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Association of Adherence to a MIND-Style Diet With the Risk of Cognitive Impairment and Decline in the REGARDS Cohort.
Neurology. 2024 Oct 22; 103(8):e209817.Neur

Abstract

BACKGROUND AND OBJECTIVES

Diet may influence the development of cognitive impairment and affect cognitive decline, but whether this relationship varies between Black American and White American people is unclear. This study examined the association of Mediterranean-Dietary Approaches to Stop Hypertension Intervention for Neurodegenerative Delay (MIND) and incident cognitive impairment and cognitive trajectories in a biracial prospective cohort study.

METHODS

Using data derived from the Food Frequency Questionnaire in the REasons for Geographic and Racial Differences in Stroke study, we compared MIND diet adherence with incident cognitive impairment and cognitive trajectory in Black participants and White participants. Logistic regression was used to model MIND diet score (continuous variable and using tertiles) and incident cognitive impairment after adjusting for age, sex, race, region, education, income, total energy, hypertension history, dyslipidemia, diabetes, estimated glomerular filtration rate, ischemic heart conditions, atrial fibrillation, and lifestyle factors including sedentary, obesity, and smoking. Mixed-effects models were used to examine the association between cognitive trajectory and MIND diet adherence.

RESULTS

Dietary data to calculate the MIND diet score and cognitive data were available on 14,145 participants with a mean age of 64 years (SD 9.0 years) that was 56.7% female. Greater MIND diet adherence was associated with a decreased incidence of cognitive impairment (odds ratio [OR] 0.96, 95% CI 0.93-0.99, p = 0.02) after adjusting for all covariates. In the fully adjusted model, greater MIND diet adherence was associated with decreased risk of cognitive impairment in female participants (OR 0.92, 95% CI 0.89-0.96, p < 0.001) but not in male participants (OR 1.01, 95% CI 0.97-1.06, p = 0.64). In all models, greater MIND diet adherence was associated with decreased risk of cognitive decline. MIND diet adherence was a better predictor of cognitive decline in Black participants (β = 0.04, SE = 0.007, p < 0.001) than in White participants (β = 0.03, SE = 0.004, p < 0.001).

DISCUSSION

Greater MIND diet adherence was associated with decreased risk of cognitive impairment in female participants but not male participants, with no difference between Black participants and White participants. However, MIND diet adherence was a better predictor of cognitive trajectory in Black participants than in White participants.

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Authors+Show Affiliations

Sawyer RP
From the Department of Neurology and Rehabilitation Medicine (R.P.S., R.S.), University of Cincinnati College of Medicine, OH; Biostatistics Department (J.B., S.E.J.), School of Public Health, University of Alabama at Birmingham; Taub Institute for Research on Alzheimer's Disease and the Aging Brain (J.J.M.), G.H. Sergievsky Center (J.J.M.), and Department of Neurology (J.J.M.), Vagelos College of Physicians and Surgeons, Columbia University, New York Presbyterian Hospital, New York.
Blair J
From the Department of Neurology and Rehabilitation Medicine (R.P.S., R.S.), University of Cincinnati College of Medicine, OH; Biostatistics Department (J.B., S.E.J.), School of Public Health, University of Alabama at Birmingham; Taub Institute for Research on Alzheimer's Disease and the Aging Brain (J.J.M.), G.H. Sergievsky Center (J.J.M.), and Department of Neurology (J.J.M.), Vagelos College of Physicians and Surgeons, Columbia University, New York Presbyterian Hospital, New York.
Shatz R
From the Department of Neurology and Rehabilitation Medicine (R.P.S., R.S.), University of Cincinnati College of Medicine, OH; Biostatistics Department (J.B., S.E.J.), School of Public Health, University of Alabama at Birmingham; Taub Institute for Research on Alzheimer's Disease and the Aging Brain (J.J.M.), G.H. Sergievsky Center (J.J.M.), and Department of Neurology (J.J.M.), Vagelos College of Physicians and Surgeons, Columbia University, New York Presbyterian Hospital, New York.
Manly JJ
From the Department of Neurology and Rehabilitation Medicine (R.P.S., R.S.), University of Cincinnati College of Medicine, OH; Biostatistics Department (J.B., S.E.J.), School of Public Health, University of Alabama at Birmingham; Taub Institute for Research on Alzheimer's Disease and the Aging Brain (J.J.M.), G.H. Sergievsky Center (J.J.M.), and Department of Neurology (J.J.M.), Vagelos College of Physicians and Surgeons, Columbia University, New York Presbyterian Hospital, New York.
Judd SE
From the Department of Neurology and Rehabilitation Medicine (R.P.S., R.S.), University of Cincinnati College of Medicine, OH; Biostatistics Department (J.B., S.E.J.), School of Public Health, University of Alabama at Birmingham; Taub Institute for Research on Alzheimer's Disease and the Aging Brain (J.J.M.), G.H. Sergievsky Center (J.J.M.), and Department of Neurology (J.J.M.), Vagelos College of Physicians and Surgeons, Columbia University, New York Presbyterian Hospital, New York.

