Association of the Mediterranean Dietary Approaches to Stop Hypertension Intervention for Neurodegenerative Delay (MIND) Diet With the Risk of Dementia

Abstract

ImportanceDementia threatens the well-being of older adults, making efforts toward prevention of great importance.ObjectiveTo evaluate the association of the Mediterranean–Dietary Approaches to Stop Hypertension (DASH) Intervention for Neurodegenerative Delay (MIND) diet with the risk of dementia in 3 prospective studies and a meta-analysis.Design, Setting, and ParticipantsCohort analyses included the Whitehall II study (WII), the Health and Retirement Study (HRS), and the Framingham Heart Study Offspring cohort (FOS), and the meta-analysis included 11 cohort studies. Participants were middle-aged and older women and men from WII in 2002 to 2004, HRS in 2013, and FOS in 1998 to 2001 without dementia at the study baseline. Data were analyzed from May 25 to September 1, 2022.ExposuresMIND diet score was measured using food frequency questionnaires, and scores ranged from 0 to 15, with a higher score indicating higher adherence to the MIND diet.Main Outcome and MeasuresIncident all-cause dementia, with cohort-specific definitions.ResultsIncluded in this study were 8358 participants (mean [SD] age, 62.2 [6.0] years; 5777 male [69.1%]) from WII, 6758 participants (mean [SD] age, 66.5 [10.4] years; 3965 female [58.7%]) from HRS, and 3020 participants (mean [SD] age, 64.2 [9.1] years; 1648 female [54.6%]) from FOS. The mean (SD) baseline MIND diet score was 8.3 (1.4) in WII, 7.1 (1.9) in HRS, and 8.1 (1.6) in FOS. Over 166 516 person-years, a total of 775 participants (220 in WII, 338 in HRS, and 217 in FOS) developed incident dementia. In the multivariable-adjusted Cox proportional hazard model, higher MIND diet score was associated with lower risk of dementia (pooled hazard ratio [HR] for every 3-point increment, 0.83; 95% CI, 0.72-0.95; P for trend = .01; I2 = 0%). The associations were consistently observed in subgroups defined by sex, age, smoking status, and body mass index. In the meta-analysis of 11 cohort studies with 224 049 participants (5279 incident dementia cases), the highest tertile of MIND diet score was associated with lower risk of dementia compared with the lowest tertile (pooled HR, 0.83; 95% CI, 0.76-0.90; I2 = 35%).Conclusions and RelevanceResults suggest that adherence to the MIND diet was associated with lower risk of incident dementia in middle-aged and older adults. Further studies are warranted to develop and refine the specific MIND diet for different populations.

Associations of the Mediterranean‐DASH Intervention for Neurodegenerative Delay diet with brain structural markers and their changes

“…The MIND diet has been linked to slower cognitive decline 16 and lower risks of all‐cause dementia 17 and Parkinson's disease, 18 but only several cross‐sectional studies have assessed its associations with brain structural markers. In 1302 participants of the Women's Health Initiative Memory Study, adherence to a MIND‐like diet was associated with higher total and temporal lobe white matter volumes 20 .…”

“…Previous studies have shown beneficial associations of the MIND diet with cognitive function and its decline, 16 all-cause dementia, 17 and Parkinson's disease, 18 which often feature structural brain changes at early stages. 19 However, associations of the MIND diet with brain structural markers remain unclear and inconsistent, and elucidating these relationships is crucial for understanding the mechanisms linking this dietary pattern to brain aging.…”

Current and Future Treatments of Vascular Cognitive Impairment

“…136 A recent meta-analysis of cohort studies showed that adherence to the MIND diet (ie, Mediterranean and dietary approaches to stop hypertension diets) in middle-aged and older adults was associated with a lower risk of incident dementia (hazard ratio, 0.83). 72 However, a recent RCT showed that the MIND diet failed to show changes in cognitive and brain MRI (WMH, hippocampal volumes, and total gray-and white-matter volumes) outcomes over 3 years among at-risk cognitively unimpaired older adults (ie, family history of AD, overweight, suboptimal diets). 137 The short duration of this trial and caloric restriction in the control group might explain the lack of difference between the randomized arms in this study.…”

Dementia Prevention and Treatment

“…Observational studies support the protective effect of a Mediterranean diet, the DASH (Dietary Approaches to Stop Hypertension) diet, and a hybrid of the 2 called the MIND diet . However, a recent clinical trial comparing 3 years of a MIND diet with a control diet with mild caloric restriction did not demonstrate differences in global cognition or magnetic resonance imaging (MRI) findings of dementia .…”