Summary:
This prospective cohort study examined whether long-term consumption of caffeinated coffee, decaffeinated coffee, and tea is associated with dementia risk or impacts cognitive health. The analysis included 131,821 adults from two large US cohorts, followed for up to 43 years, during which 11,033 cases of dementia were identified. Participants were free of dementia, cancer, and Parkinson disease at baseline, and dietary intake was assessed using validated questionnaires. The results found that higher intake of caffeinated coffee was associated with a lower risk of dementia and more favourable cognitive outcomes. Individuals with the highest intake had fewer dementia cases compared with those with the lowest intake, even after adjusting for potential confounding factors. Higher caffeinated coffee consumption was also linked to a lower likelihood of self-reported cognitive decline and slightly better performance on objective cognitive tests, although not all measures reached statistical significance. Tea consumption showed similar patterns, with higher intake associated with reduced dementia risk and improved cognitive outcomes. In contrast, decaffeinated coffee was not associated with dementia risk or cognitive performance, suggesting that the caffeine itself and its related compounds are responsible for the observed effects. Overall, this study suggests that intake of caffeinated beverages may be linked to a reduced risk of dementia and improvements in cognitive function over time.
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 = 86 606 with data from 1980-2023) and male participants from the Health Professionals Follow-up Study (HPFS; n = 45 215 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 131 821 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 11 033 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 100 000 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.
Article Publication Date: 09/02/2026
DOI: 10.1001/jama.2025.27259