MeSH

AgedFemaleHumansMaleMiddle AgedBlack or African AmericanCognition DisordersCognitive DysfunctionCohort StudiesDiet, MediterraneanDietary Approaches To Stop HypertensionIncidencePatient ComplianceProspective StudiesRisk FactorsWhite

Pub Type(s)

Journal Article

Language

eng

PubMed ID

39292985

Citation

Sawyer, Russell P., et al. "Association of Adherence to a MIND-Style Diet With the Risk of Cognitive Impairment and Decline in the REGARDS Cohort." Neurology, vol. 103, no. 8, 2024, pp. e209817.
Sawyer RP, Blair J, Shatz R, et al. Association of Adherence to a MIND-Style Diet With the Risk of Cognitive Impairment and Decline in the REGARDS Cohort. Neurology. 2024;103(8):e209817.
Sawyer, R. P., Blair, J., Shatz, R., Manly, J. J., & Judd, S. E. (2024). Association of Adherence to a MIND-Style Diet With the Risk of Cognitive Impairment and Decline in the REGARDS Cohort. Neurology, 103(8), e209817. https://doi.org/10.1212/WNL.0000000000209817
Sawyer RP, et al. Association of Adherence to a MIND-Style Diet With the Risk of Cognitive Impairment and Decline in the REGARDS Cohort. Neurology. 2024 Oct 22;103(8):e209817. PubMed PMID: 39292985.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Association of Adherence to a MIND-Style Diet With the Risk of Cognitive Impairment and Decline in the REGARDS Cohort. AU - Sawyer,Russell P, AU - Blair,Jessica, AU - Shatz,Rhonna, AU - Manly,Jennifer J, AU - Judd,Suzanne E, Y1 - 2024/09/18/ PY - 2024/9/18/medline PY - 2024/9/18/pubmed PY - 2024/9/18/entrez PY - 2025/10/22/pmc-release SP - e209817 EP - e209817 JF - Neurology JO - Neurology VL - 103 IS - 8 N2 - BACKGROUND AND OBJECTIVES: Diet may influence the development of cognitive impairment and affect cognitive decline, but whether this relationship varies between Black American and White American people is unclear. This study examined the association of Mediterranean-Dietary Approaches to Stop Hypertension Intervention for Neurodegenerative Delay (MIND) and incident cognitive impairment and cognitive trajectories in a biracial prospective cohort study. METHODS: Using data derived from the Food Frequency Questionnaire in the REasons for Geographic and Racial Differences in Stroke study, we compared MIND diet adherence with incident cognitive impairment and cognitive trajectory in Black participants and White participants. Logistic regression was used to model MIND diet score (continuous variable and using tertiles) and incident cognitive impairment after adjusting for age, sex, race, region, education, income, total energy, hypertension history, dyslipidemia, diabetes, estimated glomerular filtration rate, ischemic heart conditions, atrial fibrillation, and lifestyle factors including sedentary, obesity, and smoking. Mixed-effects models were used to examine the association between cognitive trajectory and MIND diet adherence. RESULTS: Dietary data to calculate the MIND diet score and cognitive data were available on 14,145 participants with a mean age of 64 years (SD 9.0 years) that was 56.7% female. Greater MIND diet adherence was associated with a decreased incidence of cognitive impairment (odds ratio [OR] 0.96, 95% CI 0.93-0.99, p = 0.02) after adjusting for all covariates. In the fully adjusted model, greater MIND diet adherence was associated with decreased risk of cognitive impairment in female participants (OR 0.92, 95% CI 0.89-0.96, p < 0.001) but not in male participants (OR 1.01, 95% CI 0.97-1.06, p = 0.64). In all models, greater MIND diet adherence was associated with decreased risk of cognitive decline. MIND diet adherence was a better predictor of cognitive decline in Black participants (β = 0.04, SE = 0.007, p < 0.001) than in White participants (β = 0.03, SE = 0.004, p < 0.001). DISCUSSION: Greater MIND diet adherence was associated with decreased risk of cognitive impairment in female participants but not male participants, with no difference between Black participants and White participants. However, MIND diet adherence was a better predictor of cognitive trajectory in Black participants than in White participants. SN - 1526-632X UR - https://www.unboundmedicine.com/medline/citation/39292985/full_citation DB - PRIME DP - Unbound Medicine ER -
Grapherence [↓15 ↑50]

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