Association between inflammatory diet and cognitive function with the moderating role of workforce participation in older adults: findings from NHANES 2011-2014
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Background This study aimed to investigate the association between inflammatory diets and cognitive function in older adults and examine whether workforce participation moderates this relationship. Methods Using data from the National Health and Nutrition Examination Survey (NHANES 2011–2014), we analyzed 2,327 participants aged ≥ 60 years. The Dietary Inflammatory Index (DII) was calculated from 28 dietary components, and cognitive function was assessed using the CERAD Word Learning subtest, Animal Fluency Test (AFT), and Digit Symbol Substitution Test (DSST). Workforce participation was measured by work status (working/not working) and weekly working hours. Generalized linear regression models evaluated associations, while moderation effects were tested using bootstrap resampling. Covariates included demographics, health behaviors, and clinical conditions. Results Pro-inflammatory diets (DII ≥ 0) were negatively associated with composite cognitive z-scores (β = -0.16, 95% CI: -0.28, -0.04), immediate recall (β = -0.18, 95% CI: -0.31, -0.05), AFT (β = -0.20, 95% CI: -0.39, -0.02), and DSST (β = -0.15, 95% CI: -0.30, 0.00). Workforce participation attenuated these associations: working status reduced the negative effects of DII on composite scores (β = -0.03, 95% CI: -0.06, -0.00) and AFT (β = -0.04, 95% CI: -0.06, -0.01). Working > 40 hours/week showed the strongest protective moderation (composite score: β = 0.25, 95% CI: 0.09, 0.41). Nonlinear dose-response relationships were observed for all cognitive domains except delayed recall. Conclusions Pro-inflammatory diets are linked to poorer cognitive performance in older adults, but workforce participation mitigates this risk, potentially through socioeconomic empowerment and cognitive stimulation. Public health strategies should integrate workplace policies and dietary interventions to promote cognitive longevity in aging populations.
