipping. To reduce the risk of bias owing to unmatched sample sizes between the groups, we conducted 1:1 propensity score matching (PSM) based on age, sex, education level, and ApoE genotype.

Results

At baseline and 18-month follow-up, no difference was found in MMSE scores between participants with and without breakfast skipping. However, those who habitually skipped breakfast had significantly lower MMSE scores than those who did not at 36-month follow-up. Individuals with habitual breakfast skipping had a steeper rate of cognitive decline than those without habitual breakfast skipping during follow-up. Breakfast skipping was a risk factor for longitudinal cognitive decline, defined as a decrease in MMSE scores of ≥3, adjusted for age, sex, education, body mass index, ApoE ε4 carrier status, hypertension, diabetes, and hyperlipidemia. At the last follow-up, participants who habitually skipped breakfast had significantly higher levels of ptau181 and NfL than those who did not. In the PSM cohort, similar findings were obtained regarding cognitive trajectories and plasma biomarkers.

Conclusion

Breakfast skipping was linked to an increased risk of long-term cognitive decline and neurodegeneration among older adults. The link between unhealthy dietary habits and cognitive decline may be attributed to a deficiency in neurorestoration resulting from inadequate energy consumption.

Keywords

Cognitive declineLifestyleBreakfast skippingNeurorestorationOlder adults

Electronic Supplementary Material

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jnrt-13-2-100173_ESM.docx (14.8 KB)

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Journal of Neurorestoratology
Volume 13 Issue 2,
April 2025
DOI: 10.1016/j.jnrt.2024.100173
Cite this article:
Zhang J, Li Y-J, Yang S, et al. Clinical association of habitual breakfast skipping with cognitive decline and neurodegeneration among older adults. Journal of Neurorestoratology, 2025, 13(2). https://doi.org/10.1016/j.jnrt.2024.100173

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Received: 16 June 2024
Revised: 02 September 2024
Accepted: 10 September 2024
Published: 01 April 2025
© 2024 The Authors.

This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).
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