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Associations of dietary choline intake with risk of incident dementia and with cognitive performance: the Kuopio Ischaemic Heart Disease Risk Factor Study.
Am J Clin Nutr. 2019 12 01; 110(6):1416-1423.AJ

Abstract

BACKGROUND

Moderate egg intake has been associated with better cognitive performance in observational studies. This association may be due to the rich content of choline, especially phosphatidylcholine, in eggs because choline has been suggested to have a role in the prevention of cognitive decline.

OBJECTIVES

We investigated the associations of dietary choline intake with the risk of incident dementia and with cognitive performance in middle-aged and older men in the prospective, population-based Kuopio Ischaemic Heart Disease Risk Factor Study.

METHODS

A population-based sample of 2497 dementia-free men aged 42-60 y was examined in 1984-1989. A subset of 482 men completed 5 different cognitive performance tests 4 y later. Dementia and Alzheimer disease diagnoses were retrieved from Finnish health registers. Dietary intakes were assessed with the use of 4-d food records at baseline. Cox regression and ANCOVA were used for the analyses. All analyses were also stratified by the apolipoprotein E phenotype (APOE-ε4 compared with other phenotypes). These data were available for 1259 men.

RESULTS

The mean ± SD total choline intake was 431 ± 88 mg/d, of which 188 ± 63 mg/d was phosphatidylcholine. During a 21.9-y follow-up, 337 men were diagnosed with dementia. Those in the highest compared with the lowest phosphatidylcholine intake quartile had 28% (95% CI: 1%, 48%; P-trend = 0.02 across quartiles) lower multivariable-adjusted risk of incident dementia. Total choline intake had no association with the risk of incident dementia. However, both total choline and phosphatidylcholine intakes were associated with better performance in cognitive tests assessing frontal and temporal lobe functioning. For example, higher intakes were associated with better performance in verbal fluency and memory functions. The APOE phenotype had little or no impact on the associations.

CONCLUSION

Higher phosphatidylcholine intake was associated with lower risk of incident dementia and better cognitive performance in men in eastern Finland. This trial was registered at clinicaltrials.gov as NCT03221127.

Authors+Show Affiliations

Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland.Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland.Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland.Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland.Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland.Analytical Services Oy, Helsinki, Finland. Department of Public Health, Faculty of Medicine, University of Helsinki, Helsinki, Finland.Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland.

Pub Type(s)

Clinical Trial
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

31360988

Citation

Ylilauri, Maija P T., et al. "Associations of Dietary Choline Intake With Risk of Incident Dementia and With Cognitive Performance: the Kuopio Ischaemic Heart Disease Risk Factor Study." The American Journal of Clinical Nutrition, vol. 110, no. 6, 2019, pp. 1416-1423.
Ylilauri MPT, Voutilainen S, Lönnroos E, et al. Associations of dietary choline intake with risk of incident dementia and with cognitive performance: the Kuopio Ischaemic Heart Disease Risk Factor Study. Am J Clin Nutr. 2019;110(6):1416-1423.
Ylilauri, M. P. T., Voutilainen, S., Lönnroos, E., Virtanen, H. E. K., Tuomainen, T. P., Salonen, J. T., & Virtanen, J. K. (2019). Associations of dietary choline intake with risk of incident dementia and with cognitive performance: the Kuopio Ischaemic Heart Disease Risk Factor Study. The American Journal of Clinical Nutrition, 110(6), 1416-1423. https://doi.org/10.1093/ajcn/nqz148
Ylilauri MPT, et al. Associations of Dietary Choline Intake With Risk of Incident Dementia and With Cognitive Performance: the Kuopio Ischaemic Heart Disease Risk Factor Study. Am J Clin Nutr. 2019 12 1;110(6):1416-1423. PubMed PMID: 31360988.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Associations of dietary choline intake with risk of incident dementia and with cognitive performance: the Kuopio Ischaemic Heart Disease Risk Factor Study. AU - Ylilauri,Maija P T, AU - Voutilainen,Sari, AU - Lönnroos,Eija, AU - Virtanen,Heli E K, AU - Tuomainen,Tomi-Pekka, AU - Salonen,Jukka T, AU - Virtanen,Jyrki K, PY - 2019/03/29/received PY - 2019/06/24/accepted PY - 2019/7/31/pubmed PY - 2020/4/3/medline PY - 2019/7/31/entrez KW - Alzheimer disease KW - apolipoprotein E4 KW - choline KW - cognitive function KW - cognitive performance KW - dementia KW - eggs KW - men KW - phosphatidylcholine KW - population study SP - 1416 EP - 1423 JF - The American journal of clinical nutrition JO - Am. J. Clin. Nutr. VL - 110 IS - 6 N2 - BACKGROUND: Moderate egg intake has been associated with better cognitive performance in observational studies. This association may be due to the rich content of choline, especially phosphatidylcholine, in eggs because choline has been suggested to have a role in the prevention of cognitive decline. OBJECTIVES: We investigated the associations of dietary choline intake with the risk of incident dementia and with cognitive performance in middle-aged and older men in the prospective, population-based Kuopio Ischaemic Heart Disease Risk Factor Study. METHODS: A population-based sample of 2497 dementia-free men aged 42-60 y was examined in 1984-1989. A subset of 482 men completed 5 different cognitive performance tests 4 y later. Dementia and Alzheimer disease diagnoses were retrieved from Finnish health registers. Dietary intakes were assessed with the use of 4-d food records at baseline. Cox regression and ANCOVA were used for the analyses. All analyses were also stratified by the apolipoprotein E phenotype (APOE-ε4 compared with other phenotypes). These data were available for 1259 men. RESULTS: The mean ± SD total choline intake was 431 ± 88 mg/d, of which 188 ± 63 mg/d was phosphatidylcholine. During a 21.9-y follow-up, 337 men were diagnosed with dementia. Those in the highest compared with the lowest phosphatidylcholine intake quartile had 28% (95% CI: 1%, 48%; P-trend = 0.02 across quartiles) lower multivariable-adjusted risk of incident dementia. Total choline intake had no association with the risk of incident dementia. However, both total choline and phosphatidylcholine intakes were associated with better performance in cognitive tests assessing frontal and temporal lobe functioning. For example, higher intakes were associated with better performance in verbal fluency and memory functions. The APOE phenotype had little or no impact on the associations. CONCLUSION: Higher phosphatidylcholine intake was associated with lower risk of incident dementia and better cognitive performance in men in eastern Finland. This trial was registered at clinicaltrials.gov as NCT03221127. SN - 1938-3207 UR - https://www.unboundmedicine.com/medline/citation/31360988/Associations_of_dietary_choline_intake_with_risk_of_incident_dementia_and_with_cognitive_performance:_the_Kuopio_Ischaemic_Heart_Disease_Risk_Factor_Study_ L2 - https://academic.oup.com/ajcn/article-lookup/doi/10.1093/ajcn/nqz148 DB - PRIME DP - Unbound Medicine ER -