Association of Vitamin E and Cognitive Decline in Older Adults with and without the APOEɛ4 Allele: A Biracial Population-Based Community Study

Article type: Research Article

Authors: Liu, Xiaoran^{a; b; *} | Finno, Carrie J.^c | Beck, Todd^{a; b} | Dhana, Klodian^{a; b} | Tangney, Christy^d | Desai, Pankaja^{a; b} | Krueger, Kristin^{a; b} | Evans, Denis A.^{a; b} | Rajan, Kumar B.^{a; b}

Affiliations: [a] Department of Internal MedicineRush University Medical Center, Chicago, IL, USA | [b] Rush Institute for Healthy Aging, Chicago, IL, USA | [c] Department of Population, Health & Reproduction, School of Veterinary Medicine, UC Davis, Davis, CA, USA | [d] Department of Clinical Nutrition & Preventive MedicineRush University Medical Center, Chicago, IL, USA

Correspondence: [*] Correspondence to: Xiaoran Liu, PhD, MSc, FAHA, Assistant professor, Rush Institute for Healthy Aging, Department of Internal Medicine, Rush University Medical Center, Triangle Building, Room 245D, 1700 W Van Buren St., Chicago, IL 60612, USA. E-mail: [email protected].

Abstract: Background:The association of different types of tocopherols (vitamin E) with cognition might vary by the APOE ɛ4 allele status. Objective:We examined the association of dietary tocopherols with cognitive decline among participants with and without the APOE ɛ4 allele over a median of 12 years. Methods:2,193 participants from the Chicago Health and Aging Project were included in the analyses. Global cognition was assessed in three-year cycles. We used a 144-item FFQ to assess dietary intakes of tocopherols and hME Sequenom mass-array platform to assess APOE genotype. We used linear mixed effects models to examine the relationship between tocopherol from food sources and global cognitive decline. Results:The mean baseline age was 74.1 (SD = 5.9) years. Among APOE ɛ4 carriers, participants in the highest quintile of intakes of dietary vitamin E had a slower cognitive decline of 0.022 SDU (95% CI: 0.000, 0.043) compared to those in the lowest quintile. A higher intake of dietary α-tocopherol from food sources only was associated with slower cognitive decline in APOE ɛ4 carriers (p for trend 0.002) but not among the non-carriers (p for trend 0.937). Among APOE ɛ4 carriers, those in the highest quintile of intake of α-tocopherol had a 16.4% slower rate of decline of global cognition compared to those in the lowest quintile (β= 0.034, 95% CI: 0.013, 0.054). Conclusions:Individuals consuming high α-tocopherol from food sources had slower cognitive decline among APOE ɛ4 carriers. In older adults, different forms of vitamin E might moderate the relationship of APOE ɛ4 with global cognition.

Keywords: Alpha-tocopherol, Alzheimer’s disease, antioxidant, APOE, bi-racial, cognitive decline, dietary, longitudinal cohort, nutrients, vitamin E

DOI: 10.3233/JAD-230797

Journal: Journal of Alzheimer's Disease, vol. 96, no. 3, pp. 1129-1138, 2023