Association Between the cMIND Diet Pattern, Psychological Resilience and Cognitive Decline Trajectories: Findings from a Prospective Cohort Study in China

Background: The Chinese version of the Mediterranean–DASH (Dietary Approaches to Stop Hypertension) Intervention for Neurodegenerative Delay (cMIND) diet is hypothesized to slow cognitive decline; nevertheless, most existing evidence is cross-sectional, precluding examination of the longitudinal association between the cMIND diet and heterogeneous cognitive decline trajectories. Moreover, it remains unclear whether psychological resilience mediates this relationship in older Chinese adults. Objectives: We assessed the longitudinal association between cMIND diet adherence and dynamic cognitive trajectories, and evaluated whether psychological resilience mediated the association between the cMIND diet and cognitive trajectories. Methods: Data came from the Chinese Longitudinal Healthy Longevity Survey (CLHLS), a national survey of older adults. cMIND diet scores were grouped into lower (0–4), middle (4.5–5.5), and higher (6–12). A group-based trajectory model (GBTM) was used to identify cognitive decline trajectories. A multinomial logistic regression model was applied to analyse the relationship between the cMIND diet pattern and cognitive decline trajectories in older adults. A mediation analysis was performed on the potential mediating effect of psychological resilience. Results: A total of 1755 participants were included. Participants were divided into three trajectories: the low-level rapid decline trajectory (n = 344, 19.6%), the high-level stable trajectory (n = 551, 31.4%), and the moderate-level slow decline trajectory (n = 860, 49.0%). Compared with the stable trajectory, lower diet scores were associated with the rapid decline cognitive trajectory (OR: 1.59; 95% CI: 1.03, 2.48) and the slow decline cognitive trajectory (OR: 1.61; 95% CI: 1.16, 2.23). The mediating effect of psychological resilience on the relationship between the cMIND diet pattern and cognitive trajectories was not statistically significant (p > 0.05). Conclusions: The cMIND diet pattern was significantly associated with cognitive trajectories in older Chinese adults, with higher adherence associated with stable trajectories and lower adherence associated with rapid and slow decline trajectories. However, psychological resilience did not significantly mediate the relationship between the cMIND diet pattern and cognitive trajectories.