Association between dietary nutrient density patterns and cognitive function: A latent class analysis of NHANES 2011–2014

BackgroundAlzheimer's disease (AD) and cognitive decline are major global health challenges. The impact of dietary nutrient density, particularly in the context of ultra-processed, fortified foods, on cognitive function remains uncertain.ObjectiveTo examine associations between dietary nutrient density patterns and cognitive performance in U.S. older adults and to evaluate effect modification by key subgroups.MethodsWe analyzed data from 2991 adults aged ≥60 years in NHANES 2011-2014. Nutrient density patterns were derived by latent class analysis of 24-h dietary recalls. Cognitive function was assessed with the CERAD Word Learning, Animal Fluency, and Digit Symbol Substitution Tests. Multivariable linear regression estimated associations between nutrient density patterns and cognitive scores, adjusting for sociodemographic, lifestyle, and clinical factors; stratified analyses assessed effect modification.ResultsFour distinct nutrient density patterns were identified. A High-Nutrient, Ultra-Processed pattern, characterized by high intake of processed foods and relatively lower plant-based nutrients, was associated with poorer cognitive performance, particularly on memory tasks (β = -0.43, p = 0.018), and these associations persisted after full adjustment. Associations were stronger among participants with hypertension or diabetes.ConclusionsDietary nutrient density patterns are independently associated with cognitive function in older adults, with ultra-processed, fortified dietary profiles linked to worse performance, especially in those with cardiometabolic conditions. Targeted dietary strategies that emphasize nutrient-dense, minimally processed foods may help preserve cognitive health in vulnerable subgroups.