Editors' note: Dietary patterns during adulthood and cognitive performance in midlife: The CARDIA study

In “Dietary patterns during adulthood and cognitive performance in midlife,” McEvoy et al. assessed the relationship between dietary patterns and cognitive function over a 30-year period and found that greater adherence to the Mediterranean diet (MedDiet) and A Priori Diet Quality Score (APDQS) in early adulthood was associated with better midlife cognitive performance. Muñoz-Garcia et al. complimented the authors on their use of multiple dietary questionnaires, long-term follow-up, and serial cognitive evaluations and recommended ongoing follow-up to assess cognitive function beyond middle age. However, they question the use of a cutoff of 20 on the Montreal Cognitive Assessment (MoCA), given that the literature describes a cutoff of 24/25/26. McEvoy responded that 21 was selected as the MoCA cutoff because it is one standard deviation below the sample mean MoCA of 24. The author further notes that 45% of the study cohort was black and that previous studies found the mean MoCA in black middle-aged adults in the United States to be between 19.8 and 22. In an editor’s comment on behalf of the Equity, Diversity, and Inclusion Committee, Hamilton emphasizes that performance on tests such as the MoCA may relate to a number of social factors, such as quality of education, rather than to a biological difference among persons of different racial or ethnic backgrounds.

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