IntroductionAssociations between the Mediterranean‐DASH diet Intervention for Neurological Delay (MIND) diet and incidence of cognitive impairment have not been evaluated outside the United States.MethodsWe investigated MIND and Mediterranean diet relations with 12‐year incidence of Alzheimer's disease/Vascular dementia (National Institute of Neurological Disorders criteria) and mild cognitive impairment (Winbald criteria) in the Personality and Total Health (PATH) Through Life cohort (n = 1220) set in Canberra, Australia: wave‐1 2001‐2002; wave‐2 2005‐2006; wave‐3 2009‐2010; and wave‐4 2013‐2014.MIND diet and two alternate Mediterranean diet scores were calculated from the baseline food frequency questionnaire responses. Higher dietary scores signified greater adherence.ResultsIn adjusted logistic regression models, MIND diet (OR = 0.47, 95% CI 0.24, 0.91), but not Mediterranean diet, was associated with reduced odds of 12‐year cognitive impairment.DiscussionPreliminary evidence suggests that protective effects of the MIND diet are geographically generalizable. Additional prospective studies are needed in diverse samples to determine the relative effects of the MIND and the Mediterranean diets against cognitive decline.

Findings do not support supplementing older adults with fish oil to prevent cognitive decline. Treatment interactions with sex and APOE-ε4 carrier status warrant further investigation. This trial was registered at the Australia and New Zealand Clinical Trials Register (ANZCTR) as ACTRN12607000278437.

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Objective: To demonstrate test-retest reliability (reproducibility) of a new selfadministered lifetime diet questionnaire, with a focus on foods relevant to cognitive health in older age. Design: The reproducibility of dietary recall over four or five life periods was assessed by administering the questionnaire at two time points to an older cohort. The period between questionnaire administrations was 7 weeks. Polychoric correlations measured the association between recall at time 1 and time 2 and the weighted k statistic measured the level of recall agreement for food groups across the two administrations of the questionnaire. Setting: Adelaide, South Australia. Subjects: Fifty-two cognitively healthy, older-age, community-dwelling adults completed the Lifetime Diet Questionnaire; mean age 81?8 (SD 4?4) years, range 70-90 years. Results: The questionnaire showed very good reproducibility in this sample with a mean polychoric correlation coefficient of 0?81 between administration at time 1 and time 2, and an average weighted k of 0?49 for the level of recall agreement between food groups. Conclusions: The demonstrated reliability of this lifetime diet questionnaire makes it a useful tool to assess potential relationships between long-term dietary intake and laterage cognitive outcomes.

Dietary intake is a modifiable exposure that may have an impact on cognitive outcomes in older age. The long-term aetiology of cognitive decline and dementia, however, suggests that the relevance of dietary intake extends across the lifetime. In the present study, we tested whether retrospective dietary patterns from the life periods of childhood, early adulthood, adulthood and middle age predicted cognitive performance in a cognitively healthy sample of 352 older Australian adults >65 years. Participants completed the Lifetime Diet Questionnaire and a battery of cognitive tests designed to comprehensively assess multiple cognitive domains. In separate regression models, lifetime dietary patterns were the predictors of cognitive factor scores representing ten constructs derived by confirmatory factor analysis of the cognitive test battery. All regression models were progressively adjusted for the potential confounders of current diet, age, sex, years of education, English as native language, smoking history, income level, apoE ɛ4 status, physical activity, other past dietary patterns and health-related variables. In the adjusted models, lifetime dietary patterns predicted cognitive performance in this sample of older adults. In models additionally adjusted for intake from the other life periods and mechanistic health-related variables, dietary patterns from the childhood period alone reached significance. Higher consumption of the 'coffee and high-sugar, high-fat extras' pattern predicted poorer performance on simple/choice reaction time, working memory, retrieval fluency, short-term memory and reasoning. The 'vegetable and non-processed' pattern negatively predicted simple/choice reaction time, and the 'traditional Australian' pattern positively predicted perceptual speed and retrieval fluency. Identifying early-life dietary antecedents of older-age cognitive performance contributes to formulating strategies for delaying or preventing cognitive decline.

Background: Our aim was to systematically review the relationship between iron and incident cognitive decline or dementia from midlife onwards. Methods: Systematic review of eligible studies using Medline, Embase and PsycINFO ® for the period from 1 January 1986 to 2 December 2016 (CRD42016023800), where study populations had a mean age of over 50 years and were free of cognitive impairment or dementia at baseline. Two authors independently extracted data according to eligibility criteria and assessed study characteristics, quality and outcomes. Disagreement was resolved by discussion. Results: A total of 1185 relevant records were identified with 12 full-text articles eligible for review. Six studies were excluded, leaving six texts to be included. Sample size ranged from 90 to 7173, with an average follow up of approximately 11.5 years. Baseline iron measures included brain iron (n = 2), iron-related biomarkers in blood and plasma (n = 2), and iron intake estimates from dietary records (n = 2). Outcomes were dementia incidence (n = 2) and longitudinal outcomes on neuropsychological tests (n = 4). Bias was evident across studies in one or more of the following: recruitment, iron exposure, outcome assessments, potential confounders, missing data or attrition. Conclusions: Diversity across the small number of identified studies precludes conclusions regarding the role of iron in cognitive decline or dementia. Our review highlights substantial gaps in the evidence base and the need for more comprehensive, higher quality studies in this area.

Dementia risk reduction is a global health and fiscal priority given the current lack of effective treatments and the projected increased number of dementia cases due to population ageing. There are often gaps among academic research, clinical practice, and public policy. We present information on the evidence for dementia risk reduction and evaluate the progress required to formulate this evidence into clinical practice guidelines. This narrative review provides capsule summaries of current evidence for 25 risk and protective factors associated with AD and dementia according to domains including biomarkers, demographic, lifestyle, medical, and environment. We identify the factors for which evidence is strong and thereby especially useful for risk assessment with the goal of personalising recommendations for risk reduction. We also note gaps in knowledge, and discuss how the field may progress towards clinical practice guidelines for dementia risk reduction.

Higher n-3 (ω-3) polyunsaturated fatty acids (PUFAs) and fish intake may help maintain cognitive function in older age. However, evidence is inconsistent; few studies have examined the relation in cognitively healthy individuals across numerous cognitive domains, and none to our knowledge have considered lifetime fish intake. We examined associations between multiple domains of cognition and erythrocyte membrane n-3 PUFA proportions and historical and contemporary fish intake in 390 normal older adults, analyzing baseline data from the Older People, Omega-3, and Cognitive Health trial. We measured n-3 PUFA in erythrocyte membranes, and we assessed historical and contemporary fish intake by food-frequency questionnaires. We assessed cognitive performance on reasoning, working memory, short-term memory, retrieval fluency, perceptual speed, simple/choice reaction time, speed of memory-scanning, reasoning speed, inhibition, and psychomotor speed. Cognitive outcomes for each construct were factor scores from confirmatory factor analysis. Multiple linear regression models controlled for a number of potential confounding factors, including age, education, sex, apolipoprotein E-ε 4 allele, physical activity, smoking, alcohol intake, socioeconomic variables, and other health-related variables. Higher erythrocyte membrane eicosapaentonoic acid proportions predicted slower perceptual and reasoning speed in females, which was attenuated once current fish intake was controlled. No other associations were present between n-3 PUFA proportions and cognitive performance. Higher current fish consumption predicted worse performance on several cognitive speed constructs. Greater fish consumption in childhood predicted slower perceptual speed and simple/choice reaction time. We found no evidence to support the hypothesis that higher proportions of long-chain n-3 fatty acids or fish intake benefits cognitive performance in normal older adults.