Mind diet adherence and cognitive performance in the Framingham Heart Study

Authors: MELO VAN LENT, DEBORA - University Of Texas Health Science Center; O'DONNELL, ADRIENNE - Framingham Heart Study; BEISER, ALEXA - Boston University; VASAN, RAMACHANDRAN - Framingham Heart Study; DECARLI, CHARLES - University Of California, Davis; SCARMEAS, NIKOLAOS - University Of Athens; WAGNER, MICHAEL - University Of Bonn; JACQUES, PAUL - Jean Mayer Human Nutrition Research Center On Aging At Tufts University; SESHADRI, SUDHA - University Of Texas At San Antonio; HIMALI, JAYANDRA - University Of Texas At San Antonio; PASE, MATTHEW - Framingham Heart Study

Submitted to: Journal of Alzheimer's Disease
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 5/4/2021
Publication Date: 6/1/2021
Citation: Melo Van Lent, D., O'Donnell, A., Beiser, A.S., Vasan, R.S., Decarli, C.S., Scarmeas, N., Wagner, M., Jacques, P.F., Seshadri, S., Himali, J.J., Pase, M. 2021. Mind diet adherence and cognitive performance in the Framingham Heart Study. Journal of Alzheimer's Disease. 82(2):827-839. https://doi.org/10.3233/JAD-201238.
DOI: https://doi.org/10.3233/JAD-201238

Interpretive Summary: As the population ages, there is an increasing burden of dementia. Previous research has shown that a combination of two healthier dietary patterns, the Mediterranean Diet and DASH (Dietary Approaches to Stop Hypertension) diets, called the Mediterranean-Dash for Neurodegenerative Delay (MIND) dietary pattern is associated with less cognitive decline and dementia. No prior study has investigated the association between the MIND diet and measures of brain volume and silent brain infarcts (i.e., death of brain tissue resulting from a failure of blood supply which does not present as a stroke). We examined whether adherence to the MIND diet is associated with better cognitive function, larger brain volumes, and fewer silent brain infarcts (SBIs) at the start of the study, and less cognitive decline over follow-up in the Framingham Heart Study, a community-based population. Our results showed that better adherence to the MIND diet was associated with a number of better outcomes on cognitive tests at the start of the study (i.e., better global cognitive function, visual memory, processing speed, verbal comprehensive) but was not related to the subsequent cognitive decline. MIND diet adherence was also associated with larger total brain volume but not hippocampal volume or with silent brain infarcts. Thus, future research should examine the longitudinal relationship of cognitive decline and dietary intake across different populations, including those specifically at risk for dementia or AD.

Technical Abstract: Background: Adherence to the Mediterranean-DASH for Neurodegenerative Delay (MIND) diet has previously been associated with cognitive decline and dementia. To our knowledge, no prior study has investigated the association between the MIND diet and measures of brain volume, silent brain infarcts (SBIs), or brain atrophy. Objective: We evaluated whether adherence to the MIND diet associated with superior cognitive function, larger brain volumes, fewer SBIs, and less cognitive decline in the community-based Framingham Heart Study. Methods: 2,092 participants (mean +/- SD, age 61 +/- 9) completed Food Frequency Questionnaires, averaged across a maximum of 3-time points (examination cycles 5, 6, and 7), cognitive testing at examination cycle 7 (present study baseline: 1998-2001) and after a mean +/- SD of 6.6 +/- 1.1 years from baseline (n = 1,584). A subset of participants also completed brain magnetic resonance imaging (MRI) at examination cycle 7 (n = 1,904). In addition, participants with dementia, stroke, and other relevant neurological diseases such as significant head trauma, subdural hematoma, or multiple sclerosis were excluded from the analyses. Results: Higher MIND diet scores were associated with better global cognitive function (beta +/- SE,+0.03SD +/- 0.01; p = 0.004), verbal memory, visual memory, processing speed, verbal comprehension/reasoning, and with larger total brain volume (TBV) following adjustments for clinical, lifestyle and demographic covariates, but not with other brain MRI measures (i.e. hippocampal volume, lateral ventricular volume, white matter hyperintensity volume, and SBIs) or cognitive decline. Conclusion: Higher MIND diet scores associated with better cognitive performance and larger TBV at baseline, but not with cognitive decline. Clinical trials are needed to ascertain whether adopting the MIND diet affects trajectories of cognitive decline.