{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,6]],"date-time":"2026-04-06T15:00:10Z","timestamp":1775487610521,"version":"3.50.1"},"reference-count":48,"publisher":"MDPI AG","issue":"22","license":[{"start":{"date-parts":[[2025,11,15]],"date-time":"2025-11-15T00:00:00Z","timestamp":1763164800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"FCT\u2014Funda\u00e7\u00e3o para a Ci\u00eancia e a Tecnologia, I.P.","award":["UID\/4750\/2025"],"award-info":[{"award-number":["UID\/4750\/2025"]}]},{"name":"FCT\u2014Funda\u00e7\u00e3o para a Ci\u00eancia e a Tecnologia, I.P.","award":["LA\/P\/0064\/2020"],"award-info":[{"award-number":["LA\/P\/0064\/2020"]}]},{"name":"FCT\u2014Funda\u00e7\u00e3o para a Ci\u00eancia e a Tecnologia, I.P.","award":["2022.03483.CEECIND\/CP1732\/CT0002"],"award-info":[{"award-number":["2022.03483.CEECIND\/CP1732\/CT0002"]}]},{"name":"FCT\u2014Funda\u00e7\u00e3o para a Ci\u00eancia e a Tecnologia, I.P.","award":["2022.13658.BD"],"award-info":[{"award-number":["2022.13658.BD"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Introduction: The Mediterranean diet (MD) has been linked to better cognition, but evidence in older adults at high dementia risk is limited. Moreover, the traditional Mediterranean Diet Adherence Screener (MEDAS) counts daily wine consumption as a beneficial component, which may distort genuine diet\u2013cognition relationships. Objective: Evaluate whether MD adherence, as measured with the original MEDAS (MEDAS-O) versus a version that reverses the wine item (MEDAS-R), is associated with cognitive function in Portuguese adults aged 55\u201385 years at increased dementia risk. Methodology: The sample comprised 75 participants from the NUTRIMIND randomised controlled trial (mean age 70.5 \u00b1 7.0 years). MD adherence was evaluated using the original version of MEDAS (MEDAS-O) and an adapted version with a reverse score in the wine question (MEDAS-R). Cognitive function was assessed via the Montreal Cognitive Assessment (MoCA), Addenbrooke\u2019s Cognitive Examination Revised (ACE-R) and Mini-Mental State Examination (MMSE). Statistical analysis was performed using Analysis of Covariance (ANCOVA) models adjusted for age, sex, BMI, education, and physical activity. Results: MEDAS-R was positively associated with better MMSE performance (p = 0.043) and showed a borderline association with the MoCA (p = 0.051), but not with the ACE-R score (p = 0.356). No association was found between MEDAS-O and cognitive function. Better cognitive scores were more frequently observed among participants with higher education (p &lt; 0.001). Conclusions: Reversing the wine item changes how MEDAS relates to cognitive function. These findings support re-evaluating how wine is scored in MD adherence measures.<\/jats:p>","DOI":"10.3390\/nu17223576","type":"journal-article","created":{"date-parts":[[2025,11,18]],"date-time":"2025-11-18T11:05:31Z","timestamp":1763463931000},"page":"3576","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Challenging the Wine Component in Mediterranean Diet Scores: Cognitive Outcomes in Portuguese Adults at High Risk of Dementia"],"prefix":"10.3390","volume":"17","author":[{"given":"Andreia","family":"Mesquita","sequence":"first","affiliation":[{"name":"Faculty of Nutrition and Food Sciences, University of Porto, 4150-180 Porto, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2501-8974","authenticated-orcid":false,"given":"Daniela de","family":"Sousa","sequence":"additional","affiliation":[{"name":"EPIUnit ITR, Institute of Public Health of the University of Porto, University of Porto, Rua das Taipas, n.\u00b0 135, 4050-600 Porto, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6310-4956","authenticated-orcid":false,"given":"Patr\u00edcia","family":"Padr\u00e3o","sequence":"additional","affiliation":[{"name":"Faculty of Nutrition and Food Sciences, University of Porto, 4150-180 Porto, Portugal"},{"name":"EPIUnit ITR, Institute of Public Health of the University of Porto, University of Porto, Rua das Taipas, n.\u00b0 135, 4050-600 Porto, Portugal"}]},{"given":"Ana Rute","family":"Costa","sequence":"additional","affiliation":[{"name":"EPIUnit ITR, Institute of Public Health of the University of Porto, University of Porto, Rua das Taipas, n.\u00b0 135, 4050-600 Porto, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7035-7799","authenticated-orcid":false,"given":"Pedro","family":"Moreira","sequence":"additional","affiliation":[{"name":"Faculty of Nutrition and Food Sciences, University of Porto, 4150-180 Porto, Portugal"},{"name":"EPIUnit ITR, Institute of Public Health of the University of Porto, University of Porto, Rua das Taipas, n.\u00b0 135, 4050-600 Porto, Portugal"}]}],"member":"1968","published-online":{"date-parts":[[2025,11,15]]},"reference":[{"key":"ref_1","first-page":"E36","article-title":"Modern vision of the Mediterranean diet","volume":"63","author":"Kiani","year":"2022","journal-title":"J. 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