In a prospective cohort study involving more than 130 000 US adults followed for up to 43 years, higher intake of caffeinated coffee and tea was associated with lower risk of developing dementia and modestly better cognitive performance, as measured by both subjective and objective tests.

The inverse association was most pronounced at moderate intake, approximately 2 to 3 cups per day of caffeinated coffee or 1 to 2 cups per day of tea, while decaffeinated coffee intake showed no significant relationship to dementia risk or cognitive outcomes.

Question Is long-term intake of caffeinated and decaffeinated coffee associated with risk of dementia and cognitive outcomes?

Findings In this prospective cohort study of 131 821 individuals from 2 cohorts with up to 43 years of follow-up, 11 033 dementia cases were documented. Higher caffeinated coffee intake was significantly associated with lower risk of dementia. Decaffeinated coffee intake was not significantly associated with dementia risk.

Meaning Higher caffeinated coffee intake was associated with more favorable cognitive outcomes.