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Socioeconomic status modifies the association between adherence to the Mediterranean diet and cognitive outcomes: results from the Collaborative PROMED-COG Pooled Cohorts Study
Federica Prinelli, Marianna Noale, Silvia Conti, Adele Ravelli, Giuseppe Sergi, Stefania Maggi, Chiara Ceolin, Lorraine Brennan et al.. Social Psychiatry and Psychiatric Epidemiology, 2025-09-29
Topic: Risk, prevention and care in population studies
Cognitive decline occurred in 38.1% of participants but was not associated with MD adherence. In SES-stratified analysis, among high SES individuals, each 2-point increase in MD adherence reduced cognitive decline risk by 14%, and high MD adherence was associated with a 48% reduction (HR 0.52, 95%CI 0.31-0.90). In this group, medium MedEx adherence reduced cognitive decline risk by 77% (HR 0.23, 95%CI 0.07-0.83). No significant association was found between MD/MedEx adherence and incident dementia (4.2%), regardless of SES. SES may modify the relationship between MD and cognitive decline, with greater benefits observed in higher SES groups. Further studies, particularly in vulnerable populations, are needed to inform tailored preventive strategies for cognitive decline.
Key findings
- Cognitive decline occurred in 38.1% of participants but was not associated with MD adherence.
- In SES-stratified analysis, among high SES individuals, each 2-point increase in MD adherence reduced cognitive decline risk by 14%, and high MD adherence was associated with a 48% reduction (HR 0.52, 95%CI 0.31-0.90).
- In this group, medium MedEx adherence reduced cognitive decline risk by 77% (HR 0.23, 95%CI 0.07-0.83).
- No significant association was found between MD/MedEx adherence and incident dementia (4.2%), regardless of SES.
- SES may modify the relationship between MD and cognitive decline, with greater benefits observed in higher SES groups.
Why it matters
In this pooled cohort study, Mediterranean diet adherence was not associated with cognitive decline overall, but among high socioeconomic status individuals it was linked to reduced cognitive decline risk. No significant association was found between diet adherence and incident dementia regardless of socioeconomic status.
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Study details
- Participants8,568
- Effect size52.4%; 38.1%; HR 0.52
- Evidence strengthLow
How this study scored 46/100
Published in a peer-reviewed journal. Scored zero for study design and randomised / blinded because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (Social Psychiatry and Psychiatric Epidemiology) |
| Journal's citation record | 2 / 4 | Social Psychiatry and Psychiatric Epidemiology: journal h-index 200 (OpenAlex, 2026-10-29) |
| Study design | 0 / 12 | No study design recorded — scores zero, not guessed (not stated in the record — scored 0) |
| Strength of evidence | 1 / 5 | Rated “low” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 4 / 5 | 2025 — within 3 year(s) of the newest study here |
| Sample size | 3 / 4 | 8,568 participants |
| Effect reported | 3 / 3 | Effect reported with a statistic (interval, p-value, ratio or similar) |
| Studied in people | 3 / 3 | Studied in people (participant count stated) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 1 / 7 | Cited 1 times (OpenAlex, 2026-10-10) |
| Citations per year | 0 / 5 | 0.3 citations a year over 3 year(s) since 2025 |
| Impact for its field and year | 1 / 6 | Cited 0.8× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 0 / 6 | No other study in this library cites it |
| Still being cited | 0 / 4 | Cited 1 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 3 / 4 | Last-listed author Dorothee Volkert: h-index 58 (OpenAlex, whole career) |
| Institution's track record | 2 / 3 | University of California, San Francisco: institution h-index 1,915 (OpenAlex) |
| Multi-centre collaboration | 2 / 3 | OpenAlex lists 9 institution(s) in 5 countries |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 41023206) |
| Free to read | 2 / 2 | Free to read |
| Total | 46 / 100 | — |
What each of these 20 components measures, and what this score is not →
Read the original
- DOI: 10.1007/s00127-025-02993-2
- PubMed: 41023206
- Original source →
- Free full text: Social Psychiatry and Psychiatric Epidemiology →
Full text: free to read — OpenAlex lists this copy as free to read: the link above (checked 6 Feb 1020).
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. The record's author list ends in “et al.”, so not every author is named. Check the citation against the original before you use it.
APA 7th
Prinelli, F., Noale, M., Conti, S., Ravelli, A., Sergi, G., Maggi, S., et al. (2025). Socioeconomic status modifies the association between adherence to the Mediterranean diet and cognitive outcomes: results from the Collaborative PROMED-COG Pooled Cohorts Study. Social Psychiatry and Psychiatric Epidemiology. https://doi.org/10.1007/s00127-025-02993-2
Vancouver
Prinelli F, Noale M, Conti S, Ravelli A, Sergi G, Maggi S, et al. Socioeconomic status modifies the association between adherence to the Mediterranean diet and cognitive outcomes: results from the Collaborative PROMED-COG Pooled Cohorts Study. Social Psychiatry and Psychiatric Epidemiology. 2025. doi:10.1007/s00127-025-02993-2. PMID: 41023206.
BibTeX
@article{prinelli2025-41023206,
author = {Prinelli, Federica and Noale, Marianna and Conti, Silvia and Ravelli, Adele and Sergi, Giuseppe and Maggi, Stefania and Ceolin, Chiara and Brennan, Lorraine and others},
title = {{Socioeconomic status modifies the association between adherence to the Mediterranean diet and cognitive outcomes: results from the Collaborative PROMED-COG Pooled Cohorts Study}},
journal = {Social Psychiatry and Psychiatric Epidemiology},
year = {2025},
doi = {10.1007/s00127-025-02993-2},
pmid = {41023206},
url = {https://doi.org/10.1007/s00127-025-02993-2}
}
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