Changes in ultra‐processed food consumption or MIND diet adherence and cognitive impairment

INTRODUCTION The impact of incremental dietary changes on cognitive health is inadequately understood. We investigated dietary modifications and subsequent cognitive impairment in the Reasons for Geographic and Racial Differences in Stroke study. METHODS Black and White adults aged ≥ 45 years in the United States were enrolled from 2003 to 2007. A second visit was performed from 2013 to 2016. Differences between visits in dietary scores from food frequency questionnaires were associated with subsequent impairment, defined using annual Six‐Item Screeners. RESULTS The dietary change subcohort included 7555 participants. In multivariable Cox models, a 10% increase in ultra‐processed food consumption was associated with higher impairment risk (% grams, hazard ratio [HR] = 1.24, 95% confidence interval [CI] = 1.12–1.37, p < 0.001; % calories, HR = 1.15, 95% CI = 1.06–1.25, p < 0.001). Each 1‐point increase in the Mediterranean–Dietary Approaches to Stop Hypertension Intervention for Neurodegenerative Delay diet score was associated with lower impairment risk (HR = 0.90, 95% CI = 0.85–0.96, p = 0.002). DISCUSSION Our findings support dietary interventions targeted at preventing cognitive decline.