Effect modifiers of the MIND diet for cognition in older adults: The MIND diet trial

Abstract INTRODUCTION We examined whether participant characteristics, including sociodemographics, APOE ε4 allele, lifestyle factors, and cardiovascular risk factors, modified the effect of the Mediterranean–Dietary Approach to Systolic Hypertension Intervention for Neurodegenerative Delay (MIND). METHODS The MIND trial (NCT02817074) randomized adults 65 to 85 years who were overweight or obese to the MIND diet or control diet conditions. A linear mixed‐effects model was used to examine whether participant characteristics modified the effect of MIND on the annual change in a global cognition score derived from a battery of 12 neurocognitive tests. RESULTS On average, participants ( N = 604) were 70.4 years old, 65.5% female, and with a body mass index (BMI) of 33.9 kg/m 2 . In multivariable‐adjusted models, BMI was the only significant modifier ( p = 0.009); only among individuals with BMI ≥ 35 kg/m 2 ( n = 213) was the MIND diet group associated with higher cognitive scores by 0.040 (standard error = 0.017, p = 0.018) standardized units per year versus control. DISCUSSION The MIND diet may have cognitive benefits in people with obesity, particularly BMI ≥ 35. CLINICAL TRIAL REGISTRATION NUMBER NCT02817074 Highlights This study examined potential effect modifiers of the MIND diet on cognition. BMI emerged as a significant effect modifier. In those with BMI ≥ 35 kg/m 2 , the MIND diet group had higher cognitive scores. The MIND diet may have cognitive benefits for people with obesity.