Associations between Mediterranean lifestyle and its components with cardiovascular outcomes among community-dwelling older adults

Aim: The present study examined the cross-sectional and longitudinal associations of adherence to the Mediterranean lifestyle (MEDLS) and its individual components with cardiovascular outcomes among older adults in England. Methods: Data from 565 adults aged ≥65 years participating in the English Longitudinal Study of Ageing were analyzed. MEDLS adherence (score range: 0–24) comprised six domains: Mediterranean diet adherence, physical activity, water intake, sleep, social isolation, and cooking activities. The outcomes of interest were hypertension, heart attack (myocardial infarction/coronary thrombosis), and stroke. Logistic regression models were used to examine cross-sectional and longitudinal associations, with analyses adjusted for age and sex. Results: Among 565 participants, 96 had hypertension, 14 had experienced a heart attack, and 10 had experienced a stroke at baseline; 42, 16, and 13 incident cases, respectively, were identified during follow-up. Higher MEDLS adherence was cross-sectionally associated with lower odds of hypertension (OR 0.849, 95% CI 0.722–0.999). No statistically significant longitudinal associations were observed between MEDLS and hypertension (OR 0.990, 95% CI 0.902–1.085), heart attack (OR 0.919, 95% CI 0.707–1.195), or stroke (OR 1.053, 95% CI 0.827–1.341), although the small number of events limited precision. At the component level, Mediterranean diet adherence was associated with lower odds of incident heart attack (OR 0.670, 95% CI 0.454–0.988); However, this finding was considered exploratory. Conclusion: Higher adherence to the MEDLS was associated with lower odds of prevalent hypertension but not with incident cardiovascular outcomes among communitydwelling older adults. At the component level, greater adherence to the Mediterranean diet was prospectively associated with lower odds of heart attack; however, given the absence of adjustment for multiple comparisons, this finding should be considered exploratory and requires confirmation in adequately powered studies.