Abstract Body: Background: Interventions to slow post-stroke cognitive impairment and dementia (PSCID) are currently limited. Nutrition is a potent modifiable risk factor for vascular health as well as cognition. While the Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND) diet is associated with reduced cognitive decline in older adults, its effect on cognition has not been established post-stroke.
Study features: 1) MIND diet as an intervention, testing for effects on post-stroke cognition over time; 2) 90 days of delivered MIND diet meals with dietary counseling plus post-stroke care in parallel with 90 days of usual meals plus post-stroke care; 3) MRI scans of brain structure and volume 4) nutritional and cerebrovascular brain health biomarkers.
Objective: Test if adherence to the MIND diet through a personalized lifestyle intervention will reduce PSCID.
Design: A phase III randomized controlled trial to test the effect of the MIND diet on delaying cognitive decline in acute ischemic stroke survivors over 2 to 3 years. At each visit, all participants complete a detailed cognitive assessment, as well as a series of anthropometric measurements, stroke specific surveys, blood and urine sample collection. A subgroup receives a baseline MRI and a follow up MRI at year two.
Population studied: Acute ischemic stroke survivors, aged 55 years (inclusive) and older, discharged to home from three (3) Chicago hospital systems.
Intervention: Participants are randomized to one of two study interventions, both using individual video/phone sessions via the Zoom platform. The comparator condition, “Self,” allows participants to adopt a primarily self-guided approach post-stroke care with enhancements in nutrition education and intermittent support. The treatment condition, “Coach,” provides participants with high levels of support, accountability, and behavioral coaching towards achieving MIND dietary goals.
Outcome: Change in cognitive function as measured by a global cognitive measure comprised of 19 cognitive tests.
Analyses: Recruitment commenced 11/30/2021. 238 participants have been randomized to date (mean age= 68.6, SD 8.1; 56.3% female; 61.0% African Americans, 8.0% Hispanic; mean years of education 14.2, 3.3 SD; mean BMI 31, SD 6.6; 84% hypertensive; mean NIHSS = 1.5, SD 2.5; mean MIND diet screening score = 7.3, 1.9 SD; mean screening MoCA score = 21.6, 4.5 SD)
Conclusion: Results from the study will be unique to inform dietary guidelines to prevent PSCID.