Anthropometric Status, Dietary Diversity, and Diet Quality in Relation to Cognitive Performance in Older Turkish Adults: A Cross-Sectional Study

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Abstract
Background/Objectives: The increasing incidence of mild cognitive impairment and dementia in older adults are crucial for cognitive impairment. This study aimed to examine the relationships between anthropometric status, dietary diversity, dietary quality, and cognitive performance in older adults. Methods: This single-center cross-sectional study included 117 older adults. Anthropometric measurements were performed. Dietary Diversity Score (DDS), Healthy Eating Index-2020 (HEI-2020), 24-hour dietary recall and Montreal Cognitive Assessment (MoCA) were used. We used hierarchical multiple linear regression analysis. Results: 53.0% of the participants were in the group of possible mild cognitive impairment (MCI). Participants in the probable MCI group had a higher body mass index (BMI) compared to those with normal cogni-tive performance (32.67 ± 5.78 and 29.54 ± 3.39 kg/m²; p < 0.001) and a higher prevalence of obesity (62.9% and 41.8%; p = 0.027). The final regression model explained 23.6% of the variance in MoCA scores (R² = 0.236; adjusted R² = 0.194; p < 0.001). More years of edu-cation were associated with higher MoCA scores (B = 0.795, β = 0.375, p < 0.001), while higher BMI was associated with lower MoCA scores (B = −0.282, β = −0.225, p = 0.016). Conclusions: Higher BMI was found to be associated with lower cognitive performance in older adults. However, DDS and HEI-2020 scores were not associated with cognitive performance. Longitudinal studies including repeated nutritional assessments are needed to clarify the direction and temporal pattern of these relationships.

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