Validation of a MIND diet screener in older adults

Desarae A Dempsey^{1

2}, Puja Agarwal^{3

4

5}, Shane Fernandez^{1

2

6

7}, Jared R Brosch^{1

8}, Sujuan Gao^{1

9}, Daniel O Clark¹⁰, Frederick W Unverzagt^{1

11}, Liana G Apostolova^{1

2

8

12}, David G Clark^{1

8}, Martin R Farlow^{1

2

8}, Sunu Mathew^{1

2}, Sophia Wang^{1

8

10

11}, Michelle Quirke^{1

2}, Yolanda Graham-Dotson^{1

2}, Colette Blach¹³, Leyla Schimmel¹⁴, Rima Kaddurah-Daouk¹⁴, Andrew J Saykin^{1

2

8

11

12}, Shannon L Risacher^{1

2

15}; Alzheimer Gut Microbiome Project Consortium

Affiliations

¹ Indiana Alzheimer's Disease Research Center, Indiana University School of Medicine, Indianapolis, Indiana, USA.
² Department of Radiology and Imaging Sciences, Indiana University School of Medicine, Indianapolis, Indiana, USA.
³ Rush Alzheimer's Disease Research Center, Rush University Medical Center, Chicago, Illinois, USA.
⁴ Department of Internal Medicine, Rush University Medical Center, Chicago, Illinois, USA.
⁵ Department of Clinical Nutrition, Rush University Medical Center, Chicago, Illinois, USA.
⁶ Centre for Precision Health, Edith Cowan University, Joondalup, Western Australia, Australia.
⁷ Collaborative Genomics and Translation Group, Edith Cowan University, Joondalup, Western Australia, Australia.
⁸ Department of Neurology, Indiana University School of Medicine, Indianapolis, Indiana, USA.
⁹ Department of Biostatistics and Health Data Science, Indiana University School of Medicine, Indianapolis, Indiana, USA.
¹⁰ Department of Medicine, Indiana University School of Medicine, Indiana University Center for Aging Research, Indianapolis, Indiana, USA.
¹¹ Department of Psychiatry, Indiana University School of Medicine, Indianapolis, Indiana, USA.
¹² Department of Medical and Molecular Genetics, Indiana University School of Medicine, Indianapolis, Indiana, USA.
¹³ Duke Molecular Physiology Institute, Duke University, Durham, North Carolina, USA.
¹⁴ Department of Psychiatry and Behavioral Sciences, Duke University, Durham, North Carolina, USA.
¹⁵ Wake Forest Alzheimer's Disease Research Center, Wake Forest Baptist Medical Center, Sticht Center for Healthy Aging and Alzheimer's Prevention, Medical Center Blvd, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA.

PMID: 41065051
PMCID: PMC12509044
DOI: 10.1002/alz.70766

Validation of a MIND diet screener in older adults

Desarae A Dempsey et al. Alzheimers Dement. 2025 Oct.

. 2025 Oct;21(10):e70766.

doi: 10.1002/alz.70766.

Authors

Affiliations

¹ Indiana Alzheimer's Disease Research Center, Indiana University School of Medicine, Indianapolis, Indiana, USA.
² Department of Radiology and Imaging Sciences, Indiana University School of Medicine, Indianapolis, Indiana, USA.
³ Rush Alzheimer's Disease Research Center, Rush University Medical Center, Chicago, Illinois, USA.
⁴ Department of Internal Medicine, Rush University Medical Center, Chicago, Illinois, USA.
⁵ Department of Clinical Nutrition, Rush University Medical Center, Chicago, Illinois, USA.
⁶ Centre for Precision Health, Edith Cowan University, Joondalup, Western Australia, Australia.
⁷ Collaborative Genomics and Translation Group, Edith Cowan University, Joondalup, Western Australia, Australia.
⁸ Department of Neurology, Indiana University School of Medicine, Indianapolis, Indiana, USA.
⁹ Department of Biostatistics and Health Data Science, Indiana University School of Medicine, Indianapolis, Indiana, USA.
¹⁰ Department of Medicine, Indiana University School of Medicine, Indiana University Center for Aging Research, Indianapolis, Indiana, USA.
¹¹ Department of Psychiatry, Indiana University School of Medicine, Indianapolis, Indiana, USA.
¹² Department of Medical and Molecular Genetics, Indiana University School of Medicine, Indianapolis, Indiana, USA.
¹³ Duke Molecular Physiology Institute, Duke University, Durham, North Carolina, USA.
¹⁴ Department of Psychiatry and Behavioral Sciences, Duke University, Durham, North Carolina, USA.
¹⁵ Wake Forest Alzheimer's Disease Research Center, Wake Forest Baptist Medical Center, Sticht Center for Healthy Aging and Alzheimer's Prevention, Medical Center Blvd, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA.

PMID: 41065051
PMCID: PMC12509044
DOI: 10.1002/alz.70766

Abstract

Introduction: Higher adherence to the Mediterranean-DASH (Dietary Approaches to Stop Hypertension) Intervention for Neurodegenerative Delay (MIND) diet has been associated with reduced Alzheimer's disease (AD) risk. This study assessed the validity of a brief 15-item MIND diet screener compared to a comprehensive food frequency questionnaire (FFQ).

Methods: The validity of an adapted MIND diet screener relative to the VioScreen FFQ was evaluated in 92 older adults from the Indiana Alzheimer's Disease Research Center (IADRC). Correlation coefficients and tertile-based classification statistics were used, and FFQ nutrient profiles were examined across screener-based MIND diet tertiles.

