Objective: This study sought to determine if the MIND diet (a hybrid of the Mediterranean and Dash diets, with modifications based on the science of nutrition and the brain), is effective in preventing cognitive decline after stroke. Design: We analyzed 106 participants of a community cohort study who had completed a diet assessment and two or more annual cognitive assessments and who also had a clinical history of stroke. Cognition in five cognitive domains was assessed using structured clinical evaluations that included a battery of 19 cognitive tests. MIND diet scores were computed using a valid food frequency questionnaire (FFQ). Dietary components of the MIND diet included whole grains, leafy greens and other vegetables, berries, beans, nuts, lean meats, fish, poultry, and olive oil and reduced consumption of cheese, butter, fried foods, and sweets. MIND diet scores were modeled in tertiles. The influence of baseline MIND score on change in a global cognitive function measure and in the five cognitive domains was assessed using linear mixed models adjusted for age and other potential confounders. Results: With adjustment for age, sex, education, APOE-ε4, caloric intake, smoking, and participation in cognitive and physical activities, the top vs lowest tertiles of MIND diet scores had a slower rate of global cognitive decline (β = .08; CI = 0.0074, 0.156) over an average of 5.9 years of follow-up. Conclusions: High adherence to the MIND diet was associated with a slower rate of cognitive decline after stroke.

Background Depression is common in older adults and more prevalent in those with cognitive impairment, vascular risk factors, or stroke. Nonpharmacologic strategies to reduce depression, such as diet, may be effective; however, few studies have investigated the relation. Methods A total of 709 participants (23.3% men, mean age 80.4), from an observational prospective cohort study were assessed annually for an average of 6.53 years of follow-up. Participants with missing or invalid baseline dietary evaluations or fewer than two depression assessments were excluded. Depressive symptoms were assessed with a 10-item version of the Center for Epidemiologic Studies Depression scale. High burden of depressive symptoms was defined as the presence of four or more depressive symptoms. Diet scores were computed using a validated food frequency questionnaire for the Dietary Approaches to Stop Hypertension (DASH) diet, Mediterranean diet, Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND) diet, and Western diets. Diet scores were modeled in tertiles. A generalized estimating equation (GEE) model was performed for the longitudinal analysis of depression as a binary outcome. Results Participants in the highest tertile of the DASH (β = −0.10, confidence interval [CI]: −0.20, −0.0064) and MIND (β = −0.12, CI: −0.23, −0.0092) diet scores had lower rates of depressive symptoms over time when compared to those in the respective lowest tertiles. The Western diet was positively associated with depressive symptoms over time (β = 0.093, p-trend = .05). Conclusions Diet may be effective in reducing depressive symptoms in older adults. A diet intervention trial may be needed to determine the optimal nutritional components for prevention of late onset depression.

Background: MIND diet, a hybrid of the Mediterranean diet and the Dietary Approaches to Stop Hypertension diet, is associated with a slower cognitive decline and lower risk of Alzheimer’s disease (AD) dementia in older adults. Objective: We aim to examine whether the association of the MIND diet with cognition is independent of common brain pathologies. Methods: Utilizing data from the Rush Memory and Aging Project (MAP), a longitudinal clinical-pathologic study, we studied 569 decedents with valid dietary data, cognitive testing proximate to death, and complete autopsy data at the time of these analyses. A series of regression analyses were used to examine associations of the MIND diet, dementia-related brain pathologies, and global cognition proximate to death adjusting for age, sex, education, APOE ɛ4, late-life cognitive activities, and total energy intake. Results: A higher MIND diet score was associated with better global cognitive functioning proximate to death (β= 0.119, SE = 0.040, p = 0.003), and neither the strength nor the significance of association changed substantially when AD pathology and other brain pathologies were included in the model. The β-estimate after controlling for global AD pathology was 0.111 (SE = 0.037, p = 0.003). The MIND diet-cognition relationship remained significant when we restricted our analysis to individuals without mild cognitive impairment at the baseline (β= 0.121, SE = 0.042, p = 0.005) or in people diagnosed with postmortem diagnosis of AD based on NIA-Reagan consensus recommendations (β= 0.114, SE = 0.050, p = 0.023). Conclusion: MIND diet is associated with better cognitive functioning independently of common brain pathology, suggesting that the MIND diet may contribute to cognitive resilience in the elderly.

Objective:Diet may reduce Alzheimer’s dementia risk and slow cognitive decline, but the understanding of the relevant neuropathologic mechanisms remains limited. The association of dietary patterns with Alzheimer’s disease (AD) pathology has been suggested using neuroimaging biomarkers. This study examined the association of MIND and Mediterranean dietary patterns with beta-amyloid load, phosphorylated tau tangles, and global AD pathology in postmortem brain tissue of older adults.Methods:Autopsied participants of the Rush Memory and Aging Project) with complete dietary information (collected through a validated food frequency questionnaire) and AD pathology data (beta-amyloid load, phosphorylated tau tangles, and global AD pathology [summarized neurofibrillary tangles, neuritic and diffuse plaques]) were included in this study. Linear regression models controlled for age at death, sex, education, APO-ε4 status, and total calories were used to investigate the dietary patterns (MIND and Mediterranean diet) and dietary components associated with AD pathology. Further effect modification was tested for APO-ε4 status and sex.Results:Among our study participants (N=581, age at death: 91.0 ± 6.3 years; mean age at first dietary assessment: 84.2 ±5.8; 73% female; 6.8 ± 3.9 years of follow-up) dietary patterns were associated with lower global AD pathology (MIND: β= -0.022, p=0.034, standardized β=-2.0; Mediterranean: β=-0.007, p=0.039, standardized β=-2.3) and specifically less beta-amyloid load (MIND: β=-0.068, p=0.050, standardized β=-2.0; Mediterranean: β=-0.040, p=0.004, standardized β=-2.9). The findings persisted when further adjusted for physical activity, smoking, and vascular disease burden. The associations were also retained when participants with mild cognitive impairment or dementia at the baseline dietary assessment were excluded. Those in the highest tertile of green leafy vegetables intake had less global AD pathology when compared to those in the lowest tertile (Tertile-3 vs. Tertile-1: β= -0.115, p=0.0038).Conclusion:The MIND and Mediterranean diets are associated with less postmortem AD pathology, primarily beta-amyloid load. Among dietary components, green leafy vegetables inversely correlate with AD pathology.

URL: http://www.clinicaltrials.gov. Unique identifier: NCT01994720.