Association between the Chinese version of the Mediterranean-DASH intervention for Neurodegenerative Delay diet and BADL/IADL disability among older adults in China: a nationwide survey

Abstract

Disability is a major challenge affecting older adults’ quality of life. Although the Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND) diet has been shown to protect against functional disability in Western populations, its applicability across different cultural and diet contexts remains insufficiently validated. Therefore, this study aimed to investigate the association between the Chinese MIND (cMIND) diet and Basic/Instrumental Activities of Daily Living (BADL/IADL) disability. Methods: Using cross-sectional data from the 2018 Chinese Longitudinal Healthy Longevity Survey (CLHLS), cMIND scores were categorized into Q1 (0–4), Q2 (4–5), Q3 (5–6.5), and Q4 (≥ 6.5). Potential confounders were identified using a directed acyclic graph (DAG). Logistic regression was employed to analyze the association between the cMIND diet and BADL/IADL disability. Restricted Cubic Splines (RCS) were used to assess linearity, alongside subgroup, interaction, and sensitivity analysis. Results: Among 9,511 participants, the prevalence of disability in BADL and IADL was 23.74% and 57.95%, respectively. In logistic regression, participants with a cMIND diet score in Q2 compared to those in Q1 had lower odds of BADL disability (OR = 0.821, 95% CI: 0.676–0.999), and participants with a cMIND diet score in Q2-Q4 compared to those in Q1 had lower odds of IADL disability. Subgroup analysis revealed heterogeneous associations across different populations. Conclusion: Among Chinese adults aged ≥ 65 years, the cMIND diet Q2 group was significantly associated with BADL disability, while the overall cMIND diet was significantly associated with IADL disability, supporting its potential role in promoting functional independence during aging.