- Email: [email protected]
Tea, coffee and cognitive decline in the elderly: The Cardiovascular Health Study
S82
Oral O1-06: Epidemiology: Diet and Intervention
and the Aging Brain, Columbia University Medical Center, New York, NY, USA; 2Department of Neurology, Columbia University Medical Center, New York, NY, USA; 3Clinical Research Center, Helen Hayes Hospital, West Haverstraw, NY, USA; 4Department of Epidemiology, Columbia University, New York, NY, USA; 5Department of Medicine, Columbia University Medical Center, New York, NY, USA; 6Department of Neurology and Imaging of Dementia and Aging Laboratory, Center for Neuroscience, University of California, Sacramento, Sacramento, CA, USA; 7Gertrude H. Sergievsky Center, Columbia University Medical Center, New York, NY, USA. Contact e-mail: [email protected] Background: Previous studies have shown associations between hippocampal atrophy and aging, mild cognitive impairment (MCI) and Alzheimer disease (AD), but little is known about the relation between hippocampal volume and dietary habits. Methods: High-resolution structural magnetic resonance imaging (MRI) was collected on 603 non-demented community elderly participants of the Washington Heights-Inwood Columbia Aging Project imaging sub-study with available dietary assessments administered at the same visit. Hippocampal volume was adjusted for total cranial volume. The Petersen criteria were used to define MCI. Using ReducedRank Regression (RRR) we examined whether dietary patterns (DP; linear combinations of 33 food groups) could explain variability of relative hippocampal volume. We then examined potential associations of the hippocampal volume-related DP with cognitive performance (4 cognitive domain z-scores derived from a comprehensive neuropsychological battery) and with odds of MCI (n ¼ 139). Models were adjusted for age, gender, ethnicity and education. Further adjustment for caloric intake, BMI, APOE-e4, smoking status, and comorbid diseases did not change the associations materially. Results: We identified a DP that was positively correlated with hippocampal volume (r ¼ 0.24, p < 0.0001; 5.8% of variability explained), and was characterized by higher intakes of eggs, grains, tomato, fish, nuts, salad dressing, cold cereal and coffee; and lower intakes of snack, tea, processed meat, and cruciferous vegetables. Subjects adhering more to this DP tended to have better memory performance: mean memory z-scores among the lowest, middle, and highest tertiles of the DP Score were -0.02, 0.20, and 0.20, respectively (p for trend ¼ 0.001, adjusted regression model with DP tertiles entered as an ordinal variable). No association was found between the DP and other cognitive domain z-scores. Adjusted logistic regression analysis showed that, compared to the lowest DP score tertile, the prevalence odds ratios (95%CI) of amnestic MCI for the middle and highest DP tertiles were 0.27(0.12-0.60) and 0.25(0.11-0.57), respectively (p for trend <0.001). The DP score was not associated with non-amnestic MCI odds. Conclusions: Hippocampal volume may be related to dietary factors. Foods associated with hippocampal volume seem also to be related to memory function and odds of amnestic MCI. O1-06-05
TEA, COFFEE AND COGNITIVE DECLINE IN THE ELDERLY: THE CARDIOVASCULAR HEALTH STUDY
Lenore Arab1, Mary Lou Biggs2, Ellen S. O’Meara3, Annette L. Fitzpatrick2, William T. Longstreth2, 1UCLA, Los Angeles, CA, USA; 2University of Washington, Seattle, WA, USA; 3Group Health Research Institute, Seattle, WA, USA. Contact e-mail: [email protected] Background: Although several cross sectional observational studies have shown positive associations between consumption of either tea and cognitive function in older adults, data from prospective analyses with long-term follow-up and rate of change in cognitive function is lacking. Methods: We used data on 4,809 men and women aged 65 and older from the Cardiovascular Health Study to examine the relationship between consumption of tea, coffee, and change in cognitive function over time. Usual consumption was assessed using a food frequency questionnaire at baseline. Cognitive performance was assessed using the Mini-Mental State Examination (3MSE) administered at baseline and annually up to 8 times. We used linear mixed models to estimate the rate of change in cognitive scores associated with baseline consumption. Results: At baseline, 43% participants reported drinking coffee and 25% tea daily. The average annual rate of decline in cognitive tests scores was -1.17 for the 3MSE over a mean 7 examinations. In
