(P11-045-23) B-Vitamin Containing Supplement Use Is Associated With Lower Alzheimer’s Disease and Related Dementia Incidence in the Framingham Study Offspring Cohort

Objectives: The role of B-vitamins in prevention of Alzheimer’s disease and related dementias (ADRD) remains uncertain in the face of much conflicting evidence. We assessed B-vitamin supplement use at 5 study exams over a 23-year period among members of the Framingham Study Offspring Cohort who were ADRD-free at baseline.

Methods: Vitamin supplement use was updated at each exam to represent the cumulative exposure intake during follow-up and characterized based on frequency of use of B-vitamin containing supplements and average daily supplement intakes during follow-up. Cox proportional hazards regression was used to estimate the hazard ratios (HR) for the associations between B-vitamin supplement intakes and incidence of ADRD.

Results: Over an average follow-up of 19.6 years among 2818 participants (mean baseline age = 59 years; 52% female), there were 209 ADRD events. Relative to non-supplement consumers, intermittent use was associated with a 61% reduction in ADRD incidence [HR (95% CI): 0.39 (0.28-0.55), P< 0.001] and consistent use was associated with a non-significant 29% lower risk [0.81 (0.57-1.15), p=0.25]. ADRD incidence in the consistent users was significantly higher than for intermittent users (p < 0.001). Greater declines in ADRD risk were seen as the daily consumption of supplemental B12 increased compared with non-users [B12 >0- < 5 μg: 0.53 (0.36-0.76), p=0.001; B12 5-19.9 μg: 0.61 (0.44, 0.85), p=0.003; B12 ≥20 μg: 0.24 (0.11, 0.49), p< 0.001]. FA consumption was associated with a significant reduction in ADRD risk, but the reduction in risk did not increase with increasing FA intake [FA >0- < 200 μg: 0.36 (0.24, 0.54), p< 0.001; FA 200-399 μg: 0.50 (0.34, 0.73), p< 0.001; FA ≥400 μg: 0.59 (0.39, 0.89), p=0.02]. The highest FA intake category was not significantly different from the other FA user categories, whereas risk for those with the highest B12 intakes was significantly lower than the risk for participants with lower average intakes of B12.

Conclusions: Our findings imply that B-vitamin containing supplements may be important for lowering risk of ADRD. The possibility of attenuated benefit of continuous long-term B-vitamin containing supplement use needs further investigation, including consideration of other vitamins and minerals included in these supplements.

Funding Sources: NHLBI, NIA, ODS, USDA-ARS