(OR12-04-25) The MIND Diet and Incidence of Alzheimer's Disease and Related Dementias Among Five Racial and Ethnic Groups in the Multiethnic Cohort Study

Objectives: The Mediterranean-Dietary Approaches to Stop Hypertension Intervention for Neurodegenerative Delay (MIND) diet has been linked to lower risk of dementia in observational studies. However, data have been limited to determine whether the association between the MIND diet and dementia differs across racial and ethnic populations and whether dietary improvement at older ages is beneficial in preventing dementia. We examined the MIND diet in relation to late-onset Alzheimer’s disease and related dementia (ADRD) risk across five racial and ethnic groups in the Multiethnic Cohort Study.

Methods: Participants were scored for the MIND diet based on their food frequency questionnaire responses at baseline (45-75 years) and at a 10-year follow-up. The MIND diet-ADRD associations [hazard ratios (HRs) and 95% confidence intervals (CIs)] were assessed using multivariable Cox proportional hazards models for diet at baseline (21,478 cases among 92,849 participants) and for diet change reported at follow-up (8,360 cases among 45,065 participants).

Results: A modest decrease in ADRD risk was observed between the highest vs. lowest MIND diet score group (HR = 0.91, 95% CI: 0.87-0.96, P for trend < 0.001). However, the inverse association varied by race and ethnicity (P for heterogeneity = 0.06), suggesting stronger protection among African American, Latino, and White participants than in Japanese American or Native Hawaiian groups. Improvement over 10 years was associated with a lower risk overall by 25% (HR = 0.75, 95% CI: 0.69-0.82), comparing groups with greatest increase (≥1 SD increase) vs. decrease (≥1 SD decrease) in MIND score, with an inverse association observed for all racial and ethnic groups except Native Hawaiian (P for heterogeneity = 0.68), but consistently for younger ( < 60 years at baseline) and older (≥60 years) age group.

Conclusions: Higher adherence to the MIND diet in mid- to late-life and improvement in older age were associated with a reduced risk of ADRD in a diverse population. The observed racial and ethnic heterogeneity in the relationships warrants further study.

Funding Sources: This work was supported by the National Cancer Institute (U01 CA164973) and the National Institute on Aging (U01 CA164973-08S1, R03 AG081824) of the National Institutes of Health.