a model including both tea and coffee, age, gender, education, smoking status, clinic site, history of stroke, history of CHD, diabetes, hypertension, depression score, and ApoE genotype; consumption of tea at the highest 3 levels was associated with a statistically significant 17-37% reduction in decline in 3MSE scores. Coffee only at the highest level of consumption was associated with significantly decreased decline (20%) in 3MSE. Compared with never drinkers, participants drinking tea 5-10 times/yr, 1-3 times/m, 1-4 times/w, and 5+ times/w had average annual rates of decline (95% CI) of 3MSE scores that were 0.20 (-0.05-0.46), 0.38(0.16-0.60), 0.43 (0.230.64), and 0.31 (0.10-0.51) points lower, respectively. The comparable estimates for coffee drinkers were 0.08 (-0.21-0.38), 0.27(-0.025-0.56), 0.05 (-0.22-0.31), and 0.24 (0.08-0.40), respectively. Conclusions: These longitudinal analyses show less cognitive decline with increasing consumption of tea beginning at consumption of one cup a month. Coffee was significantly inversely related to cognitive decline only at the highest level of consumption. These patterns suggest that the observed associations are unlikely to be related to caffeine, which is present in coffee at levels 2-3 times higher than in tea. The suggestion of a neuroprotective effect of tea consumption requires further investigation. O1-06-06
AN ASSOCIATION OF COGNITIVE DECLINE WITH BLOOD FOLATE AND BETA-CAROTENE CONCENTRATIONS: THE NUN STUDY
Myron D. Gross1, Andrew Odegaard1, Bharat Thyagarajan1, Mark Desrosiers2, Suzanne L. Tyas3, 1University of Minnesota, Minneapolis, MN, USA; 2University of Kentucky, Lexington, KY, USA; 3University of Waterloo, Waterloo, ON, Canada. Contact e-mail: [email protected] Background: Dietary intakes have been associated with the risk of Alzheimer’s disease in several studies. Often, these have involved ‘‘healthy’’ dietary patterns such as increased intakes of fruits and vegetables or other components. In the current study, blood levels of carotenoids, tocopherols and folate were evaluated for an association with decline in cognitive function with long-term follow-up. Methods: In the Nun Study cohort, cognitive function was defined by a summary of tests involving the CERAD Battery and ranged from 1(intact cognition) to 6 (dementia). Individuals with a cognitive status rating of 1-5 at baseline were followed for transitions to dementia (incident dementia). Baseline blood samples of 117 older women (mean age ¼ 90.4 at baseline) were collected prospectively and analyzed for folate, tocopherols and carotenoids. The association between nutritional factors and incident dementia was analyzed by logistic regression and adjusted for age, education and apoE4 and years of survival from baseline. Similar analyses was also performed to analyze the cross sectional associations between cognitive function and nutritional factors. Results: Twenty-three subjects had incident dementia during follow-up. The risk of incident dementia was lowest among subjects with the highest quartile of folate (OR ¼ 0.13, CI ¼ 0.02-0.77). The only carotenoid associated with incident dementia was beta-carotene (OR ¼ 0.03, CI ¼ 0.001-0.46) for highest vs. lowest quartile. Cross-sectional analyses found an association between cognitive state at baseline and folate, and beta-carotene. Conclusions: High blood concentrations of folate and beta-carotene, were associated with an decreased risk of incident dementia in these older female subjects. Folate and beta-carotene and/or associated dietary constituents appeared to aid the maintenance of cognitive function. This activity may be the result of maintenance of neural tissues and/or the repair of neural lesions. O1-06-07
DESIGNING PREVENTION PROGRAMS TO REDUCE DEMENTIA INCIDENCE : SIMULATION OF THE IMPACT OF REMOVAL OF SPECIFIC RISK FACTORS
Karen A. Ritchie1,2, Isabelle Carriere1, Craig Ritchie2, Claudine Berr1, Sylvaine Artero1, Marie-Laure Ancelin1, 1Inserm, Montpellier, France; 2 Imperial College, London, United Kingdom. Contact e-mail: karen. [email protected] Background: Multiple risk factors for dementia have been identified over the past 20 years by prospective epidemiological studies but this information has not so far been used to determine intervention priorities for the reduction of
