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

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/m2. In multivariable-adjusted models, BMI was the only significant modifier (p = 0.009); only among individuals with BMI ≥ 35 kg/m2 (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/m2, the MIND diet group had higher cognitive scores. The MIND diet may have cognitive benefits for people with obesity.