The role of nutrition and the Mediterranean diet on the trajectories of cognitive decline

The worldwide burden of dementia is immense, and set to increase to unprecedented levels in the coming de-cades, due to population aging. In the absence of disease-modifying treatment, there is therefore a strong rationale to support the assumption that acting on modifiable risk factors, especially in midlife, is a good strategy for reducing the burden of dementia. Among these risk factors, nutrition is key, as it is fundamental to healthy aging, and has interrelated benefits on a number of organ systems, metabolic processes and health states that can all contribute to modifying the risk of dementia. In this paper, we review the methodological challenges of comparing studies of dietary interventions. We then discuss the effect of genetics and the environment on brain health, and review in particular the literature data on the effect of nutrition on cognition. We summarize the body of data reporting the largely beneficial effects of the Mediterranean diet on brain health, and the possible mechanisms that mediate these effects. Finally, we discuss future perspectives for further research in the field, notably the gut-brain axis, thought to be a key mediator of the effect of nutrition on brain health.

Automated summary

The global burden of dementia is huge and expected to increase significantly in the future due to population aging. The paper highlights the importance of acting on modifiable risk factors such as nutrition in midlife to reduce dementia burden. It reviews the challenges in comparing dietary intervention studies, discusses the impact of genetics and environment on brain health, and emphasizes the largely beneficial effects of the Mediterranean diet on cognition.