MIND Diet, Common Brain Pathologies, and Cognition in Community-Dwelling Older Adults

Article type: Research Article

Authors: Dhana, Klodian^{a; b; *} | James, Bryan D.^{b; c} | Agarwal, Puja^{a; b} | Aggarwal, Neelum T.^{c; d} | Cherian, Laurel J.^d | Leurgans, Sue E.^{c; d} | Barnes, Lisa L.^{c; d} | Bennett, David A.^{c; d} | Schneider, Julie A.^{c; d; e}

Affiliations: [a] Rush Institute for Healthy Aging, Rush University Medical Center, Chicago, IL, USA | [b] Department of Internal Medicine, Rush University Medical Center, Chicago, IL, USA | [c] Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, IL, USA | [d] Department of Neurological Sciences, Rush University Medical Center, Chicago, IL, USA | [e] Department of Pathology, Rush University Medical Center, Chicago, IL, USA

Correspondence: [*] Correspondence to: Klodian Dhana MD, PhD, Rush University Medical Center, 1700 W Van Buren, Suite 245, Chicago, IL 60612, USA. Tel.: +1 312 942 3237; E-mail: klodian_dhana@rush.edu.

Abstract: Background:MIND diet, a hybrid of the Mediterranean diet and the Dietary Approaches to Stop Hypertension diet, is associated with a slower cognitive decline and lower risk of Alzheimer’s disease (AD) dementia in older adults. Objective:We aim to examine whether the association of the MIND diet with cognition is independent of common brain pathologies. Methods:Utilizing data from the Rush Memory and Aging Project (MAP), a longitudinal clinical-pathologic study, we studied 569 decedents with valid dietary data, cognitive testing proximate to death, and complete autopsy data at the time of these analyses. A series of regression analyses were used to examine associations of the MIND diet, dementia-related brain pathologies, and global cognition proximate to death adjusting for age, sex, education, APOE ɛ4, late-life cognitive activities, and total energy intake. Results:A higher MIND diet score was associated with better global cognitive functioning proximate to death (β= 0.119, SE = 0.040, p = 0.003), and neither the strength nor the significance of association changed substantially when AD pathology and other brain pathologies were included in the model. The β-estimate after controlling for global AD pathology was 0.111 (SE = 0.037, p = 0.003). The MIND diet-cognition relationship remained significant when we restricted our analysis to individuals without mild cognitive impairment at the baseline (β= 0.121, SE = 0.042, p = 0.005) or in people diagnosed with postmortem diagnosis of AD based on NIA-Reagan consensus recommendations (β= 0.114, SE = 0.050, p = 0.023). Conclusion:MIND diet is associated with better cognitive functioning independently of common brain pathology, suggesting that the MIND diet may contribute to cognitive resilience in the elderly.

Keywords: Amyloid-β, brain pathology, cognition, MIND diet

DOI: 10.3233/JAD-210107

Journal: Journal of Alzheimer's Disease, vol. 83, no. 2, pp. 683-692, 2021