Introduction: Stroke survivors are at increased risk of cognitive decline and dementia. Recent studies have shown that the MIND diet (a hybrid of the Mediterranean and Dash diets, with modifications based on the science of nutrition and the brain) slows cognitive decline in the general population, but it is not known whether the diet may also be effective in stroke survivors.
Methods: A total of 106 participants from an observational prospective cohort study with a history of stroke at their baseline enrollment were assessed annually for an average of 4.7 years of follow-up. Participants with baseline dementia, missing or invalid baseline dietary evaluations, or less than two cognitive assessments were excluded. Cognition in five cognitive domains were assessed using structured clinical evaluations that included a battery of 19 cognitive tests. MIND diet scores were computed using a valid food frequency questionnaire. Dietary components of the MIND diet included whole grains, green leafy and other vegetables, berries, beans, nuts, lean meats, fish, poultry, and olive oil and less consumption of regular cheese, butter and sweets. MIND diet scores were modeled in tertiles. Change in global cognitive scores was regressed on baseline MIND score using linear mixed models adjusted for age and other potential confounders.
Results: In the age adjusted model, the top tertile of MIND diet scores versus the lowest tertile was positively associated with a slower rate of global cognitive decline (β = .08; P = .02.) With further adjustment for sex, education, apo-E4, late-life cognitive activity, caloric intake, physical activity, and smoking the association remained unchanged (β = .08; P = .03).
Conclusions: High adherence to the MIND diet was associated with substantially slower rate of cognitive decline in stroke survivors. A dietary intervention trial would be necessary to validate the role of the diet in long-term outcomes for stroke survivors.