Mediterranean, DASH, and MIND Dietary Patterns and Cognitive Function: The 2-Year Longitudinal Changes in an Older Spanish Cohort
Authors: Nishi Stephanie K. , Babio Nancy , Gómez-Martínez Carlos , Martínez-González Miguel Ángel , Ros Emilio , Corella Dolores , Castañer Olga , Martínez J. Alfredo , Alonso-Gómez Ángel M. , Wärnberg Julia , Vioque Jesús , Romaguera Dora , López-Miranda José , Estruch Ramon , Tinahones Francisco J. , Lapetra José , Serra-Majem J. Luís , Bueno-Cavanillas Aurora , Tur Josep A. , Martín Sánchez Vicente , Pintó Xavier , Delgado-Rodríguez Miguel , Matía-Martín Pilar , Vidal Josep , Vázquez Clotilde , Daimiel Lidia , Razquin Cristina , Coltell Oscar , Becerra-Tomás Nerea , De La Torre Fornell Rafael , Abete Itziar , Sorto-Sanchez Carolina , Barón-López Francisco Javier , Signes-Pastor Antonio José , Konieczna Jadwiga , Garcia-Rios Antonio , Casas Rosa , Gomez-Perez Ana Maria , Santos-Lozano José Manuel , García-Arellano Ana , Guillem-Saiz Patricia , Ni Jiaqi , Trinidad Soria-Florido Maria , Zulet M. Ángeles , Vaquero-Luna Jessica , Toledo Estefanía , Fitó Montserrat , Salas-Salvadó Jordi 
Published: December 2021

Background and Aims: Plant-forward dietary patterns have been associated with cardiometabolic health benefits, which, in turn, have been related to cognitive performance with inconsistent findings. The objective of this study was to examine the relationship between baseline adherence to three a priori dietary patterns (Mediterranean, DASH, and MIND diets) with 2-year changes in cognitive performance in older adults with overweight or obesity and high cardiovascular disease risk.

Methods: A prospective cohort analysis was conducted within the PREDIMED-Plus trial, involving 6,647 men and women aged 55–75 years with overweight or obesity and metabolic syndrome. Using a validated, semiquantitative 143-item food frequency questionnaire completed at baseline, the dietary pattern adherence scores were calculated. An extensive neuropsychological test battery was administered at baseline and 2-year follow-up. Multivariable-adjusted linear regression models were used to assess associations between 2-year changes in cognitive function z-scores across tertiles of baseline adherence to the a priori dietary patterns.

Results: Adherence to the Mediterranean diet at baseline was associated with 2-year changes in the general cognitive screening Mini-Mental State Examination (MMSE, β: 0.070; 95% CI: 0.014, 0.175, P-trend = 0.011), and two executive function-related assessments: the Trail Making Tests Part A (TMT-A, β: −0.054; 95% CI: −0.110, − 0.002, P-trend = 0.047) and Part B (TMT-B, β: −0.079; 95% CI: −0.134, −0.024, P-trend = 0.004). Adherence to the MIND diet was associated with the backward recall Digit Span Test assessment of working memory (DST-B, β: 0.058; 95% CI: 0.002, 0.114, P-trend = 0.045). However, higher adherence to the DASH dietary pattern was not associated with better cognitive function over a period of 2 years.

Conclusion: In older Spanish individuals with overweight or obesity and at high cardiovascular disease risk, higher baseline adherence to the Mediterranean dietary pattern may be associated with better cognitive performance than lower adherence over a period of 2 years.