May A Beydoun1, Hind A Beydoun1, Marie T Fanelli-Kuczmarski1, Jordan Weiss1, Sharmin Hossain1, Jose Atilio Canas1, Michele Kim Evans1, Alan B Zonderman1. 1. From the Laboratory of Epidemiology and Population Sciences (M.A.B., S.H., M.K.E., A.B.Z.), National Institute on Aging, Intramural Research Program, NIA/NIH/IRP, Baltimore, MD; Department of Research Programs (H.A.B.), Fort Belvoir Community Hospital, VA; Department of Behavioral Health and Nutrition (M.T.F.-K.), University of Delaware, Newark; Department of Demography (J.W.), University of California, Berkeley; and Department of Pediatrics (J.A.C.), Johns Hopkins Medical Institutions, St. Petersburgh, FL.
Abstract
BACKGROUND AND OBJECTIVES: Serum antioxidant vitamins and carotenoids may protect against neurodegeneration with age. We examined associations of these nutritional biomarkers with incident all-cause and Alzheimer disease (AD) dementia among US middle-aged and older adults. METHODS: Using data from the third National Health and Nutrition Examination Surveys (1988-1994), linked with Centers for Medicare & Medicaid follow-up data, we tested associations and interactions of serum vitamins A, C, and E and total and individual serum carotenoids and interactions with incident AD and all-cause dementia. Cox proportional hazards regression models were conducted. RESULTS: After ≤26 years follow-up (mean 16-17 years, 7,283 participants aged 45-90 years at baseline), serum lutein+zeaxanthin was associated with reduced risk of all-cause dementia (65+ age group), even in the lifestyle-adjusted model (per SD: hazard ratio [HR] 0.93, 95% CI 0.87-0.99; p = 0.037), but attenuated in comparison with a socioeconomic status (SES)-adjusted model (HR 0.92, 95% CI 0.86-0.93; p = 0.013). An inverse relationship was detected between serum β-cryptoxanthin (per SD increase) and all-cause dementia (45+ and 65+) for age- and sex-adjusted models (HR 0.86, 95% CI 0.80-0.93; p < 0.001 for 45+; HR 0.86, 95% CI 0.80-0.93; p = 0.001 for 65+), a relationship remaining strong in SES-adjusted models (HR 0.89, 95% CI 0.82-0.96; p = 0.006 for 45+; HR 0.88, 95% CI 0.81-0.96; p = 0.007 for 65+), but attenuated in subsequent models. Antagonistic interactions indicate putative protective effects of 1 carotenoid may be observed at lower levels other carotenoids or antioxidant vitamin. DISCUSSION: Incident all-cause dementia was inversely associated with serum lutein+zeaxanthin and β-cryptoxanthin levels. Further studies with time-dependent exposures and randomized trials are needed to test neuroprotective effects of supplementing the diet with select carotenoids. CLASSIFICATION OF EVIDENCE: This study provides Class II evidence that incident all-cause dementia was inversely associated with serum lutein+zeaxanthin and β-cryptoxanthin levels.
BACKGROUND AND OBJECTIVES: Serum antioxidant vitamins and carotenoids may protect against neurodegeneration with age. We examined associations of these nutritional biomarkers with incident all-cause and Alzheimer disease (AD) dementia among US middle-aged and older adults. METHODS: Using data from the third National Health and Nutrition Examination Surveys (1988-1994), linked with Centers for Medicare & Medicaid follow-up data, we tested associations and interactions of serum vitamins A, C, and E and total and individual serum carotenoids and interactions with incident AD and all-cause dementia. Cox proportional hazards regression models were conducted. RESULTS: After ≤26 years follow-up (mean 16-17 years, 7,283 participants aged 45-90 years at baseline), serum lutein+zeaxanthin was associated with reduced risk of all-cause dementia (65+ age group), even in the lifestyle-adjusted model (per SD: hazard ratio [HR] 0.93, 95% CI 0.87-0.99; p = 0.037), but attenuated in comparison with a socioeconomic status (SES)-adjusted model (HR 0.92, 95% CI 0.86-0.93; p = 0.013). An inverse relationship was detected between serum β-cryptoxanthin (per SD increase) and all-cause dementia (45+ and 65+) for age- and sex-adjusted models (HR 0.86, 95% CI 0.80-0.93; p < 0.001 for 45+; HR 0.86, 95% CI 0.80-0.93; p = 0.001 for 65+), a relationship remaining strong in SES-adjusted models (HR 0.89, 95% CI 0.82-0.96; p = 0.006 for 45+; HR 0.88, 95% CI 0.81-0.96; p = 0.007 for 65+), but attenuated in subsequent models. Antagonistic interactions indicate putative protective effects of 1 carotenoid may be observed at lower levels other carotenoids or antioxidant vitamin. DISCUSSION: Incident all-cause dementia was inversely associated with serum lutein+zeaxanthin and β-cryptoxanthin levels. Further studies with time-dependent exposures and randomized trials are needed to test neuroprotective effects of supplementing the diet with select carotenoids. CLASSIFICATION OF EVIDENCE: This study provides Class II evidence that incident all-cause dementia was inversely associated with serum lutein+zeaxanthin and β-cryptoxanthin levels.
Authors: Christine A F von Arnim; Florian Herbolsheimer; Thorsten Nikolaus; Richard Peter; Hans K Biesalski; Albert C Ludolph; Matthias Riepe; Gabriele Nagel Journal: J Alzheimers Dis Date: 2012 Impact factor: 4.472
Authors: G McNeill; X Jia; L J Whalley; H C Fox; J Corley; A J Gow; C E Brett; J M Starr; I J Deary Journal: Eur J Clin Nutr Date: 2011-02-23 Impact factor: 4.016
Authors: Joanne Feeney; Neil O'Leary; Rachel Moran; Aisling M O'Halloran; John M Nolan; Stephen Beatty; Ian S Young; Rose Anne Kenny Journal: J Gerontol A Biol Sci Med Sci Date: 2017-10-01 Impact factor: 6.053
Authors: Elizabeth J Johnson; Rohini Vishwanathan; Mary Ann Johnson; Dorothy B Hausman; Adam Davey; Tammy M Scott; Robert C Green; L Stephen Miller; Marla Gearing; John Woodard; Peter T Nelson; Hae-Yun Chung; Wolfgang Schalch; Jonas Wittwer; Leonard W Poon Journal: J Aging Res Date: 2013-06-09