Long-term adherence and changes in the Mediterranean and MIND diets in relation to dementia risk and cognitive function

Alzheimers Dement. 2026 Mar;22(3):e71324. doi: 10.1002/alz.71324.

Abstract

Introduction: Associations of adherence to and changes in Mediterranean (MedDiet) and Mediterranean-Dietary Approaches to Stop Hypertension Intervention for Neurodegenerative Delay (MIND) diets with cognitive outcomes are unclear.

Methods: We prospectively followed 86,740 women (Nurses' Health Study, 1980-2023) and 43,500 men (Health Professionals Follow-Up Study, 1986-2023). Diet was assessed repeatedly using food frequency questionnaires. Dementia cases were identified from self-reported physician diagnoses and death records. Cognitive function was assessed by telephone tests, and subjective cognitive decline (SCD) was self-reported.

Results: Participants in the highest versus lowest MedDiet and MIND categories had 21% (hazard ratio [HR] = 0.79, 95% confidence interval [CI]: 0.73-0.84) and 14% (HR = 0.86, 95% CI: 0.81-0.91) lower dementia risk, respectively. Higher adherence was associated with 0.75 to 1.59 fewer years of cognitive aging, and 40% to 42% lower risk of SCD. Similar inverse associations were observed for improved adherence over 4 or 8 years.

Discussion: Adherence to Mediterranean and MIND diets was associated with cognitive benefits.

Keywords: cognitive function; dementia; mediterranean diet; mediterranean–dietary approaches to stop hypertension diet intervention for neurodegenerative delay diet; subjective cognitive decline.

MeSH terms

  • Aged
  • Cognition* / physiology
  • Cognitive Dysfunction* / prevention & control
  • Dementia* / epidemiology
  • Dementia* / prevention & control
  • Diet, Mediterranean*
  • Dietary Approaches To Stop Hypertension*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Patient Compliance*
  • Prospective Studies
  • Risk Factors