Association between cMIND diet adherence and frailty among Chinese older adults: A 10-year longitudinal study

Both cognitive impairment and diet are significant factors associated with frailty, however, the association between the Chinese Mediterranean-DASH Intervention for Neurodegenerative Delay (cMIND) diet and frailty remains unclear.

This longitudinal study analyzed data from 1,943 adults aged ≥65 in the Chinese Longitudinal Healthy Longevity Survey (CLHLS) spanning 2008-2018. Adherence to the cMIND diet was assessed using a food frequency questionnaire, whereas frailty status was determined using the frailty index. The cMIND dietary scores were categorized into three groups based on tertiles: (T1:0-4; T2:4.5-5.5; T3:6-12). The association between cMIND adherence and frailty incidence was assessed using Cox proportional hazards models, while the dose-response relationship was examined with restricted cubic splines (with knots at the 5th, 35th, 65th, and 95th percentiles).

The mean age was 74.9 ± 7.3 years; 50.5% were female. The restricted cubic spline model revealed a significant nonlinear association between baseline cMIND dietary scores and frailty risk (nonlinear p < 0.05). Subsequently, the Cox proportional hazards model showed that, after adjusting for covariates, participants in the highest tertile of cMIND scores exhibited a 16% reduction in frailty risk compared to those in the lowest tertile (HR = 0.84, 95% CI: 0.72-0.97, p = 0.022). However, subgroup analyses revealed that the association varied according to baseline cognitive function. A significant inverse association was present in those with normal cognition (HR = 0.91, 95% CI: 0.86-0.96) but absent in those with cognitive impairment (HR = 1.01, 95% CI: 0.93-1.09; interaction p = 0.037).

Higher adherence to the cMIND diet is associated with a lower risk of frailty among older adults in China, specifically in those with normal cognitive function at baseline.