Associations between cMIND diet, mold exposure, and visual impairment among older adults in China: a national cross-sectional study.

Background: Visual impairment poses a major challenge to healthy ageing, and its occurrence may be related to both dietary factors and the indoor environment. However, evidence regarding the associations of the Chinese version of the Mediterranean-Dietary Approaches to Stop Hypertension Intervention for Neurodegenerative Delay (cMIND) diet and mold exposure with visual impairment remains limited. Methods: This study included 14031 participants aged ≥ 65 years from the 2018 wave of the Chinese Longitudinal Healthy Longevity Survey (CLHLS). The cMIND diet score was calculated based on a validated questionnaire, and mold exposure was defined based on self-reported frequent perception of musty odors at home. Visual impairment was defined based on responses to a visual function assessment. We used multivariable logistic regression analyses to assess the independent and joint associations of the cMIND diet and mold exposure with visual impairment. Results: Among the participants, the median age was 85.00 years, and 35.97% had visual impairment. For every 1-point increase in the cMIND diet score, lower odds of visual impairment were observed (OR = 0.91, 95% CI: 0.88-0.94), whereas mold exposure was associated with higher odds (OR = 1.19, 95% CI: 1.04-1.35). A linear inverse association was observed between the cMIND diet score and visual impairment. Joint analysis showed the highest odds of visual impairment among participants with both low cMIND diet scores and mold exposure (OR = 1.68, 95% CI: 1.38-2.05). Findings were robust in sensitivity analyses. Conclusion: Independent and joint associations of the cMIND diet and mold exposure with visual impairment were observed among older adults, highlighting the potential importance of dietary and indoor environmental factors for visual health.