A Mediterranean-Dietary Approaches to Stop Hypertension Intervention for Neurodegenerative Delay-Based Diet with or without Digital Cognitive Training Improves Cognitive Function and Nutritional Status in Older Adults with Mild Cognitive Impairment

Abstract

Background: Given the growing prevalence of mild cognitive impairment (MCI) among the aging population, there is a critical need for multifaceted lifestyle interventions that combine nutritional support with cognitive stimulation to prevent further decline. Objectives: This study aimed to evaluate the effects of a cognitive function improvement management diet (Diet), with or without a digital cognitive enhancement program (SUPERBRAIN for group, SG), on cognitive function in adults aged >= 65 y with MCI attending daycare centers. Methods: This 12-wk cluster-randomized controlled trial included 80 older adults. Participants were assigned to a dietary intervention group (Diet, n = 33), a combined dietary and program intervention group (Diet+SG, n = 28), or a control group (n = 19) in an open-label trial. The Mediterranean-Dietary Approaches to Stop Hypertension (DASH) Intervention for Neurodegenerative Delay-based diet was provided to the Diet and Diet+SG groups as meals and snacks 5 d/wk. Assessments included anthropometry, physical measurements, blood parameters, nutritional indices, quality of life, activities of daily living (ADL), and cognitive function. Cognitive outcomes were evaluated using the Korean Mini-Mental State Examination 2 (K-MMSE2) and the clinical dementia rating. Results: Compared with the control group, both Diet and Diet+SG groups showed significant improvements in nutritional status (Nutrition Quotient for the Elderly, P < 0.001), quality of life (EuroQol 5-Dimension 5-Level (EQ-5D-5L), P < 0.001), ADL (Korean ADL, P < 0.001; Korean Instrumental Activities of Daily Living, P < 0.001), and cognitive function (K-MMSE2, P < 0.001). Improvements in maximum muscle strength (P < 0.001), an indicator of frailty, were observed only in the Diet+SG group compared with the control group.Conclusions: These findings suggest that adults with MCI may derive benefits from the combined application of a cognitive function improvement management diet and a digital cognitive enhancement program. This trial was registered at Clinical Research Information Service (CRIS) as KCT0009528 (https://cris.nih.go.kr/cris/search/detailSearch. do?search_lang=E&focus=reset_12&search_page=L&pageSize=10&page=undefined&seq=27374&status=5&seq_group=27374).