TABLE 5.
Characteristics of the included observational human studies on the MIND diet in relation to cognitive decline, dementia, and AD1
| Authors, year, study name | Study design | Population | Follow-up (y) | Exposure | Outcome | Results | Covariates |
|---|---|---|---|---|---|---|---|
| McEvoy, Guyer, Langa & Yaffe (2017) (57), US Health and Retirement Study | Cross-sectional | n = 5907 (40% men) age: 67.8 y community dwelling adults from the age of 50 y | — | 163-item SFFQ, A-MeDi score, MIND diet score | Cognitive performance (global cognition score based on immediate and delayed recall, backward counting and serial seven subtraction) | Higher MIND score tertile was significantly associated with better cognitive performance (P-trend < 0.001). Higher tertile of MIND score was significantly associated with lower risk of poor cognitive performance (ORT3vs.T1: 0.70; 95% CI: 0.56, 0.86; P = 0.001) | Sex, age, race, low education attainment, current smoking, obesity, total wealth, hypertension, diabetes mellitus, physical inactivity, depression, and total energy intake |
| Hosking, Eramudugolla, Cherbuin, & Anstey (2019) (75), Australia PATH Through Life Study | Longitudinal | n = 1220 (50% men) age: 60–64 y older Australian adults | 12 | CSIRO-FFQ, MeDi, A-MeDi, and MIND scores, dietary components | Cognitive impairment: MCI/dementia (Winbald criteria, NINCDS-ADRDA criteria) | Higher tertile of MIND score was significantly associated with a lower risk of cognitive impairment (ORT3vs.T1: 0.47; 95% CI: 0.24, 0.91; P-trend = 0.026) | Energy intake, age, sex, APOE ε4 allele, education, mental activity, physical activity, smoking status, depression, diabetes, BMI, hypertension, heart disease, and stroke |
| Berendsen et al. (2018) (73), US Nurses’ Health Study | Longitudinal | n = 16,058 (0% men) age: 74.3 y older women | 12.9 | 116-item FFQ, MIND score | Global cognition (TICS and composite score of TICS, EBMT, CF, and DST backward) and verbal memory (immediate and delayed recalls of EBMT and TICS 10-word list) | Higher adherence to MIND diet was not significantly associated with less decline in global cognition (P-trend = 0.95), verbal memory (P-trend = 0.98), or TICS score (P-trend = 0.73) during follow-up | Age, education, physical activity, caloric intake, alcohol intake, smoking status, multivitamin use, BMI, depression, and history of hypertension, hypercholesterolemia, myocardial infarction, and diabetes mellitus |
| Shakersain et al. (2018) (79), Sweden SNAC-K | Longitudinal | n = 2223 (39% men) age: 69.5 y community residents from Kungsholmen ≥60 y | 6 | 98-item SFFQ, A-MeDi, A-DASH, and MIND scores, dietary components | Global cognition (MMSE) | Higher MIND score was significantly associated with less cognitive decline (β: 0.006; 95% CI: 0.003, 0.009; P < 0.001; βT3vs.T1: 0.126; 95% CI: 0.064, 0.188; P < 0.001) and with lower risk of MMSE score ≤24 (HR: 0.965; 95% CI: 0.941, 0.989; P = 0.005; HRT3vs.T1: 0.468; 95% CI: 0.261, 0.840; P = 0.011) | Total caloric intake, age, sex, education, civil status, physical activity, smoking, BMI, vitamin/mineral supplement intake, vascular disorders, diabetes, cancer, depression APOE ε4, and dietary components other than those included in each dietary index |
| Morris et al. (2015) (53), US Rush MAP | Longitudinal | n = 923 (± 24% men) age: 58–98 y people living in retirement communities or senior public housing units in Chicago | 4.5 | 144-item SFFQ, A-MeDi, A-DASH, and MIND scores | AD (based on NINCDS-ADRDA criteria) | Both middle and high tertile of MIND diet score were significantly associated with lower risk of AD (HRT2vs.T1: 0.65; 95% CI: 0.44, 0.98; HRT3vs.T1: 0.47, 95% CI: 0.29, 0.76; P-trend = 0.002) | Age, sex, education, APOE ε4, participation in cognitively stimulating activities, physical activity, total energy intake, and cardiovascular conditions |
| Morris et al. (2015) (11), US Rush MAP | Longitudinal | n = 960 (25% men) age: 81.4 y elderly living in retirement communities or senior public housing units in Chicago | 4.7 | 144-item SFFQ, MIND diet score | Global cognition, episodic memory, semantic memory, visuospatial ability, perceptual speed and working memory | MIND diet score was significantly associated with slower decline in global cognition (β: 0.0106; P < 0.0001), episodic memory (β: 0.0090; P = 0.001), semantic memory (β: 0.0113; P < 0.0001), visuospatial ability (β: 0.0077; P = 0.002), perceptual speed (β: 0.0097; P < 0.0001), and working memory (β = 0.0060; P = 0.01). Higher tertile of MIND diet score was significantly associated with slower decline of global cognitive score (βT3vs.T1: 0.0366; P = 0.01). MIND diet score was more protective against cognitive decline than the DASH score or MeDi score according to the standardized β coefficients (βMIND: 4.39, βMeDi: 2.46, βDASH: 2.60; PMIND vs. MeDi = 0.02; PMIND vs. DASH = 0.03) | Age, sex, education, participation in cognitive activities, smoking history, physical activity hours per week, total energy intake, (APOE ε4 allele, time, history of stroke, myocardial infarction, diabetes, hypertension, and interaction terms between each covariate and time) |
1
AD, Alzheimer's disease; A-MeDi, alternate Mediterranean diet; CF, category fluency; CSIRO, Commonwealth Scientific and Industrial Research Organisation; DASH, Dietary Approaches to Stop Hypertension; DST, digit span test; EBMT, East Boston Memory Test; MAP, Memory and Aging Project; MIND, Mediterranean-DASH Intervention for Neurodegenerative Delay; MMSE, Mini-Mental State Examination; NINCDS-ADRDA, National Institute of Neurological and Communicative Disorders and Stroke-Alzheimer's Disease and Related Disorders Association; PATH, Personality and Total Health; SFFQ, semi-quantitative FFQ; SNAC-K, Swedish National Study on Aging and Care in Kungsholmen; TICS, Telephone Interview For Cognitive Status.