Trial of the MIND Diet for Prevention of Cognitive Decline in Older Persons

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Journal Article 2 Mentions

Lisa L. Barnes•2023

Klodian DhanaXiaoran Liu

Top 5% · 95th percentile

321 citations · Public Health, Environmental and Occupational Health

Open Access

TLDR

Eating a special diet rich in certain healthy foods did not help older adults keep their minds sharper over three years compared to just eating fewer calories.

Summary

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1 Study Aim

The main goal of this study was to find out if following the MIND diet (Mediterranean-DASH Intervention for Neurodegenerative Delay), which combines elements of the Mediterranean and DASH (Dietary Approaches to Stop Hypertension) diets and emphasizes foods linked to brain health, could prevent or slow down cognitive decline in older adults who are at higher risk for dementia due to family history, being overweight, and having a less healthy diet. Simply put: The study wanted to see if a special healthy diet could help older people keep their minds sharp.

2 Study Design

This research was a three-year, randomized, controlled trial at two sites in the United States. It included 604 adults aged 65 or older who had no cognitive problems but were overweight, had a family history of dementia, and ate a suboptimal diet. Participants were randomly assigned to either the MIND diet with mild calorie restriction or a control diet with the same calorie restriction. Both groups received regular counseling and support for weight loss. Cognitive function was measured using a set of 12 tests, and some participants also had brain MRI scans to check for changes in brain structure. Simply put: The study compared two groups of older adults—one eating a special diet, the other just eating fewer calories—to see if their thinking or brains changed over three years.

3 Findings

The study reveals that both groups—those on the MIND diet and those on the control diet with mild calorie restriction—showed small improvements in cognitive test scores over three years. However, there was no significant difference between the two groups in overall cognitive performance or in specific areas like memory or attention. Brain MRI scans also showed similar changes in both groups, with no clear benefit from the MIND diet. Both groups lost a similar amount of weight. The authors suggest that simply reducing calories and supporting weight loss may be as effective as following the MIND diet for maintaining cognitive health in this group. They recommend further research to see if longer studies or different groups might show other results. Simply put: The special diet did not work better than just eating less when it came to keeping older people's minds healthy.

Abstract

BACKGROUND: Findings from observational studies suggest that dietary patterns may offer protective benefits against cognitive decline, but data from clinical trials are limited. The Mediterranean-DASH Intervention for Neurodegenerative Delay, known as the MIND diet, is a hybrid of the Mediterranean diet and the DASH (Dietary Approaches to Stop Hypertension) diet, with modifications to include foods that have been putatively associated with a decreased risk of dementia. METHODS: We performed a two-site, randomized, controlled trial involving older adults without cognitive impairment but with a family history of dementia, a body-mass index (the weight in kilograms divided by the square of the height in meters) greater than 25, and a suboptimal diet, as determined by means of a 14-item questionnaire, to test the cognitive effects of the MIND diet with mild caloric restriction as compared with a control diet with mild caloric restriction. We assigned the participants in a 1:1 ratio to follow the intervention or the control diet for 3 years. All the participants received counseling regarding adherence to their assigned diet plus support to promote weight loss. The primary end point was the change from baseline in a global cognition score and four cognitive domain scores, all of which were derived from a 12-test battery. The raw scores from each test were converted to z scores, which were averaged across all tests to create the global cognition score and across component tests to create the four domain scores; higher scores indicate better cognitive performance. The secondary outcome was the change from baseline in magnetic resonance imaging (MRI)-derived measures of brain characteristics in a nonrandom sample of participants. RESULTS: A total of 1929 persons underwent screening, and 604 were enrolled; 301 were assigned to the MIND-diet group and 303 to the control-diet group. The trial was completed by 93.4% of the participants. From baseline to year 3, improvements in global cognition scores were observed in both groups, with increases of 0.205 standardized units in the MIND-diet group and 0.170 standardized units in the control-diet group (mean difference, 0.035 standardized units; 95% confidence interval, -0.022 to 0.092; P = 0.23). Changes in white-matter hyperintensities, hippocampal volumes, and total gray- and white-matter volumes on MRI were similar in the two groups. CONCLUSIONS: Among cognitively unimpaired participants with a family history of dementia, changes in cognition and brain MRI outcomes from baseline to year 3 did not differ significantly between those who followed the MIND diet and those who followed the control diet with mild caloric restriction. (Funded by the National Institute on Aging; ClinicalTrials.gov number, NCT02817074.).

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