Race/ethnicity and gender modify the association between diet and cognition in U.S. older adults: National Health and Nutrition Examination Survey 2011‐2014

Introduction It is unclear whether the association between Mediterranean‐type Diet (MeDi) and cognition is similar across different racial/ethnic groups or between women and men. Methods The current study included 2435 participants (≥60 years of age) of the National Health and Nutrition Examination Survey (NHANES) 2011‐2014. Linear regression models were applied to examine the association between diet and cognition, adjusted for multiple demographic variables. Interaction between MeDi and race/ethnicity (non‐Hispanic White, non‐Hispanic Black, Hispanic, other), and between MeDi and gender, were examined, followed by stratified analyses. Results One score increase in MeDi was associated with 0.039 (95%confidence interval [CI] = 0.016‐0.062) higher global cognitive z‐score. Significant associations between MeDi and global cognition and between MeDi and immediate recall were found in the non‐Hispanic Whites only (P‐interaction = 0.057 and 0.059, respectively). MeDi was associated with increased score of animal fluency score in men but not in women (P‐interaction = 0.082). Discussion The positive association between MeDi and cognition might be dependent on race/ethnicity and gender.