Karosas Tasija, Wallace Taylor C, Li Muya, Pan Yongyi, Agarwal Puja, Bennett David A, Jacques Paul F, Chung Mei
Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, United States; International Life Sciences Institute, Washington, DC, United States.
Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, United States; Think Healthy Group, LLC, Washington, DC, United States; School of Medicine and Health Sciences, George Washington University, Washington, DC, United States.
J Nutr. 2025 Jul;155(7):2322-2332. doi: 10.1016/j.tjnut.2025.05.015. Epub 2025 May 28.
Dietary choline intake has been associated with a lower risk of cognitive dysfunction, lessened brain white-matter hyperintensity volume, and a reduced risk of incident dementia.
This study aims to evaluate the relationship between dietary choline intake and risk of clinical diagnosis of Alzheimer's dementia (AD) in participants enrolled in the Rush Memory and Aging Project prospective cohort.
Participants who were free of AD at baseline and had completed ≥1 food frequency questionnaire were included in the present analyses. Clinical AD was assessed among participants annually using a 3-stage process of neurological examinations and standardized diagnostic criteria. Dietary choline intake was quantified using the United States Department of Agriculture Database for the Choline Content of Common Foods. Multivariable Cox proportional hazard models were used to assess risk of incident of AD by quantiles of dietary choline intake. Mixed-effect Poisson regression models were used to investigate potential nonlinear relationships.
Mean baseline age of the study participants (N = 991) was 81.4 (±7.2) y. During a mean follow-up of 7.67 y, 266 participants (27%) were clinically diagnosed with AD (incident rate = 38/1000 person-year). In the fully adjusted model, compared with the lowest quantile of dietary choline intake, consumption of 200-250, 251-300, 301-350, and >350 mg/d were associated with a 23% [hazard ratio (HR): 0.73; 95% confidence interval (CI): 0.45, 1.17; P = 0.10], 40% (HR = 0.60; 95% CI: 0.60, 0.98; P = 0.04), 38% (HR = 0.62; 95% CI: 0.36, 1.07; P = 0.09), and 51% (HR: 0.49; 95% CI: 0.25, 0.95; P = 0.04) reduced rate of AD, respectively. Results of the curve linear Poisson regression model showed the point of lowest risk for AD to be ∼350 mg/d with effects being similar based on apolipoprotein E gene genotype.
Dietary choline intake ∼ 350 mg/d was associated with the lowest risk of clinical diagnosis of AD in older adults.
膳食胆碱摄入量与认知功能障碍风险降低、脑白质高信号体积减小以及新发痴呆风险降低有关。
本研究旨在评估参加拉什记忆与衰老项目前瞻性队列研究的参与者膳食胆碱摄入量与阿尔茨海默病（AD）临床诊断风险之间的关系。
本分析纳入了基线时无AD且完成了≥1份食物频率问卷的参与者。每年通过3阶段神经学检查和标准化诊断标准对参与者进行临床AD评估。使用美国农业部常见食物胆碱含量数据库对膳食胆碱摄入量进行量化。多变量Cox比例风险模型用于按膳食胆碱摄入量分位数评估AD发病风险。混合效应泊松回归模型用于研究潜在的非线性关系。
研究参与者（N = 991）的平均基线年龄为81.4（±7.2）岁。在平均7.67年的随访期间，266名参与者（27%）被临床诊断为AD（发病率 = 38/1000人年）。在完全调整模型中，与膳食胆碱摄入量最低分位数相比，摄入200 - 250、251 - 300、301 - 350和>350 mg/d分别与AD发病率降低23%[风险比（HR）：0.73；95%置信区间（CI）：0.45，1.17；P = 0.10]、40%（HR = 0.60；95% CI：0.60，0.98；P = 0.04）、38%（HR = 0.62；95% CI：0.36，1.07；P = 0.09）和51%（HR：0.49；95% CI：0.25，0.95；P = 0.04）相关。曲线线性泊松回归模型结果显示，AD风险最低的点约为350 mg/d，基于载脂蛋白E基因基因型的效应相似。
老年人膳食胆碱摄入量约350 mg/d与AD临床诊断风险最低相关。