Oral O1-06: Epidemiology: Diet and Intervention
and the Aging Brain, Columbia University Medical Center, New York, NY, USA; 2Department of Neurology, Columbia University Medical Center, New York, NY, USA; 3Clinical Research Center, Helen Hayes Hospital, West Haverstraw, NY, USA; 4Department of Epidemiology, Columbia University, New York, NY, USA; 5Department of Medicine, Columbia University Medical Center, New York, NY, USA; 6Department of Neurology and Imaging of Dementia and Aging Laboratory, Center for Neuroscience, University of California, Sacramento, Sacramento, CA, USA; 7Gertrude H. Sergievsky Center, Columbia University Medical Center, New York, NY, USA. Contact e-mail: [email protected] Background: Previous studies have shown associations between hippocampal atrophy and aging, mild cognitive impairment (MCI) and Alzheimer disease (AD), but little is known about the relation between hippocampal volume and dietary habits. Methods: High-resolution structural magnetic resonance imaging (MRI) was collected on 603 non-demented community elderly participants of the Washington Heights-Inwood Columbia Aging Project imaging sub-study with available dietary assessments administered at the same visit. Hippocampal volume was adjusted for total cranial volume. The Petersen criteria were used to define MCI. Using ReducedRank Regression (RRR) we examined whether dietary patterns (DP; linear combinations of 33 food groups) could explain variability of relative hippocampal volume. We then examined potential associations of the hippocampal volume-related DP with cognitive performance (4 cognitive domain z-scores derived from a comprehensive neuropsychological battery) and with odds of MCI (n ¼ 139). Models were adjusted for age, gender, ethnicity and education. Further adjustment for caloric intake, BMI, APOE-e4, smoking status, and comorbid diseases did not change the associations materially. Results: We identified a DP that was positively correlated with hippocampal volume (r ¼ 0.24, p < 0.0001; 5.8% of variability explained), and was characterized by higher intakes of eggs, grains, tomato, fish, nuts, salad dressing, cold cereal and coffee; and lower intakes of snack, tea, processed meat, and cruciferous vegetables. Subjects adhering more to this DP tended to have better memory performance: mean memory z-scores among the lowest, middle, and highest tertiles of the DP Score were -0.02, 0.20, and 0.20, respectively (p for trend ¼ 0.001, adjusted regression model with DP tertiles entered as an ordinal variable). No association was found between the DP and other cognitive domain z-scores. Adjusted logistic regression analysis showed that, compared to the lowest DP score tertile, the prevalence odds ratios (95%CI) of amnestic MCI for the middle and highest DP tertiles were 0.27(0.12-0.60) and 0.25(0.11-0.57), respectively (p for trend <0.001). The DP score was not associated with non-amnestic MCI odds. Conclusions: Hippocampal volume may be related to dietary factors. Foods associated with hippocampal volume seem also to be related to memory function and odds of amnestic MCI. O1-06-05
TEA, COFFEE AND COGNITIVE DECLINE IN THE ELDERLY: THE CARDIOVASCULAR HEALTH STUDY
Lenore Arab1, Mary Lou Biggs2, Ellen S. O’Meara3, Annette L. Fitzpatrick2, William T. Longstreth2, 1UCLA, Los Angeles, CA, USA; 2University of Washington, Seattle, WA, USA; 3Group Health Research Institute, Seattle, WA, USA. Contact e-mail: [email protected] Background: Although several cross sectional observational studies have shown positive associations between consumption of either tea and cognitive function in older adults, data from prospective analyses with long-term follow-up and rate of change in cognitive function is lacking. Methods: We used data on 4,809 men and women aged 65 and older from the Cardiovascular Health Study to examine the relationship between consumption of tea, coffee, and change in cognitive function over time. Usual consumption was assessed using a food frequency questionnaire at baseline. Cognitive performance was assessed using the Mini-Mental State Examination (3MSE) administered at baseline and annually up to 8 times. We used linear mixed models to estimate the rate of change in cognitive scores associated with baseline consumption. Results: At baseline, 43% participants reported drinking coffee and 25% tea daily. The average annual rate of decline in cognitive tests scores was -1.17 for the 3MSE over a mean 7 examinations. In
