MIND diet and the risk of dementia: a population-based study

Abstract

Background Adherence to the Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND) diet has been linked to a decreased risk of dementia, but reverse causality and residual confounding by lifestyle may partly account for this link. We aimed to address these issues by studying the associations over cumulative time periods, which may provide insight into possible reverse causality, and by using both historical and more contemporary dietary data as this could give insight into confounding since historical data may be less affected by lifestyle factors. Methods In the population-based Rotterdam Study, dietary intake was assessed using validated food frequency questionnaires in 5375 participants between 1989 and 1993 (baseline I) and in a largely non-overlapping sample in 2861 participants between 2009 and 2013 (baseline II). We calculated the MIND diet score and studied its association with the risk of all-cause dementia, using Cox models. Incident all-cause dementia was recorded until 2018. Results During a mean follow-up of 15.6 years from baseline I, 1188 participants developed dementia. A higher MIND diet score at baseline I was associated with a lower risk of dementia over the first 7 years of follow-up (hazard ratio (HR) [95% confidence interval (CI)] per standard deviation (SD) increase, 0.85 [0.74, 0.98]), but associations disappeared over longer follow-up intervals. The mean follow-up from baseline II was 5.9 years during which 248 participants developed dementia. A higher MIND diet score at baseline II was associated with a lower risk of dementia over every follow-up interval, but associations slightly attenuated over time (HR [95% CI] for 7 years follow-up per SD increase, 0.76 [0.66, 0.87]). The MIND diet score at baseline II was more strongly associated with the risk of dementia than the MIND diet score at baseline I. Conclusion Better adherence to the MIND diet is associated with a decreased risk of dementia within the first years of follow-up, but this may in part be explained by reverse causality and residual confounding by lifestyle. Further research is needed to unravel to which extent the MIND diet may affect the risk of dementia.

Adherence to MIND Diet, Genetic Susceptibility, and Incident Dementia in Three US Cohorts

“…The main effects of MIND on cognitive impairment have not been observed universally [43]. In the Rotterdam Study, MIND was associated with a lower risk of all-cause dementia over the first seven years of follow-up, but associations disappeared with longer follow-up, consistent with the notion of reverse causation [44]. This does not likely explain the lack of an association between MIND and dementia in CHAP, since this cohort had a shorter follow-up than MAP and WHIMS.…”

Dementia and Diet, Methodological and Statistical Issues: A Pilot Study

“…This study ( Akbaraly et al, 2019 ) did not find that diet quality was significantly associated with subsequent risk for dementia. de Crom et al (2022) noted positive effects of the MIND diet. Munoz-Garcia et al (2020) concurred with this and in addition found no effect of the DASH diet.…”

Relationship between Nutrition, Lifestyle, and Neurodegenerative Disease: Lessons from ADH1B, CYP1A2 and MTHFR

“…Importantly, a recent study found an association between the Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND) diet and a decreased risk of dementia. In particular, the MIND diet contains recommendations regarding several foods (i.e., green leafy vegetables, whole grains, other vegetables, nuts, berries, beans, fish, poultry, olive oil, and wine) considered to be healthy for the brain, in contrast to others classified as unhealthy (red meat, butter, cheese, pastries, fast fried food, and sweets) [ 19 ]. Hence, healthy food components (i.e., polyunsaturated fatty acids, antioxidants including resveratrol, blueberry polyphenols, curcumin, sulphoraphane, and salvionic acid) as well as caloric restriction and physical activity may counteract ageing and any associated neurodegenerative diseases [ 20 ].…”