July 2023: Trial of the MIND Diet for Prevention of Cognitive Decline in Older Persons
The issue
A three‑year randomized trial of the MIND diet — a Mediterranean + DASH hybrid created to protect brain health — found no meaningful advantage over a standard, calorie‑restricted control diet in preventing cognitive decline or brain‑scan changes in older adults at elevated dementia risk.
What do I need to know?
Researchers enrolled 604 cognitively normal adults (mean age ≈ 70) who were overweight, ate sub‑optimal diets, and had a first‑degree relative with dementia. Participants were randomized 1 : 1 to MIND + mild calorie restriction or to calorie restriction alone and were counselled for weight loss in both arms. After three years, global cognition improved slightly in both groups, but the difference between them was small and statistically non‑significant (Δ = 0.035 SD units; P = 0.23). MRI measures (hippocampal volume, white‑matter lesions) also changed similarly in each arm. Participants adhered well (MIND scores up by 3 points; antioxidant biomarkers rose), and both groups lost ~5 kg, suggesting any benefit seen was largely from weight control and healthier eating overall rather than from the specific MIND pattern. Serious adverse events and deaths did not differ between diets.
Potential risk of diet‑related cognitive decline
An older adult eats a low‑quality diet but has normal memory and no major vascular risks.
Recommended Actions
Adopt general heart‑healthy habits (vegetables, nuts, whole grains, exercise) to lower overall dementia risk.
Re‑check weight, blood pressure, and diet quality yearly; modest calorie reduction alone yields health gains.
Imminent risk of cognitive decline
Family history of dementia plus overweight and consistently poor diet, though cognition remains normal.
Recommended Actions
Improve diet quality using Mediterranean, DASH, or MIND principles, focusing on leafy greens, berries, fish, and olive oil.
Combine changes with 3–5 % weight loss and regular aerobic activity; monitor memory annually with MoCA or similar tools.
Confirmed early cognitive concerns
Subjective memory complaints or mild cognitive impairment on testing.
Recommended Actions
Seek a full cognitive work‑up and address reversible factors (sleep apnea, hypertension, depression).
Use diet upgrades as supportive care, but do not rely on MIND‑alone for disease modification; discuss emerging anti‑amyloid or vascular interventions if appropriate.
Engage in multimodal prevention: exercise, intellectual stimulation, social engagement, risk‑factor control.
What can I do?
Ask your clinician, “Am I at potential, imminent, or confirmed risk, and what part should diet play now?” Keep a simple log of meals, weight, and memory slips. Aim for balanced, plant‑forward eating rather than chasing a single “brain diet,” and pair it with physical activity and vascular‑risk management. Family or caregivers can help with grocery planning, shared cooking, and reminding loved ones to schedule yearly cognition checks so that any decline is caught early and treated promptly.