a model including both tea and coffee, age, gender, education, smoking status, clinic site, history of stroke, history of CHD, diabetes, hypertension, depression score, and ApoE genotype; consumption of tea at the highest 3 levels was associated with a statistically significant 17-37% reduction in decline in 3MSE scores. Coffee only at the highest level of consumption was associated with significantly decreased decline (20%) in 3MSE. Compared with never drinkers, participants drinking tea 5-10 times/yr, 1-3 times/m, 1-4 times/w, and 5+ times/w had average annual rates of decline (95% CI) of 3MSE scores that were 0.20 (-0.05-0.46), 0.38(0.16-0.60), 0.43 (0.230.64), and 0.31 (0.10-0.51) points lower, respectively. The comparable estimates for coffee drinkers were 0.08 (-0.21-0.38), 0.27(-0.025-0.56), 0.05 (-0.22-0.31), and 0.24 (0.08-0.40), respectively. Conclusions: These longitudinal analyses show less cognitive decline with increasing consumption of tea beginning at consumption of one cup a month. Coffee was significantly inversely related to cognitive decline only at the highest level of consumption. These patterns suggest that the observed associations are unlikely to be related to caffeine, which is present in coffee at levels 2-3 times higher than in tea. The suggestion of a neuroprotective effect of tea consumption requires further investigation. O1-06-06
AN ASSOCIATION OF COGNITIVE DECLINE WITH BLOOD FOLATE AND BETA-CAROTENE CONCENTRATIONS: THE NUN STUDY
Myron D. Gross1, Andrew Odegaard1, Bharat Thyagarajan1, Mark Desrosiers2, Suzanne L. Tyas3, 1University of Minnesota, Minneapolis, MN, USA; 2University of Kentucky, Lexington, KY, USA; 3University of Waterloo, Waterloo, ON, Canada. Contact e-mail: [email protected] Background: Dietary intakes have been associated with the risk of Alzheimer’s disease in several studies. Often, these have involved ‘‘healthy’’ dietary patterns such as increased intakes of fruits and vegetables or other components. In the current study, blood levels of carotenoids, tocopherols and folate were evaluated for an association with decline in cognitive function with long-term follow-up. Methods: In the Nun Study cohort, cognitive function was defined by a summary of tests involving the CERAD Battery and ranged from 1(intact cognition) to 6 (dementia). Individuals with a cognitive status rating of 1-5 at baseline were followed for transitions to dementia (incident dementia). Baseline blood samples of 117 older women (mean age ¼ 90.4 at baseline) were collected prospectively and analyzed for folate, tocopherols and carotenoids. The association between nutritional factors and incident dementia was analyzed by logistic regression and adjusted for age, education and apoE4 and years of survival from baseline. Similar analyses was also performed to analyze the cross sectional associations between cognitive function and nutritional factors. Results: Twenty-three subjects had incident dementia during follow-up. The risk of incident dementia was lowest among subjects with the highest quartile of folate (OR ¼ 0.13, CI ¼ 0.02-0.77). The only carotenoid associated with incident dementia was beta-carotene (OR ¼ 0.03, CI ¼ 0.001-0.46) for highest vs. lowest quartile. Cross-sectional analyses found an association between cognitive state at baseline and folate, and beta-carotene. Conclusions: High blood concentrations of folate and beta-carotene, were associated with an decreased risk of incident dementia in these older female subjects. Folate and beta-carotene and/or associated dietary constituents appeared to aid the maintenance of cognitive function. This activity may be the result of maintenance of neural tissues and/or the repair of neural lesions. O1-06-07
DESIGNING PREVENTION PROGRAMS TO REDUCE DEMENTIA INCIDENCE : SIMULATION OF THE IMPACT OF REMOVAL OF SPECIFIC RISK FACTORS
Karen A. Ritchie1,2, Isabelle Carriere1, Craig Ritchie2, Claudine Berr1, Sylvaine Artero1, Marie-Laure Ancelin1, 1Inserm, Montpellier, France; 2 Imperial College, London, United Kingdom. Contact e-mail: karen. [email protected] Background: Multiple risk factors for dementia have been identified over the past 20 years by prospective epidemiological studies but this information has not so far been used to determine intervention priorities for the reduction of