The impact of lifestyle and dietary habits on CT characteristics and cognitive progression in mild cognitive impairment

Background Alzheimer's disease (AD) is a leading cause of dementia, with mild cognitive impairment (MCI) representing a precursor state. This study aimed to explore how lifestyle and dietary habits affect cognitive function and anatomical changes in MCI patients, potentially delaying its onset. Methods A retrospective, non-randomized analysis was conducted with 237 MCI patients, divided into a Routine Group (n = 124) and a Personalized Group (n = 113) based on clinical management choices. Patients in the Routine Group received standard health education, while those in the Personalized Group were provided with Mediterranean diet education and lifestyle modifications over a 20-week period. Dietary adherence, physical activity, sleep quality, and general lifestyle were evaluated using standardized assessment tools. Biomarkers related to MCI progression, such as phosphorylated tau protein (P-Tau181) and C-reactive protein (CRP), were measured. Cognitive function was assessed using scales like the AD Assessment Scale-Cognitive Subscale (ADAS-cog). CT parameters, including Global Cortical Atrophy (GCA) Score and Frontal Horn Index (FHI, %), were also analyzed. Results By Week 20, the Personalized Group showed increased dietary adherence (MEDAS: P = 0.001), greater physical activity (PASE: P = 0.027), reduced sleep disturbance (PSQI: P = 0.003), and healthier overall lifestyle (LAQ: P = 0.012). The group also showed reduced P-Tau181 (P = 0.023) and lower systemic inflammation (CRP: P = 0.014), better cognitive performance (ADAS-cog: P = 0.001), and less cortical and ventricular atrophy (GCA: P = 0.045; FHI: P = 0.042). Conclusion Tailored lifestyle and dietary modifications were associated with better cognitive performance and favorable biomarker/CT profiles. These findings suggest non-pharmacological approaches may aid MCI management, though causal inferences are precluded by the retrospective, non-randomized design.