Aims: The PROMED-COG project aims to (i) increase knowledge on the balance between the Mediterranean diet (MedDiet) and physical activity for prevention of undernutrition and promotion of healthy neurocognitive ageing, (ii) generate data on the mechanistic pathways by which the MedDiet and exercise may act to influence nutritional status and cognition, and, (iii) produce evidence-based lifestyle guidelines for prevention of undernutrition and, specifically, the promotion of healthy neurocognitive ageing in older adults. Workplan: The project will use robust statistical methods to pool epidemiologic data from four Italian cohorts to enable us to; 1) identify determinants of undernutrition, 2) provide improved estimates of exposure to undernutrition and weight loss from mid to later life on cognitive decline and dementia, 3) provide improved estimates of exposure to MedDiet and physical activity on MRI-Brain biomarkers, cognitive decline and dementia, and, 4) explore influences of sex and genetic risk on associations. Findings will inform the design of a randomised controlled trial to evaluate the effect of a protein enriched MedDiet and exercise intervention on nutritional status and cognitive performance in older undernourished adults. Across studies, we will use state of the art metabolomics and biomarker assessment to uncover biological mechanisms underlying how MedDiet can influence nutrition status and neurocognitive ageing, and how physical activity interacts with nutrition to influence these processes. Expected impact: The PROMED-COG project will provide new and critical insight into the role of undernutrition in neurocognitive ageing, how these effects can differ by sex, genetic risk and timing of exposure, and how modifications of dietary and physical activity behaviour can act to reduce the burden of undernutrition and neurodegeneration. The resulting scientific knowledge will be translated into public and practice recommendations to prevent undernutrition for healthy neurocognitive ageing in older European citizens. This research will also be useful to public health bodies to inform policy and practice about the dietary guidelines of older people, and industry to inform the development of food-based solutions to prevent undernutrition and increase healthy life years.
