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Adherence to four dietary indices and the risk of all-cause and cause-specific dementia: Findings from the UK Biobank study

Lookup NU author(s): Dr Oliver ShannonORCiD, Professor John MathersORCiD

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This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).


Abstract

© 2025 The Author(s). Diabetes, Obesity and Metabolism published by John Wiley & Sons Ltd.Aims: Despite several modifiable risk factors for dementia being identified, diet is often excluded from consideration due to insufficient evidence. Although various healthy dietary indices have been associated with improved health outcomes, their link to dementia risk remains unclear. This study investigates the association between four dietary indices and dementia risk among UK Biobank participants. Materials and Methods: This study utilized data from the UK Biobank cohort. Dietary intake was self-reported using repeated 24-h recalls (up to five occasions), averaged for analysis. Adherence to a healthy diet was assessed using four dietary indices: the Recommended Food Score (RFS), Healthy Diet Indicator (HDI), Mediterranean Diet Score (MDS) and the Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND) score. The primary outcome was incident all-cause dementia, Alzheimer disease, vascular dementia, and non-vascular dementia extracted from hospital and primary care records using ICD-10 codes. Censored Cox proportional hazards models were used to estimate the risk of developing dementia and reported as hazard ratios (HRs) with their 95% confidence interval (CI). Analyses were adjusted for age, sex, education and various lifestyle and health-related factors. Results: The analysis included 121 521 participants (mean age: 55.7 years; 53.5% women), followed for a median of 10.9 years. During follow-up, 621 participants developed dementia. Compared with individuals with the lowest dietary adherence (Quartile 1), those in the highest adherence group (Quartile 4) showed a lower risk of all-cause dementia for MDS (HR: 0.53; 95% CI: 0.45–0.63), MIND (HR: 0.61; 95% CI: 0.48–0.78), and RFS (HR: 0.66; 95% CI: 0.53–0.85). Similar associations were observed for Alzheimer disease and MDS (HR: 0.55; 95% CI: 0.46–0.67), RFS (HR: 0.61; 95% CI: 0.47–0.80), and MIND (HR: 0.66; 95% CI: 0.51–0.87). For vascular dementia, only MDS (HR: 0.46; 95% CI: 0.31–0.68) and MIND (HR: 0.68; 95% CI: 0.40–0.97) showed a lower risk. These associations remained in a 5-year landmark analysis. No associations were observed for HDI with any dementia outcome. Our findings indicate that higher adherence to specific dietary patterns, particularly the Mediterranean, RFS and MIND diet, is associated with a lower risk of dementia. Conclusions: The Mediterranean Diet demonstrated the strongest association. These results highlight the potential of healthy dietary patterns to improve brain health in older adults.


Publication metadata

Author(s): Carrasco-Marin F, Parra-Soto S, Guerrero-Wyss M, Araya-Bastias C, Boonpor J, Villagran-Cerro C, Petermann-Rocha F, Shannon OM, Mathers JC, Livingstone KM, Dingle S, Galvez-Tejeda S, Hernandez-Peregrina A, Pranay N, Molina-Recio G, Pell J, Ho F, Celis-Morales C, Molina-Luque R

Publication type: Article

Publication status: Published

Journal: Diabetes, Obesity and Metabolism

Year: 2025

Pages: epub ahead of print

Online publication date: 16/07/2025

Acceptance date: 30/06/2025

Date deposited: 29/07/2025

ISSN (print): 1462-8902

ISSN (electronic): 1463-1326

Publisher: John Wiley and Sons Inc

URL: https://doi.org/10.1111/dom.16609

DOI: 10.1111/dom.16609

Data Access Statement: The data that support the findings of this study are available from UK Biobank. Restrictions apply to the availability of these data, which were used under license for this study. Data are available from UK Biobank (https://www.ukbiobank.ac.uk) with the permission of UK Biobank.


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