(P29-022-23) The Association Between Dietary Choline Intake and Alzheimer’s Dementia Risk: The Rush Memory and Aging Project

Objectives: To evaluate the relationship between dietary choline intake and risk of Alzheimer’s dementia in a cohort of community-dwelling older adults.

Methods: Our analytical sample included participants from a longitudinal cohort, Rush Memory and Aging Project (R01AG017917). Study participants (n=995; mean age at first dietary assessment 81.4 ± 7.2 years) were free of Alzheimer’s dementia (AD) at baseline and had completed at least one food frequency questionnaire (FFQ). AD was assessed clinically in a 3-stage process using neurological exams and standardized diagnostic criteria. Choline intake was estimated using a validated FFQ and quantified as a sum of free choline, glycerophosphocholine, phosphocholine, phosphatidylcholine, and sphingomyelin. Participants were grouped into quintiles by average choline intakes of < 200 (ref), 200–250, 251–300, 301–350, >350 mg/day. Cox proportional hazard models were used to assess risk of incident of AD by quintile of choline intake. Covariates used in the fully adjusted model included: age, sex, education, BMI, smoking status, physical activity score, late life cognitive frequency score, vascular disease burden score, diabetes, ApoE-4 genotype, total calories, and vitamin b6, vitamin b12, folate, vitamin C, vitamin E, and lutein.

Results: Over a mean follow up period of 7.04 ± 4.6 years, 27% of participants developed AD (incident rate = 38/1000 person-year). In the fully adjusted model, compared to the lowest quintile of dietary choline intake, consumption of 200–250, 251–300, 301–350, and >350 mg/day were associated with a 30% (HR: .70; 95% CI: 0.44, 1.12; P = 0.137), 45% (HR = 0.55; 95% CI: 0.34, 0.90; P = 0.018), 44% (HR = 0.56; 95% CI: 0.32, 0.97; P = 0.039), and 54% (HR: 0.46; 95% CI: 0.24–0.90; P = 0.023) reduced risk of AD incidence, respectively. These results are consistent with energy-residuals model (same covariates), which showed a 50% (HR: 0.50; 95% CI: 0.33–0.76; P = 0.001) reduced risk of AD incidence when comparing the highest vs. lowest intake quintiles.

Conclusions: Higher dietary choline intakes may decrease risk of AD in the older adults. Randomized controlled trials are needed to confirm these findings.

Funding Sources: Funding for the Rush University qualifications of choline intake was provided through an unrestricted investigator-initiated grant from the Egg Nutrition Center to Think Healthy Group, LLC.