近日，美国哈佛大学Dong D. Wang团队研究了咖啡和茶的摄入量与痴呆风险和认知功能的相关性。相关论文于2026年2月10日发表在《美国医学会杂志》上。

咖啡和茶与认知健康关系的证据仍不明确，且大多数研究未能区分含咖啡因咖啡与脱咖啡因咖啡。

为了探究咖啡和茶的摄入量与痴呆风险及认知功能的关系，研究组进行了一项前瞻性队列研究，研究对象为美国的女性护士健康研究（NHS；纳入了1980年至2023年期间有数据的86606名女性参与者）和男性健康专业人员随访研究（HPFS；纳入了1986年至2023年期间有数据的45215名男性参与者）中，在进入研究（基线）时未患癌症、帕金森病或痴呆的参与者。主要暴露因素是含咖啡因咖啡、脱咖啡因咖啡和茶的摄入量。膳食摄入数据每2至4年通过经过验证的食物频率问卷收集一次。

主要结局是痴呆，通过死亡记录和医生诊断来确定。次要结局包括：通过基于问卷的评分（范围0-7分；分数越高表示自认下降越严重；病例定义为得分≥3分者）评估的主观认知衰退，以及仅在NHS队列中通过电话神经心理学测试评估的客观认知功能，例如电话认知状态访谈（TICS）得分（范围0-41分）和总体认知测量指标（所有6项认知测试标准化后的平均z分数）。

在长达43年的随访期间（中位数36.8年；四分位距28-42年），131821名参与者（NHS队列基线平均年龄46.2 [标准差7.2] 岁；HPFS队列基线平均年龄53.8 [标准差9.7] 岁；女性占65.7%）中，共发生11033例新发痴呆。在调整潜在混杂因素并合并队列结果后，较高的含咖啡因咖啡摄入量与较低的痴呆风险显著相关（比较摄入量第四[最高]四分位数与第一[最低]四分位数，每10万人-年发病例数分别为141例 vs 330例；风险比为0.82 [95% 置信区间, 0.76 至 0.89]），并且与较低的主观认知衰退患病率相关（分别为7.8% vs 9.5%；患病率比为0.85 [95% 置信区间, 0.78 至 0.93]）。

在NHS队列中，较高的含咖啡因咖啡摄入量还与较好的客观认知表现相关。与摄入量最低四分位数的参与者相比，摄入量最高四分位数的参与者平均TICS得分更高（平均差为0.11 [95% 置信区间, 0.01 至 0.21]），平均总体认知得分也更高（平均差为0.02 [95% 置信区间, −0.01 至 0.04]）；然而，与总体认知得分的关联在统计学上不显著（P = .06）。较高的茶摄入量与这些认知结局显示出相似的关联，而脱咖啡因咖啡摄入量与较低的痴呆风险或较好的认知表现无关。剂量反应分析显示，含咖啡因咖啡和茶的摄入水平与痴呆风险及主观认知衰退之间存在非线性负相关。观察到的最显著的关联差异出现在每天摄入约2-3杯含咖啡因咖啡或每天摄入1-2杯茶的情况下。

研究结果表明，多饮用含咖啡因的咖啡和茶与较低的痴呆风险和略微更好的认知功能相关，其中在中等摄入量水平时关联最为显著。

附：英文原文

Title: Coffee and Tea Intake, Dementia Risk, and Cognitive Function

Author: Yu Zhang, Yuxi Liu, Yanping Li, Yuhan Li, Xiao Gu, Jae H. Kang, A. Heather Eliassen, Molin Wang, Eric B. Rimm, Walter C. Willett, Frank B. Hu, Meir J. Stampfer, Dong D. Wang

Issue&Volume: 2026-02-10

Abstract:

Importance  Evidence linking coffee and tea to cognitive health remains inconclusive, and most studies fail to differentiate caffeinated from decaffeinated coffee.

Objective  To investigate associations of coffee and tea intake with dementia risk and cognitive function.

Design, Setting, and Participants  Prospective cohort study that included female participants from the Nurses’ Health Study (NHS; n=86606 with data from 1980-2023) and male participants from the Health Professionals Follow-up Study (HPFS; n=45215 with data from 1986-2023) who did not have cancer, Parkinson disease, or dementia at study entry (baseline) in the US.

Exposures  The primary exposures were intakes of caffeinated coffee, decaffeinated coffee, and tea. Dietary intake was collected every 2 to 4 years using validated food frequency questionnaires.

Main Outcomes and Measures  The primary outcome was dementia, which was identified via death records and physician diagnoses. The secondary outcomes included subjective cognitive decline assessed by a questionnaire-based score (range, 0-7; higher scores indicate greater perceived decline; cases defined as those with a score ≥3) and objective cognitive function assessed only in the NHS cohort using telephone-based neuropsychological tests such as the Telephone Interview for Cognitive Status (TICS) score (range, 0-41) and a measure of global cognition (a standardized mean z score for all 6 administered cognitive tests).

Results  Among 131821 participants (mean age at baseline, 46.2 [SD, 7.2] years in the NHS cohort and 53.8 [SD, 9.7] years in the HPFS cohort; 65.7% were female) during up to 43 years of follow-up (median, 36.8 years; IQR, 28-42 years), there were 11033 cases of incident dementia. After adjusting for potential confounders and pooling results across cohorts, higher caffeinated coffee intake was significantly associated with lower dementia risk (141 vs 330 cases per 100000 person-years comparing the fourth [highest] quartile of consumption with the first [lowest] quartile; hazard ratio, 0.82 [95% CI, 0.76 to 0.89]) and lower prevalence of subjective cognitive decline (7.8% vs 9.5%, respectively; prevalence ratio, 0.85 [95% CI, 0.78 to 0.93]). In the NHS cohort, higher caffeinated coffee intake was also associated with better objective cognitive performance. Compared with participants in the lowest quartile, those in the highest quartile had a higher mean TICS score (mean difference, 0.11 [95% CI, 0.01 to 0.21]) and a higher mean global cognition score (mean difference, 0.02 [95% CI, 0.01 to 0.04]); however, the association with global cognition was not statistically significant (P=.06). Higher intake of tea showed similar associations with these cognitive outcomes, whereas decaffeinated coffee intake was not associated with lower dementia risk or better cognitive performance. A dose-response analysis showed nonlinear inverse associations of caffeinated coffee and tea intake levels with dementia risk and subjective cognitive decline. The most pronounced associated differences were observed with intake of approximately 2 to 3 cups per day of caffeinated coffee or 1 to 2 cups per day of tea.

Conclusions and Relevance  Greater consumption of caffeinated coffee and tea was associated with lower risk of dementia and modestly better cognitive function, with the most pronounced association at moderate intake levels.

DOI: 10.1001/jama.2025.27259

Source: https://jamanetwork.com/journals/jama/fullarticle/2844764