A blood-based nutritional risk index explains cognitive enhancement and decline in the multidomain Alzheimer prevention trial

Gene L Bowman; Hiroko H Dodge; Sophie Guyonnet; Nina Zhou; Juliana Donohue; Aline Bichsel; Jeroen Schmitt; Claudie Hooper; Tamas Bartfai; Sandrine Andrieu; Bruno Vellas; MAPT/DSA Study Group

doi:10.1016/j.trci.2019.11.004

A blood-based nutritional risk index explains cognitive enhancement and decline in the multidomain Alzheimer prevention trial

Alzheimers Dement (N Y). 2019 Dec 28:5:953-963. doi: 10.1016/j.trci.2019.11.004. eCollection 2019.

Authors

Gene L Bowman^{1

2

3}, Hiroko H Dodge^{2

4}, Sophie Guyonnet^{5

6}, Nina Zhou⁷, Juliana Donohue¹, Aline Bichsel¹, Jeroen Schmitt⁸, Claudie Hooper⁵, Tamas Bartfai⁹, Sandrine Andrieu^{6

10}, Bruno Vellas^{5

6}; MAPT/DSA Study Group

Collaborators

Affiliations

¹ Department of Nutrition and Brain Health, Nestlé Institute of Health Sciences, EPFL Campus, Lausanne, Switzerland.
² Department of Neurology and Layton Aging and Alzheimer's Disease Center, Oregon Health & Science University, Portland, OR, USA.
³ Department of Medicine, Harvard Medical School, Boston, MA, USA.
⁴ Department of Neurology and Michigan Alzheimer's Disease Center, University of Michigan, Ann Arbor, MI, USA.
⁵ Department of Internal Medicine and Geriatrics, Gerontopole, CHU, Toulouse, France.
⁶ LEASP UMR1027 INSERM, University Paul Sabatier, France.
⁷ Department of Biostatistics, University of Michigan, Ann Arbor, MI, USA.
⁸ Clinical Development Unit, Nestle Research, Lausanne, Switzerland.
⁹ Department of Neurochemistry, Stockholm University, Sweden.
¹⁰ Department of Public Health, CHU de Toulouse, Toulouse, France.

Abstract

Introduction: Multinutrient approaches may produce more robust effects on brain health through interactive qualities. We hypothesized that a blood-based nutritional risk index (NRI) including three biomarkers of diet quality can explain cognitive trajectories in the multidomain Alzheimer prevention trial (MAPT) over 3-years.

Methods: The NRI included erythrocyte n-3 polyunsaturated fatty acids (n-3 PUFA 22:6n-3 and 20:5n-3), serum 25-hydroxyvitamin D, and plasma homocysteine. The NRI scores reflect the number of nutritional risk factors (0-3). The primary outcome in MAPT was a cognitive composite Z score within each participant that was fit with linear mixed-effects models.

Results: Eighty percent had at lease one nutritional risk factor for cognitive decline (NRI ≥1: 573 of 712). Participants presenting without nutritional risk factors (NRI=0) exhibited cognitive enhancement (β = 0.03 standard units [SU]/y), whereas each NRI point increase corresponded to an incremental acceleration in rates of cognitive decline (NRI-1: β = -0.04 SU/y, P = .03; NRI-2: β = -0.08 SU/y, P < .0001; and NRI-3: β = -0.11 SU/y, P = .0008).

Discussion: Identifying and addressing these well-established nutritional risk factors may reduce age-related cognitive decline in older adults; an observation that warrants further study.

Keywords: Aging; Biomarkers of diet quality; Cognitive decline; DHA; EPA; Elderly; Homocysteine; Metabolomics; Nutrient biomarkers; Omega-3 fatty acids; Vitamin D.

Abstract

Grants and funding