Importance Dementia threatens the well-being of older adults, making efforts toward prevention of great importance. Objective To evaluate the association of the Mediterranean-Dietary Approaches to Stop Hypertension (DASH) Intervention for Neurodegenerative Delay (MIND) diet with the risk of dementia in 3 prospective studies and a meta-analysis. Design, Setting, and Participants Cohort analyses included the Whitehall II study (WII), the Health and Retirement Study (HRS), and the Framingham Heart Study Offspring cohort (FOS), and the meta-analysis included 11 cohort studies. Participants were middle-aged and older women and men from WII in 2002 to 2004, HRS in 2013, and FOS in 1998 to 2001 without dementia at the study baseline. Data were analyzed from May 25 to September 1, 2022. Exposures MIND diet score was measured using food frequency questionnaires, and scores ranged from 0 to 15, with a higher score indicating higher adherence to the MIND diet. Main Outcome and Measures Incident all-cause dementia, with cohort-specific definitions. Results Included in this study were 8358 participants (mean [SD] age, 62.2 [6.0] years; 5777 male [69.1%]) from WII, 6758 participants (mean [SD] age, 66.5 [10.4] years; 3965 female [58.7%]) from HRS, and 3020 participants (mean [SD] age, 64.2 [9.1] years; 1648 female [54.6%]) from FOS. The mean (SD) baseline MIND diet score was 8.3 (1.4) in WII, 7.1 (1.9) in HRS, and 8.1 (1.6) in FOS. Over 166 516 person-years, a total of 775 participants (220 in WII, 338 in HRS, and 217 in FOS) developed incident dementia. In the multivariable-adjusted Cox proportional hazard model, higher MIND diet score was associated with lower risk of dementia (pooled hazard ratio [HR] for every 3-point increment, 0.83; 95% CI, 0.72-0.95; P for trend = .01; I2 = 0%). The associations were consistently observed in subgroups defined by sex, age, smoking status, and body mass index. In the meta-analysis of 11 cohort studies with 224 049 participants (5279 incident dementia cases), the highest tertile of MIND diet score was associated with lower risk of dementia compared with the lowest tertile (pooled HR, 0.83; 95% CI, 0.76-0.90; I2 = 35%). Conclusions and Relevance Results suggest that adherence to the MIND diet was associated with lower risk of incident dementia in middle-aged and older adults. Further studies are warranted to develop and refine the specific MIND diet for different populations.

中文翻译：

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地中海饮食方法协会停止高血压干预神经退行性延迟 (MIND) 饮食与痴呆症的风险。

重要性 痴呆症威胁着老年人的健康，因此努力预防非常重要。目的 在 3 项前瞻性研究和一项荟萃分析中评估地中海饮食方法停止高血压 (DASH) 干预神经退行性延迟 (MIND) 饮食与痴呆症风险之间的关系。设计、设置和参与者队列分析包括 Whitehall II 研究 (WII)、健康与退休研究 (HRS) 和 Framingham 心脏研究后代队列 (FOS)，荟萃分析包括 11 项队列研究。参与者是 2002 年至 2004 年 WII、2013 年 HRS 和 1998 年至 2001 年 FOS 的中老年女性和男性，在研究基线时没有痴呆症。分析了 2022 年 5 月 25 日至 9 月 1 日的数据。暴露 MIND 饮食评分使用食物频率问卷进行测量，评分范围为 0 至 15，评分越高表明对 MIND 饮食的依从性越高。主要结果和测量事件全因痴呆，具有队列特定定义。结果 本研究包括来自 WII 的 8358 名参与者（平均 [SD] 年龄，62.2 [6.0] 岁；5777 名男性 [69.1%]），6758 名参与者（平均 [SD] 年龄，66.5 [10.4] 岁；3965 名女性 [58.7] %]）来自 HRS，3020 名参与者（平均 [SD] 年龄，64.2 [9.1] 岁；1648 名女性 [54.6%]）来自 FOS。平均 (SD) 基线 MIND 饮食评分在 WII 中为 8.3 (1.4)，在 HRS 中为 7.1 (1.9)，在 FOS 中为 8.1 (1.6)。在超过 166516 人年的时间里，共有 775 名参与者（WII 中有 220 人，HRS 中有 338 人，FOS 中有 217 人）发生了痴呆事件。在多变量调整的 Cox 比例风险模型中，较高的 MIND 饮食评分与较低的痴呆风险相关（每 3 点增量的合并风险比 [HR]，0.83；95% CI，0.72-0.95；趋势 P = .01；I2 = 0%）。在按性别、年龄、吸烟状况和体重指数定义的亚组中，始终观察到这种关联。在涉及 224049 名参与者（5279 例痴呆病例）的 11 项队列研究的荟萃分析中，与最低三分位数相比，MIND 饮食评分的最高三分位数与较低的痴呆风险相关（合并 HR，0.83；95% CI，0.76 -0.90；I2 = 35%）。结论和相关性结果表明，坚持 MIND 饮食与中年和老年人患痴呆症的风险较低有关。需要进一步的研究来开发和完善针对不同人群的特定 MIND 饮食。