Mediterranean diet and cognitive decline: using epidemiologic and pilot study data to inform a large-scale intervention. (360G-Wellcome-202097_Z_16_Z)

Given the lack of effective treatments and projected increased prevalence of dementia1, there is a need to identify strategies to prevent cognitive decline. The Mediterranean diet (MD) has anti-inflammatory2 and vascular benefits3 and may be neuroprotective. Meta-analyses have demonstrated protective associations between MD adherence and cognitive decline4,5 but evidence is limited6 and the effect of MD on cognitive function is uncertain7. Further research is needed to investigate MD-associated neurological change from the earliest through to latest stages of cognitive decline. Furthermore, intervention strategies require insight into mechanisms involved in diet-induced cognitive change8 and an understanding of how to support MD behaviour change, particularly in non-Mediterranean populations9. This proposal integrates epidemiologic and pilot behaviour change data to address identified gaps in existing knowledge and to inform the development of a large trial where the efficacy of a MD intervention to preserve cognitive function will be tested. Key goals are to: 1. Comprehensively examine associations between MD adherence and cognitive function in non-Mediterranean populations 2. Evaluate the feasibility of MD behaviour change in adults at high risk of cognitive decline 3. Study mechanistic pathways by which a MD may act and identify cognitive outcomes most likely to respond to dietary change