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While evidence supports a relationship between higher diet quality and better cognitive outcomes, the association between ultra-processed foods (UPFs) and cognitive function remains underexplored. We examined this association using prospective data from the ASPirin in Reducing Events in the Elderly (ASPREE) study, a cohort of Australian adults aged 70\u00a0years and older. Dietary intake was assessed via a mail-based diet screening questionnaire and categorised according to the Nova classification. Cognitive performance was assessed using the Controlled Oral Word Association Test (COWAT), Symbol Digit Modalities Test (SDMT), Hopkins Verbal Learning Test\u2013Revised (HVLT-R), Modified Mini-Mental State Examination (3MS), and a composite cognitive\n                    <jats:italic>Z<\/jats:italic>\n                    score. Participants were stratified into high UPF (\u2265\u20094 servings\/day) and low UPF (&lt;\u20094 servings\/day). Marginal structural models with inverse probability of treatment weighting estimated associations, adjusting for demographic, lifestyle, and clinical confounders. Among 11,502 participants (3505 high UPF; 7997 low UPF), over a median follow-up of 5.6 (\u00b1\u20092.4) years, higher UPF consumption was associated with poorer performance on the 3MS (mean difference \u20130.28, 95% CI \u20130.52 to \u20130.04), COWAT (\u20130.23, 95% CI \u20130.44 to \u20130.03), SDMT (\u20130.51, 95% CI \u20130.94 to \u20130.08), and the composite\n                    <jats:italic>Z<\/jats:italic>\n                    score (\u20130.04, 95% CI \u20130.07 to \u20130.01), but not HVLT-R (\u20130.12, 95% CI \u20130.26 to 0.02). Higher UPF intake was associated with poorer cognitive performance across multiple domains. These findings support initiatives to reduce UPF exposure as a potential strategy to promote healthy cognitive ageing.\n                  <\/jats:p>","DOI":"10.1007\/s11357-026-02269-w","type":"journal-article","created":{"date-parts":[[2026,5,6]],"date-time":"2026-05-06T00:53:35Z","timestamp":1778028815000},"page":"5149-5160","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The association between ultra-processed food exposure and cognition in older adults"],"prefix":"10.1007","volume":"48","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1907-1066","authenticated-orcid":false,"given":"Sarah","family":"Gauci","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Belayneh","family":"Mengist","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mojtaba","family":"Lotfaliany","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Malcolm","family":"Forbes","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Farzaneh","family":"Asoudeh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deb Junyi","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suzanne G.","family":"Orchard","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alice J.","family":"Owen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Clayton-Chubb","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robyn L.","family":"Woods","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John J.","family":"McNeil","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joanne","family":"Ryan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Berk","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adrienne","family":"O\u2019Neil","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammadreza","family":"Mohebbi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,5,6]]},"reference":[{"key":"2269_CR1","unstructured":"United Nations, Department of Economic and Social Affairs PD (2019). 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Monash University Human Research Ethics Committee and the Alfred Hospital Human Research Ethics Committee approved the ALSOP and ASPREE-XT (Monash 4HRECCF11\/1935\/2011001094 and Alfred HREC 593\/17). All participants provided their written informed consent to participation. The current secondary analysis was approved by the Monash University Human Research Ethics Committee.","order":1,"name":"Ethics","label":"Ethics approval and consent to participate","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"S.G. and A.O. are affiliated with the Food & Mood Centre, Deakin University, which has received research funding support from Be Fit Food, Bega Dairy and Drinks, and the a2 Milk Company and philanthropic research funding support from the Waterloo.Foundation, Wilson Foundation, the JTM Foundation, the Serp Hills Foundation, the Roberts Family Foundation, and the Fernwood Foundation. The authors report no other conflicts of interest.During the preparation of this work, the authors used OpenAI ChatGPT in order to help with editing and improve the readability of the manuscript. After using this tool, the authors reviewed and edited the content as needed and take full responsibility for the content of the publication.","order":2,"name":"Ethics","label":"Conflict of interest","group":{"name":"EthicsHeading","label":"Declarations"}}]}}