Yun Zhang1, Xurui Jin2, Michael W Lutz3, Sang-Yhun Ju4, Keyang Liu5, Guang Guo6, Yi Zeng7, Yao Yao8. 1. School of Sociology and Anthropology, Sun Yat-sen University, Guangzhou, Guangdong, 510275, China. Electronic address: zhangy853@sysu.edu.cn. 2. Global Health Research Center, Duke Kunshan University, Kunshan, Jiangsu, 215374, China. Electronic address: xurui.jin@dukekunshan.edu.cn. 3. Department of Neurology, Duke University of Medicine, Durham, NC, 27710, USA. Electronic address: michael.lutz@duke.edu. 4. Department of Family Medicine, St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Gyeonggi-do, 11765, Republic of Korea. Electronic address: kolpos@daum.net. 5. Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, Osaka, 565-0871, Japan. Electronic address: liu@pbhel.med.osaka-u.ac.jp. 6. Department of Sociology, Carolina Population Center, Carolina Center for Genome Sciences, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, USA. Electronic address: guang_guo@unc.edu. 7. Center for Healthy Aging and Development Studies, National School of Development, Peking University, Beijing, 100871, China; Center for the Study of Aging and Human Development and Geriatrics Division, Medical School of Duke University, Durham, NC, 27710, USA. Electronic address: zengyi@nsd.pku.edu.cn. 8. Center for Healthy Aging and Development Studies, National School of Development, Peking University, Beijing, 100871, China; Center for the Study of Aging and Human Development and Geriatrics Division, Medical School of Duke University, Durham, NC, 27710, USA. Electronic address: yaoyao@nsd.pku.edu.cn.
Abstract
OBJECTIVE: To exam the association of cognitive decline with APOE ε4 allele carriage and dietary protein intake and investigate whether there is a gene-diet (GxD) interaction of APOE ε4 allele carriage and dietary protein intake on cognitive decline in a nationwide cohort of older adults. METHODS: A cohort study of participants from Chinese Longitudinal Healthy Longevity Survey was conducted from 2008 to 2014. A total of 3029 participants (mean age of 77.0 years, SD = 9.0; 49.3% were women) was enrolled. We genotyped APOE ε4 allele for each participant and calculated the diversity of dietary protein intake (DDPI) by summing up the frequency of intake of the 6 protein-rich foods (meats, fish, eggs, nuts, dairy products, and bean products). We assessed cognitive function using the Mini-Mental State Examination (MMSE). We used ordinal regression model to estimate the independent and joint effects of APOE ε4 carrier and dietary protein intake on cognitive decline, adjusting for potential confounders of age, sex, education, socio-economic status, lifestyles, BMI, and cardiometabolic conditions. RESULTS: There was significant association between carrying APOE ε4 allele and faster cognitive decline (Odds ratio: 1.19, 95% CI = 1.00-1.42), independent of potential confounders. While the associations of DDPI and the intake of 6 protein-rich foods with cognitive decline did not reach any statistical significance. We observed significant interactions of APOE ε4 with DDPI and fish intake, at multiple correction-adjusted Ps < 0.05. In those who were APOE ε4 carriers rather than non-carriers, both high DDPI (OR = 0.54, 95% CI: 0.34-0.88) and daily fish intake (OR = 0.43, 95% CI: 0.22-0.78) were significantly associated with slower cognitive decline, respectively. We also found that frequent intake of fish benefits women more than men regarding the mitigating of cognitive decline among APOE ε4 allele carriers (P for interaction = 0.016). CONCLUSIONS: The results of this study support the hypothesis that diversified protein food intake in addition to frequent fish intake may reduce the detrimental effect of APOE ε4 on cognitive health.
OBJECTIVE: To exam the association of cognitive decline with APOE ε4 allele carriage and dietary protein intake and investigate whether there is a gene-diet (GxD) interaction of APOE ε4 allele carriage and dietary protein intake on cognitive decline in a nationwide cohort of older adults. METHODS: A cohort study of participants from Chinese Longitudinal Healthy Longevity Survey was conducted from 2008 to 2014. A total of 3029 participants (mean age of 77.0 years, SD = 9.0; 49.3% were women) was enrolled. We genotyped APOE ε4 allele for each participant and calculated the diversity of dietary protein intake (DDPI) by summing up the frequency of intake of the 6 protein-rich foods (meats, fish, eggs, nuts, dairy products, and bean products). We assessed cognitive function using the Mini-Mental State Examination (MMSE). We used ordinal regression model to estimate the independent and joint effects of APOE ε4 carrier and dietary protein intake on cognitive decline, adjusting for potential confounders of age, sex, education, socio-economic status, lifestyles, BMI, and cardiometabolic conditions. RESULTS: There was significant association between carrying APOE ε4 allele and faster cognitive decline (Odds ratio: 1.19, 95% CI = 1.00-1.42), independent of potential confounders. While the associations of DDPI and the intake of 6 protein-rich foods with cognitive decline did not reach any statistical significance. We observed significant interactions of APOE ε4 with DDPI and fish intake, at multiple correction-adjusted Ps < 0.05. In those who were APOE ε4 carriers rather than non-carriers, both high DDPI (OR = 0.54, 95% CI: 0.34-0.88) and daily fish intake (OR = 0.43, 95% CI: 0.22-0.78) were significantly associated with slower cognitive decline, respectively. We also found that frequent intake of fish benefits women more than men regarding the mitigating of cognitive decline among APOE ε4 allele carriers (P for interaction = 0.016). CONCLUSIONS: The results of this study support the hypothesis that diversified protein food intake in addition to frequent fish intake may reduce the detrimental effect of APOE ε4 on cognitive health.