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We investigated dietary modifications and subsequent cognitive impairment in the Reasons for Geographic and Racial Differences in Stroke study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>Black and White adults aged\u00a0\u2265\u00a045 years in the United States were enrolled from 2003 to 2007. A second visit was performed from 2013 to 2016. Differences between visits in dietary scores from food frequency questionnaires were associated with subsequent impairment, defined using annual Six\u2010Item Screeners.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>\n                      The dietary change subcohort included 7555 participants. In multivariable Cox models, a 10% increase in ultra\u2010processed food consumption was associated with higher impairment risk (% grams, hazard ratio [HR]\u00a0=\u00a01.24, 95% confidence interval [CI]\u00a0=\u00a01.12\u20131.37,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a00.001; % calories, HR\u00a0=\u00a01.15, 95% CI\u00a0=\u00a01.06\u20131.25,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a00.001). Each 1\u2010point increase in the Mediterranean\u2013Dietary Approaches to Stop Hypertension Intervention for Neurodegenerative Delay diet score was associated with lower impairment risk (HR\u00a0=\u00a00.90, 95% CI\u00a0=\u00a00.85\u20130.96,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.002).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>DISCUSSION<\/jats:title>\n                    <jats:p>Our findings support dietary interventions targeted at preventing cognitive decline.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/dad2.70277","type":"journal-article","created":{"date-parts":[[2026,3,23]],"date-time":"2026-03-23T03:40:00Z","timestamp":1774237200000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Changes in ultra\u2010processed food consumption or MIND diet adherence and cognitive impairment"],"prefix":"10.1002","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4442-3454","authenticated-orcid":false,"given":"Varun M.","family":"Bhave","sequence":"first","affiliation":[{"name":"Harvard Medical School  Boston Massachusetts USA"},{"name":"Department of Anesthesiology Massachusetts General Hospital  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carol R.","family":"Oladele","sequence":"additional","affiliation":[{"name":"Equity Research and Innovation Center Yale School of Medicine  New Haven Connecticut USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan","family":"Duskin","sequence":"additional","affiliation":[{"name":"Center for Genomic Medicine Massachusetts General Hospital  Boston Massachusetts USA"},{"name":"Department of Neurology Massachusetts General Hospital  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amelia","family":"Demopoulos","sequence":"additional","affiliation":[{"name":"Center for Genomic Medicine Massachusetts General Hospital  Boston Massachusetts USA"},{"name":"Department of Neurology Massachusetts General Hospital  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zsuzsanna","family":"Ament","sequence":"additional","affiliation":[{"name":"Center for Genomic Medicine Massachusetts General Hospital  Boston Massachusetts USA"},{"name":"Department of Neurology Massachusetts General Hospital  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana\u2010Lucia Garcia","family":"Guarniz","sequence":"additional","affiliation":[{"name":"Department of Neurology Massachusetts General Hospital  Boston Massachusetts USA"},{"name":"Comprehensive Stroke Center Rhode Island Hospital  Providence Rhode Island USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hemant","family":"Tiwari","sequence":"additional","affiliation":[{"name":"Department of Biostatistics School of Public Health University of Alabama at Birmingham  Birmingham Alabama USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suzanne E.","family":"Judd","sequence":"additional","affiliation":[{"name":"Department of Biostatistics School of Public Health University of Alabama at Birmingham  Birmingham Alabama USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M. 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Taylor","family":"Kimberly","sequence":"additional","affiliation":[{"name":"Harvard Medical School  Boston Massachusetts USA"},{"name":"Center for Genomic Medicine Massachusetts General Hospital  Boston Massachusetts USA"},{"name":"Department of Neurology Massachusetts General Hospital  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,3,22]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1474\u20104422(19)30411\u20109"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0b013e3182904f69"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/ana.23944"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1093\/advances\/nmz054"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jalz.2015.04.011"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamapsychiatry.2023.0800"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jalz.2014.11.009"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000200871"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaneurol.2022.4397"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000209432"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp\u20102012\u2010304792"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamainternmed.2015.1668"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.3945\/an.115.011023"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.lana.2024.100859"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc16\u20100574"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.115.017158"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1613502"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598\u2010024\u201063899\u20108"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1093\/ajcn\/nqab326"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jalz.2018.10.001"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clnu.2020.11.036"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.1159\/000086678"},{"key":"e_1_2_9_24_1","doi-asserted-by":"publisher","DOI":"10.1002\/ana.22385"},{"key":"e_1_2_9_25_1","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kwy253"},{"key":"e_1_2_9_26_1","doi-asserted-by":"publisher","DOI":"10.1080\/13854046.2015.1042524"},{"key":"e_1_2_9_27_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0b013e318236ef23"},{"key":"e_1_2_9_28_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000209817"},{"key":"e_1_2_9_29_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000209808"},{"key":"e_1_2_9_30_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.sleep.2023.09.021"},{"key":"e_1_2_9_31_1","doi-asserted-by":"publisher","DOI":"10.1002\/ana.22432"},{"key":"e_1_2_9_32_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005650\u2010200209000\u201000007"},{"key":"e_1_2_9_33_1","doi-asserted-by":"publisher","DOI":"10.1197\/j.aem.2005.01.017"},{"key":"e_1_2_9_34_1","doi-asserted-by":"publisher","DOI":"10.1017\/S1368980018003762"},{"key":"e_1_2_9_35_1","doi-asserted-by":"publisher","DOI":"10.3389\/fnut.2014.00029"},{"key":"e_1_2_9_36_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.114.014421"},{"key":"e_1_2_9_37_1","doi-asserted-by":"publisher","DOI":"10.1161\/HYPERTENSIONAHA.123.22341"},{"key":"e_1_2_9_38_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2019.3121"},{"key":"e_1_2_9_39_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj\u20102023\u2010078476"},{"key":"e_1_2_9_40_1","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.168.7.713"},{"key":"e_1_2_9_41_1","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.114.007894"},{"key":"e_1_2_9_42_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199711203372102"},{"key":"e_1_2_9_43_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2302368"},{"key":"e_1_2_9_44_1","doi-asserted-by":"publisher","DOI":"10.1093\/ageing\/afae030"},{"key":"e_1_2_9_45_1","doi-asserted-by":"publisher","DOI":"10.1093\/ajcn\/nqx070"},{"key":"e_1_2_9_46_1","doi-asserted-by":"publisher","DOI":"10.1093\/ajcn\/nqab305"},{"key":"e_1_2_9_47_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajcnut.2023.01.015"},{"key":"e_1_2_9_48_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1553\u20102712.2008.00158.x"},{"key":"e_1_2_9_49_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.l1451"},{"key":"e_1_2_9_50_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.tifs.2021.02.059"},{"key":"e_1_2_9_51_1","doi-asserted-by":"publisher","DOI":"10.3945\/jn.115.219634"}],"container-title":["Alzheimer's &amp; 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