Results: MIND diet scores from the screener showed strong positive correlation (r = 0.71, ρ = 0.70, p < 0.001) and comparable ranking ability (63% correctly classified, 1% grossly misclassified, k_w= 0.67) compared to those from the FFQ, as well as significant associations with nutrient profiles.

Conclusion: The MIND diet screener is an acceptable, time-efficient tool for estimating MIND diet scores in older adults.

Highlights: The MIND diet screener effectively differentiated participants by diet quality. Agreement between instrument scores was consistent across diagnostic groups. Reliability of the screener over approximately 1 year was comparable to the FFQ. The MIND diet screener is an acceptable tool for use in time-constrained settings. Future studies should confirm validity using objective biomarkers.

Keywords: Alzheimer's disease; Mediterranean‐DASH Intervention for Neurodegenerative Delay (MIND) diet; diet records; healthy eating indices; nutrition surveys; plant‐based diet.

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Conflict of interest statement

Dr. Saykin receives support from multiple NIH grants (P30 AG010133, P30 AG072976, R01 AG019771, R01 AG057739, U19 AG024904, R01 LM013463, R01 AG068193, T32 AG071444, U01 AG068057, U01 AG072177, and U19 AG074879). He has also received in‐kind support from Avid Radiopharmaceuticals, a subsidiary of Eli Lilly (positron emission tomography tracer precursor) and Gates Ventures, LLC (SomaScan 7K proteomics panel assays on IADRC participants as part of the Global Neurodegeneration Proteomics Consortium), and has served on scientific advisory boards (Bayer Oncology, Eisai, Novo Nordisk, and Siemens Medical Solutions USA, Inc) and an Observational Study Monitoring Board (MESA, NIH NHLBI), as well as external advisory committees for multiple NIA grants. He also serves as editor‐in‐chief of Brain Imaging and Behavior, a Springer‐Nature Journal. Dr. Kaddurah‐Daouk is an inventor on a series of patents on the use of metabolomics for the diagnosis and treatment of central nervous system diseases and holds equity in Metabolon Inc., Chymia LLC, and PsyProtix. All other authors have no conflicts of interest relevant to this study. Author disclosures are available in the Supporting Information.

Figures

**FIGURE 1**
Comparison of absolute MIND diet scores from screener and FFQ. (A) Overlaid density curves representing the distribution of MIND diet scores derived from the two methods, with the FFQ scores in orange and the MIND diet screener scores in blue. The x‐axis represents the potential range of the total MIND diet score (0 to 15). For the FFQ, the mean MIND diet score was 7.66 ± 2.07 (range: 2.5 to 12.0) with a median of 8. For the screener, the mean MIND diet score was 10.00 ± 1.96 (range: 5.0 to 13.5) with a median of 10.5. (B) Bland–Altman plot showing agreement and differences between MIND diet scores derived from screener and FFQ. Dashed red line: mean difference between MIND diet scores (screener–FFQ); dashed blue lines: 95% LOA (± 1.96 SD). The mean difference ± SD was 2.35 ± 1.54, and the LOA were −0.67 and 5.37. (C) Distributions after adjusting screener scores to account for observed mean offset. The mean difference of 2.35 points was subtracted from each screener score to align its scale more closely with the FFQ. The adjusted screener scores (blue) are shown overlaid with the FFQ scores (orange). (D) Bland–Altman plot of adjusted screener scores, with mean difference centered at zero. As indicated in (B), the dashed line represents the mean difference, which is now centered at zero, and the dashed blue lines indicate the 95% LOA. The SD remained the same (± 1.54) and the LOA were −3.02 to 3.02. FFQ, food frequency questionnaire; LOA, limits of agreement; MIND, Mediterranean‐Dietary Approaches to Stop Hypertension Intervention for Neurodegenerative Delay; SD, standard deviation.

**FIGURE 2**
Association between MIND diet scores from screener and FFQ. (A) Scatterplot between MIND diet scores from screener and FFQ in the full sample (n = 92; r = 0.71, 95% CI [0.59 to 0.80], p < 0.001; ρ = 0.70, p < 0.001). (B) Scatterplot showing association stratified by diagnostic group (CN, SCD, MCI). The correlation coefficients were strong for the CN group (n = 50; r = 0.74, 95% CI [0.57 to 0.84], p < 0.001; ρ = 0.68, p < 0.001) and the MCI group (n = 12; r = 0.85, 95% CI [0.54 to 0.96], p < 0.001; ρ = 0.72, p < 0.01) and moderate for the SCD group (n = 30; r = 0.45, 95% CI [0.10 to 0.69], p = 0.01; ρ = 0.54, p < 0.01). There were no significant differences in the slopes, indicating the strength of association between the screener‐based MIND diet score and the FFQ‐based MIND diet score did not significantly differ across diagnosis groups. CN, cognitively normal; FFQ, food frequency questionnaire; MCI, mild cognitive impairment; MIND, Mediterranean‐Dietary Approaches to Stop Hypertension Intervention for Neurodegenerative Delay; SCD, subjective cognitive decline.

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References

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Validation of a MIND diet screener in older adults

Affiliations

Validation of a MIND diet screener in older adults

Authors

Affiliations

Abstract

Conflict of interest statement

Figures

References

Publication types

MeSH terms

Grants and funding

LinkOut - more resources

Full Text Sources

Medical