基于血液的营养风险指数解释了多领域阿尔茨海默病预防试验中的认知增强和衰退情况。
A blood-based nutritional risk index explains cognitive enhancement and decline in the multidomain Alzheimer prevention trial.
作者信息
Bowman Gene L, Dodge Hiroko H, Guyonnet Sophie, Zhou Nina, Donohue Juliana, Bichsel Aline, Schmitt Jeroen, Hooper Claudie, Bartfai Tamas, Andrieu Sandrine, Vellas Bruno
机构信息
Department of Nutrition and Brain Health, Nestlé Institute of Health Sciences, EPFL Campus, Lausanne, Switzerland.
Department of Neurology and Layton Aging and Alzheimer's Disease Center, Oregon Health & Science University, Portland, OR, USA.
出版信息
Alzheimers Dement (N Y). 2019 Dec 28;5:953-963. doi: 10.1016/j.trci.2019.11.004. eCollection 2019.
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 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 ( = 0.03 standard units [SU]/y), whereas each NRI point increase corresponded to an incremental acceleration in rates of cognitive decline (NRI-1: = -0.04 SU/y, = .03; NRI-2: = -0.08 SU/y, < .0001; and NRI-3: = -0.11 SU/y, = .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.
引言
多种营养素的方法可能通过相互作用对大脑健康产生更强有力的影响。我们假设，一个基于血液的营养风险指数（NRI），包括三种饮食质量生物标志物，可以解释多领域阿尔茨海默病预防试验（MAPT）中3年的认知轨迹。
方法
NRI包括红细胞n-3多不饱和脂肪酸（n-3 PUFA 22:6n-3和20:5n-3）、血清25-羟基维生素D和血浆同型半胱氨酸。NRI分数反映营养风险因素的数量（0-3）。MAPT的主要结果是每个参与者的认知综合评分，该评分采用线性混合效应模型进行拟合。
结果
80%的人至少有一个认知能力下降的营养风险因素（NRI≥1：712人中的573人）。没有营养风险因素（NRI=0）的参与者表现出认知能力增强（=0.03标准单位[SU]/年），而NRI每增加1分，认知能力下降速度就会相应加快（NRI-1：=-0.04 SU/年，=0.03；NRI-2：=-0.08 SU/年，<0.0001；NRI-3：=-0.11 SU/年，=0.0008）。
讨论
识别并解决这些公认的营养风险因素可能会减少老年人与年龄相关的认知能力下降；这一观察结果值得进一步研究。
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