Author Identifier (ORCID)
Abstract
Background: Preventive strategies, including adherence to specific dietary patterns, have received increasing attention as approaches to reduce cognitive decline and dementia risk. However, findings remain inconsistent, partly due to differences in dietary assessment methods, cognitive outcomes, and THE consideration of genetic susceptibility factors such as apolipoprotein E (APOE) genotype.
Methods: This study examined associations between dietary patterns and longitudinal cognitive change in 185 older adults without dementia from the Western Australia Memory Study. Participants completed a food frequency questionnaire at baseline and underwent comprehensive neuropsychological assessments at baseline and up to five follow-up visits at 18-month intervals. Composite scores were generated for six cognitive domains and the Preclinical Alzheimer’s Cognitive Composite (PACC).
Results: Western and Prudent dietary pattern scores were analysed using linear mixed-effects models stratified by APOE ε4 carrier status. Among APOE ε4 carriers, greater adherence to a Western dietary pattern was associated with a faster decline in attention (p = 0.016), whereas no significant associations were observed for the Prudent dietary pattern or among APOE ε4 non-carriers. This association was attenuated after excluding participants with possible baseline cognitive impairment (MoCA < 23).
Conclusion: These findings suggest that adherence to a Western dietary pattern may accelerate cognitive decline in individuals genetically at risk for Alzheimer’s disease, highlighting the importance of considering gene–diet interactions when developing dietary strategies for dementia prevention.
Keywords
Alzheimer’s disease, APOE ε4 genotype, attention, cognition, cognitive decline, dietary patterns
Document Type
Journal Article
Date of Publication
8-1-2026
Article Number
2592
E-ISSN
20726643
Volume
18
Issue
16
PubMed ID
42654172
Publication Title
Nutrients
Publisher
MDPI
School
School of Medical and Health Sciences
Funding Information
R.L.L. is supported by the Department of Jobs, Tourism, Science and Innovation, Government of Western Australia, through the Premier’s Science Fellowship Program.
Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 License.
Recommended Citation
Castro, C. B., Gardener, S. L., Jahan, F., Chen, J., Brown, B. M., Loo, R. L., Taddei, K., Rainey-Smith, S. R., Weinborn, M., Reis, A. C. R. D., Garg, M. L., Martins, R. N., & Sohrabi, H. R. (2026). Dietary patterns and cognitive decline in older adults: Findings from the Western Australia Memory Study. Nutrients, 18(16). https://doi.org/10.3390/nu18162592