The MIND Diet and Physical Activity in Cognitive Ageing: From Mechanisms to Multidomain Trials

Preserving cognitive function against the effects of ageing and neurodegenerative disease is the goal of lifestyle-based approaches to brain health. This review examines the evidence for the Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND) diet, for physical activity covering aerobic, resistance, and mind–body exercise modalities, and for the multidomain programmes in which both are embedded. For each, we consider the mechanistic rationale, the biomarker, neuroimaging, and the observational and interventional evidence. Overall, a substantial body of evidence links both exposures to better cognitive performance; however, uncertainties remain regarding optimal intervention dose, duration, target populations, and whether MIND diet and exercise exert independent or synergistic effects. We further propose that the discordance between cohort and trial findings may reflect baseline neurodegenerative risk, with benefit being hardest to detect in low-risk populations over short follow-up. Few trials have tested the MIND dietary pattern change alongside structured exercise, and none has isolated the contribution of either within a multidomain programme. More strategically designed trials, with clinical endpoints and single domain comparators, are needed to answer these questions.