The relation of dietary choline to cognitive performance and white-matter hyperintensity in the Framingham Offspring Cohort

Am J Clin Nutr. 2011 Dec;94(6):1584-91. doi: 10.3945/ajcn.110.008938. Epub 2011 Nov 9.


Background: Choline is the precursor to the neurotransmitter acetylcholine. Loss of cholinergic neurons is associated with impaired cognitive function, particularly memory loss and Alzheimer disease (AD). Brain atrophy and white-matter hyperintensity (WMH) are also associated with impaired cognitive function and AD.

Objective: The objective was to determine whether a relation exists between dietary choline intake, cognitive function, and brain morphology in a large, nondemented community-based cohort.

Design: A dementia-free cohort of 1391 subjects (744 women, 647 men; age range: 36-83 y; mean ± SD age: 60.9 ± 9.29 y) from the Framingham Offspring population completed a food-frequency questionnaire administered from 1991 to 1995 (exam 5; remote intake) and from 1998 to 2001 (exam 7; concurrent intake). Participants underwent neuropsychological evaluation and brain MRI at exam 7. Four neuropsychological factors were constructed: verbal memory (VM), visual memory (VsM), verbal learning, and executive function. MRI measures included WMH volume (WMHV).

Results: Performance on the VM and VsM factors was better with higher concurrent choline intake in multivariable-adjusted models for VM (average change in neuropsychological factor per 1-unit change in choline = 0.60; 95% CI: 0.29, 0.91; P < 0.01) and VsM (0.66; 95% CI: 0.19, 1.13; P < 0.01). Remote choline intake was inversely related to log-transformed WMHV (average change in log WMHV per 1-unit change in choline = -0.05; 95% CI: -0.10, -0.01; P = 0.02). Furthermore, an inverse association was observed between remote higher choline intake and presence of large WMVH (OR: 0.56; 95% CI: 0.34, 0.92; P = 0.01).

Conclusion: In this community-based population of nondemented individuals, higher concurrent choline intake was related to better cognitive performance, whereas higher remote choline intake was associated with little to no WMHV.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Brain / anatomy & histology
  • Brain / drug effects*
  • Choline / pharmacology*
  • Cognition / drug effects*
  • Cognition Disorders / etiology*
  • Cognition Disorders / prevention & control
  • Cohort Studies
  • Diet Surveys
  • Diet*
  • Executive Function / drug effects*
  • Female
  • Humans
  • Magnetic Resonance Imaging
  • Male
  • Memory / drug effects*
  • Middle Aged
  • Multivariate Analysis
  • Surveys and Questionnaires


  • Choline