The MIND Diet and Cognitive Health in Older Adults: Clinical Evidence, Neuroprotective Mechanisms and Research Gaps—A Narrative Review

Background. The MIND diet combines elements of the Mediterranean and DASH dietary patterns and was developed to support cognitive health. Evidence includes observational, randomised and experimental research. Aim. This narrative review evaluated associations between MIND diet adherence and cognitive outcomes in older adults and compared observational and randomised findings. Methods. PubMed, MEDLINE and Google Scholar were searched through August 2026. Studies addressing cognitive performance, cognitive decline, mild cognitive impairment or dementia were included. Experimental studies were used to assess biological plausibility. Findings were synthesised descriptively. Results. Most observational studies associated greater adherence with better global cognition and memory, slower cognitive decline and lower risks of cognitive impairment and dementia. Experimental evidence supports vascular, metabolic, antioxidant, anti-inflammatory, amyloid-related and gut–brain mechanisms. The principal three-year randomised trial found no significant cognitive or neuroimaging advantage over an active control. Both groups received dietary counselling and caloric restriction and experienced weight loss, while the intervention may have been too short to detect long-term effects. Secondary analyses suggested possible differences according to obesity and achieved adherence, but were exploratory. Conclusions. The MIND diet is consistent with established cardiometabolic recommendations and can be a part of a broader healthy-ageing strategy. Its specific ability to prevent cognitive decline or dementia remains unconfirmed. Longer randomised trials are required.