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Although it has been speculated that the Japanese dietary pattern has a preventive effect against incident dementia, no reported study has yet investigated this issue. The present prospective cohort study investigated the association between dietary patterns and incident dementia in elderly Japanese subjects.We analyzed follow-up data covering a 5.7-year period for 14,402 older adults (≥65 years) participating in a community-based, prospective cohort study. Three dietary patterns (Japanese pattern, animal food pattern, and high-dairy pattern) were derived using principal component analysis of the consumption of 39 food and beverage items assessed using a food frequency questionnaire. Data on incident dementia were retrieved from the public Long-term Care Insurance database.With 71,043 person-years of follow-up, incidence of dementia was 9.0%. The score for the Japanese dietary pattern was associated with a lower risk of incident dementia (hazard ratio of the highest quartile vs the lowest, 0.80; 95% confidence interval: 0.66–0.97; p-trend = .016). The animal food pattern and the high-dairy pattern showed no significant association with incident dementia.In this population of elderly Japanese individuals, the Japanese dietary pattern was associated with a decreased risk of incident dementia.