Division of Human Nutrition and Health, Wageningen University & Research, Wageningen, The Netherlands.
Glenn Biggs Institute for Alzheimer's & Neurodegenerative Diseases, UT Health San Antonio, San Antonio, Texas, USA.
Alzheimers Dement. 2024 Jul;20(7):4594-4601. doi: 10.1002/alz.13884. Epub 2024 Jun 12.
While observational research suggests a protective role for nutrition in brain aging, intervention studies remain inconclusive. This failing translation from observational to interventional research may result from overlooking nutrient interactions.
We developed a nutrient status index capturing the number of suboptimal statuses of omega-3 fatty acids, homocysteine, and vitamin D (range 0 to 3). We associated this index with dementia incidence in a subsample (age ≥ 50 years) of the Framingham Heart Study Offspring cohort.
Among 968 participants, 79 developed dementia over 15.5 years (median follow-up). Each point increase in nutrient status index was associated with a 50% higher risk of dementia (hazard ratio [HR] = 1.50; 95% confidence interval [CI] = 1.16, 1.96). Participants with three high-risk statuses had a four-fold increased risk of dementia compared to participants without high-risk status (HR = 4.68; 95% CI = 1.69, 12.94).
Concurrent nutrient deficiencies are associated with the risk of dementia. The potential of optimizing nutritional status to lower dementia risk warrants further study.
Nutrition and dementia research calls for multiple-nutrient approaches. We studied combined suboptimal statuses of omega-3 polyunsaturated fatty acids, homocysteine, and vitamin D. Suboptimal status of the three nutrients was associated with dementia risk. The risk estimate was larger than for other factors (ie, diabetes, apolipoprotein E ε4 carrier). Future studies should assess the effect of improving nutrient status on dementia risk.
尽管观察性研究表明营养对大脑衰老具有保护作用，但干预研究仍未有定论。这种从观察性研究到干预性研究的失败可能是由于忽视了营养素的相互作用。
我们开发了一个营养素状态指数，该指数反映了ω-3 脂肪酸、同型半胱氨酸和维生素 D 三种营养素中出现亚最佳状态的数量（范围为 0 至 3）。我们将该指数与弗雷明汉心脏研究后代队列中（年龄≥50 岁）的一个亚组的痴呆发病率相关联。
在 968 名参与者中，有 79 人在 15.5 年的中位随访期间发生了痴呆。营养素状态指数每增加 1 分，痴呆的风险就会增加 50%（风险比 [HR] = 1.50；95%置信区间 [CI] = 1.16，1.96）。与没有高风险状态的参与者相比，有三种高风险状态的参与者患痴呆的风险增加了四倍（HR = 4.68；95%CI = 1.69，12.94）。
同时存在的营养缺乏与痴呆风险相关。优化营养状况以降低痴呆风险的潜力值得进一步研究。
营养与痴呆研究需要采用多种营养素方法。我们研究了 ω-3 多不饱和脂肪酸、同型半胱氨酸和维生素 D 三种营养素的联合亚最佳状态。三种营养素的亚最佳状态与痴呆风险相关。风险估计大于其他因素（即糖尿病、载脂蛋白 E ε4 携带者）。未来的研究应该评估改善营养状况对痴呆风险的影响。
