Anti-inflammatory dietary patterns and cognitive aging in older adults: a scoping review of mechanistic, clinical, and nursing implications

Background Dietary patterns with lower inflammatory potential may support cognitive aging, but Mediterranean, Dietary Approaches to Stop Hypertension (DASH), Mediterranean–DASH Intervention for Neurodegenerative Delay (MIND), and dietary inflammatory scores represent non-equivalent exposures, and observational findings have not been consistently confirmed in randomized trials. This scoping review mapped evidence linking whole-diet patterns and dietary inflammatory indices with cognitive aging, measured biological pathways, and clinical interpretation and potential nursing implications. Methods PubMed, Embase, Web of Science Core Collection, and Scopus were searched from inception to 30 June 2026. Eligible studies evaluated dietary patterns or validated inflammatory indices in older adults or cohorts assessed in later life and reported cognitive, dementia, mechanistic, neuroimaging, neuropathological, or implementation outcomes. Evidence was synthesized narratively, with observational and interventional findings considered separately. Results Thirty-eight reports were included: 27 longitudinal observational studies, seven randomized intervention reports, three cross-sectional biomarker or neuroimaging studies, and one post hoc analysis. Mediterranean- and MIND-oriented patterns and lower dietary inflammatory potential were recurrently associated with more favorable cognitive outcomes, but findings varied across definitions, populations, measures, and follow-up. Randomized evidence was mixed and not definitive. Fourteen reports measured inflammatory, proteomic, microbiome, neuroimaging, cerebrospinal-fluid, spectroscopy, or neuropathological outcomes, supporting selected biological links without establishing a complete diet-neuroinflammation-cognition pathway. No study evaluated a complete nurse-led or nurse-supported dietary pathway; the nursing framework is author-derived and untested. Conclusion The evidence is epidemiologically suggestive and biologically plausible, but does not establish that any specific diet prevents dementia. Dietary improvement may be incorporated into individualized multidomain risk reduction, provided that nutritional adequacy, frailty, cultural fit, affordability, and sustained adherence are addressed. Better-contrasted trials, temporally ordered mechanistic studies, and prospective implementation evaluations are needed.