Evidence map›Paper›PMID 39797935›Full record

SynthesisGeroScience2025

The role of the Mediterranean diet in reducing the risk of cognitive impairement, dementia, and Alzheimer's disease: a meta-analysis.

Mónika Fekete, Péter Varga, Zoltan Ungvari, János Tibor Fekete, Annamaria Buda, Ágnes Szappanos, Andrea Lehoczki, Noémi Mózes, Giuseppe Grosso, Justyna Godos and 6 more

Abstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in GeroScience, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 96 papers, 5 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
96citing papers in PubMed, 5 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

96 citing papers in PubMed, 5 syntheses or guidelines pooled it.

  1. Pooled it
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  6. Trial
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  8. Review
  9. Article
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  12. From adolescence to Alzheimer's: a neurodevelopmental lifespan model of cognitive vulnerability.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2026
    Review
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  16. A Short Questionnaire for Evaluating Mediterranean Diet Adherence and Nutritional Sustainability: Validation in Turkish Adults.Journal of human nutrition and dietetics : the official journal of the British Dietetic Association · 2026
    Article
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  19. Article
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36 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

16 authors.

Mónika Fekete *Institute of Preventive Medicine and Public Health, Semmelweis University, Budapest, Hungary.
Péter Varga *Institute of Preventive Medicine and Public Health, Semmelweis University, Budapest, Hungary.
Zoltan Ungvari *Vascular Cognitive Impairment, Neurodegeneration and Healthy Brain Aging Program, Department of Neurosurgery, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA.
János Tibor FeketeDept. of Bioinformatics, Semmelweis University, 1094, Budapest, Hungary.
Annamaria BudaInstitute of Preventive Medicine and Public Health, Semmelweis University, Budapest, Hungary.
Ágnes SzappanosDepartment of Vascular and Endovascular Surgery, Heart and Vascular Center, Semmelweis University, Budapest, Hungary.
Andrea LehoczkiInstitute of Preventive Medicine and Public Health, Semmelweis University, Budapest, Hungary.
Noémi MózesInstitute of Preventive Medicine and Public Health, Semmelweis University, Budapest, Hungary.
Giuseppe GrossoDepartment of Biomedical and Biotechnological Sciences, University of Catania, Catania, Italy.
Justyna GodosDepartment of Biomedical and Biotechnological Sciences, University of Catania, Catania, Italy.
Otilia MenyhartDept. of Bioinformatics, Semmelweis University, 1094, Budapest, Hungary.
Gyöngyi MunkácsyDept. of Bioinformatics, Semmelweis University, 1094, Budapest, Hungary.
Stefano TarantiniVascular Cognitive Impairment, Neurodegeneration and Healthy Brain Aging Program, Department of Neurosurgery, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA.
Andriy YabluchanskiyVascular Cognitive Impairment, Neurodegeneration and Healthy Brain Aging Program, Department of Neurosurgery, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA.
Anna UngvariInstitute of Preventive Medicine and Public Health, Semmelweis University, Budapest, Hungary. Ungann2004@gmail.com.ORCID 0009-0001-5053-2828
Balázs GyőrffyDept. of Bioinformatics, Semmelweis University, 1094, Budapest, Hungary.

Funding

Cerebral microhemorrhages and gait dysfunction in agingR01AG055395 · NIA · UNIVERSITY OF OKLAHOMA HLTH SCIENCES CTR · PI CSISZAR, ANNA · 2017 to 2025
$2.3M
Age-related vascular cognitive impairment: role of endothelial senescenceR01AG068295 · NIA · UNIVERSITY OF OKLAHOMA HLTH SCIENCES CTR · PI CSISZAR, ANNA, UNGVARI, ZOLTAN ISTVAN · 2020 to 2024
$1.8M
The role of IGF-1 signaling in vascular smooth muscle cells in age-related vascular cognitive impairment and dementiaR01AG070915 · NIA · UNIVERSITY OF OKLAHOMA HLTH SCIENCES CTR · PI CONLEY, SHANNON M · 2021 to 2025
$1.8M
Radiation-induced astrocyte dysfunction and cognitive declineR01NS100782 · NINDS · UNIVERSITY OF OKLAHOMA HLTH SCIENCES CTR · PI UNGVARI, ZOLTAN ISTVAN · 2018 to 2022
$1.7M
Chemotherapy-induced vascular cognitive impairment: role of endothelial senescenceR01CA255840 · NCI · UNIVERSITY OF OKLAHOMA HLTH SCIENCES CTR · PI CSISZAR, ANNA · 2021 to 2025
$1.6M
Cerebromicrovascular rejuvenation by heterochronic blood exchangeRF1AG072295 · NIA · UNIVERSITY OF OKLAHOMA HLTH SCIENCES CTR · PI CSISZAR, ANNA, UNGVARI, ZOLTAN ISTVAN · 2021 to 2021
$1.4M
NCI NIH HHS R01 CA255840NIA NIH HHS R01 AG055395NIA NIH HHS R01 AG068295NIA NIH HHS R01 AG070915NIA NIH HHS RF1 AG072295NINDS NIH HHS R01 NS100782
6 · The paper itself

Abstract

Age-related cognitive impairment and dementia pose a significant global health, social, and economic challenge. While Alzheimer's disease (AD) has historically been viewed as the leading cause of dementia, recent evidence reveals the considerable impact of vascular cognitive impairment and dementia (VCID), which now accounts for nearly half of all dementia cases. The Mediterranean diet-characterized by high consumption of fruits, vegetables, whole grains, fish, and olive oil-has been widely recognized for its cardiovascular benefits and may also reduce the risk of cognitive decline and dementia. To investigate the protective effects of the Mediterranean diet on cognitive health, we conducted a systematic literature review using PubMed, Web of Science, and Google Scholar, focusing on studies published between 2000 and 2024. The studies included in the meta-nalysis examined the adherence to the Mediterranean diet and the incidence of dementia and AD. We applied a random-effects model to calculate pooled hazard ratios (HRs) with 95% confidence intervals (CIs) and assessed heterogeneity through I-square statistics. Forest plots, funnel plots, and Z-score plots were used to visualize study outcomes. Of the 324 full-text records reviewed, 23 studies met the inclusion criteria. The combined HR for cognitive impairment among those adhering to the Mediterranean diet was 0.82 (95% CI 0.75-0.89); for dementia, the HR was 0.89 (95% CI 0.83-0.95); and for AD, the HR was 0.70 (95% CI 0.60-0.82), indicating substantial protective effects. Significant heterogeneity was observed across studies, though Z-score plots suggested sufficient sample sizes to support reliable conclusions for each condition. In conclusion, this meta-analysis confirms that adherence to the Mediterranean diet is associated with an 11-30% reduction in the risk of age-related cognitive disorders, including cognitive impairment, dementia, and AD. These findings underscore the Mediterranean diet's potential as a central element in neuroprotective public health strategies to mitigate the global impact of cognitive decline and dementia and to promote healthier cognitive aging.

Indexed as

Alzheimer DiseaseCognitive DysfunctionDementiaDiet, MediterraneanAgedHumansCognitive declineNeurodegenerative diseasesNutritional epidemiologyPharmacologyPrevention

Identifiers

PMID39797935
PMCPMC12181514

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.