The New England Journal of MedicineTrial of the MIND Diet for Prevention of Cognitive Decline in Older Persons

Unraveling the Diet’s Potential Influence on Dementia Risk

The effectiveness of the Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND) diet, a potential cognitive protector, was evaluated in a comprehensive two-site, randomized, controlled trial. The participants were older adults with a family history of dementia, but who were not cognitively impaired themselves. The MIND diet, with mild caloric restriction, showed no significant difference in cognitive or brain MRI outcomes compared to a control diet, also with mild caloric restriction.

Study Design:

• A two-site, randomized, controlled trial involving older adults without cognitive impairment but with a family history of dementia.
• Participants also had a body-mass index (BMI) greater than 25 and a suboptimal diet, as determined by a 14-item questionnaire.
• The trial assigned participants in a 1:1 ratio to follow either the MIND diet or a control diet, both with mild caloric restriction, for three years.
• Primary end point: change from baseline in global cognition score and four cognitive domain scores, derived from a 12-test battery.
• Secondary outcome: change from baseline in MRI-derived measures of brain characteristics in a nonrandom sample of participants.

Key Findings:

• 1,929 individuals underwent screening, and 604 were enrolled, with 301 assigned to the MIND-diet group and 303 to the control-diet group.
• The trial had a completion rate of 93.4%.
• Improvements in global cognition scores were observed in both groups, with slightly higher increases in the MIND-diet group, but the difference was not statistically significant.
• Changes in white-matter hyperintensities, hippocampal volumes, and total gray- and white-matter volumes on MRI were similar in the two groups.

Conclusion:

• The MIND diet, with mild caloric restriction, did not significantly impact changes in cognition and brain MRI outcomes over three years in older adults without cognitive impairment but with a family history of dementia, as compared to a control diet with similar caloric restriction. This challenges the potential protective cognitive benefits attributed to the MIND diet in observational studies.

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Did You Know?
According to the Alzheimer’s Association, nearly two-thirds of those with Alzheimer’s disease—5.8 million people—are women.