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The study explored DP in 248 patients with AD. Two neurobehavioral assessments (intervals 13.4 months) and two cortical thickness measurements derived from magnetic resonance images (intervals 26.5 months) were collected as outcome measures. Reduced rank regression was used to assess the groups of DPs and a linear mixed-effect model to explore the cortical neurodegenerative patterns. At screening, underweight body mass index (BMI) was related to significant higher lipid profile, impaired cognitive function, smaller cortical thickness, lower protein DP factor loading scores and the non-spouse caregiver status. Higher mini-mental state examination (MMSE) scores were related to the DP of coffee\/tea, compared to the lipid\/sugar or protein DP group. The underweighted-BMI group had faster cortical thickness atrophy in the pregenual and lateral temporal cortex, while the correlations between cortical thickness degeneration and high HbA1C or low B12 and folate levels were localized in the medial and lateral prefrontal cortex. The predictive model suggested that factors related to MMSE score were related to the caregiver status. In conclusion, normal or overweight BMI, coffee\/tea DP group and living with a spouse were considered as protective factors for better cognitive outcomes in patients with AD. The influence of glucose, B12 and folate on the cortical degeneration was spatially distinct from the pattern of AD degeneration.<\/jats:p>","DOI":"10.3390\/nu14245300","type":"journal-article","created":{"date-parts":[[2022,12,14]],"date-time":"2022-12-14T02:54:21Z","timestamp":1670986461000},"page":"5300","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Cognitive Decline Related to Diet Pattern and Nutritional Adequacy in Alzheimer\u2019s Disease Using Surface-Based Morphometry"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9039-9788","authenticated-orcid":false,"given":"Hua-Tsen","family":"Hsiao","sequence":"first","affiliation":[{"name":"Department of Nursing, National Tainan Junior College of Nursing, Tainan 700007, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1949-3004","authenticated-orcid":false,"given":"Mi-Chia","family":"Ma","sequence":"additional","affiliation":[{"name":"Department of Statistics and Institute of Data Science, National Cheng Kung University, Tainan 701401, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2375-9813","authenticated-orcid":false,"given":"Hsin-I","family":"Chang","sequence":"additional","affiliation":[{"name":"Department of Neurology, Cognition and Aging Center, Institute for Translational Research in Biomedicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung 833401, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8042-5484","authenticated-orcid":false,"given":"Ching-Heng","family":"Lin","sequence":"additional","affiliation":[{"name":"Center for Artificial Intelligence in Medicine, Chang Gung Memorial Hospital, Taoyuan 333008, Taiwan"},{"name":"Bachelor Program in Artificial Intelligence, Chang Gung University, Taoyuan 333323, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3564-1524","authenticated-orcid":false,"given":"Shih-Wei","family":"Hsu","sequence":"additional","affiliation":[{"name":"Department of Radiology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung 833401, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6542-5315","authenticated-orcid":false,"given":"Shu-Hua","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Nuclear Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung 833401, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8677-9806","authenticated-orcid":false,"given":"Chen-Chang","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Radiology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung 833401, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2868-3961","authenticated-orcid":false,"given":"Chi-Wei","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Neurology, Cognition and Aging Center, Institute for Translational Research in Biomedicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung 833401, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4931-0128","authenticated-orcid":false,"given":"Chiung-Chih","family":"Chang","sequence":"additional","affiliation":[{"name":"Department of Neurology, Cognition and Aging Center, Institute for Translational Research in Biomedicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung 833401, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,12,13]]},"reference":[{"key":"ref_1","first-page":"145","article-title":"Pathways to neurodegeneration: Mechanistic insights from GWAS in Alzheimer\u2019s disease, Parkinson\u2019s disease, and related disorders","volume":"2","author":"Ramanan","year":"2013","journal-title":"Am. 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