Association of Malaysian-MIND Diet Scores with Brain Activation in Older Adults: A Functional MRI Study

Background/Objectives: Cognitive flexibility and working memory are regulated by the dorsolateral prefrontal cortex (DLPFC), which is closely linked to the progression of cognitive decline. The Mediterranean-DASH Intervention for the Neurodegenerative Delay (MIND) diet shows potential to lower cognitive decline risk in older adults. This study aimed to examine the association between Malaysian-MIND diet (MY-MINDD©) scores with brain activation among Malaysian older adults. Methods: A cross-sectional study was conducted among forty older adults aged 60-75 years. Subjects were stratified into quartiles of MY-MINDD© scores with ten subjects per quartile. Dietary intake was evaluated utilising a validated 124-item semiquantitative Food Frequency Questionnaire (FFQ). Brain activation was measured using task-based fMRI (N-back and Stroop Colour Word Test). DLPFC activation was analysed in Brodmann's areas 9, 46, and the anterior cingulate cortex (ACC). ANCOVA and multiple linear regression were used to evaluate brain activation differences across MY-MINDD© quartiles, accommodating for gender, age, education, and body mass index (BMI). Results: Subjects in the highest MY-MINDD© quartile had significantly greater DLPFC activation during 0-back, 1-back, and SCWT incongruent tasks (p < 0.05). Higher MY-MINDD© adherence is linked to better task performance (p < 0.001). Multivariate General Linear Model (GLM) revealed a significant overall effect on brain activation (Pillai's Trace = 0.544, F(8,27) = 4.11, p = 0.003). Multiple linear regression demonstrated significant positive associations between MY-MINDD© scores and DLPFC activation (p < 0.0125). Conclusions: Higher adherence to the MY-MINDD© diet was associated with greater brain activation, suggesting its relevance as a proxy for identifying risk of cognitive decline.