Abstract
Carotenoids may strengthen the association of antioxidant vitamins A, C, and E with favorable cognitive outcomes over time, though a few prospective studies have examined this hypothesis. We evaluated the longitudinal data from 1251 participants in the Healthy Aging in Neighborhoods of Diversity across the Life Span (HANDLS) study (Age at visit 1 in 2004–2009 (v1): 30–65 years). Vitamins A, C, and E dietary intakes and total and individual dietary carotenoids were computed using two 24-h recalls at v1. Cognitive tests, covering global mental status and domains of memory/learning, attention, psychomotor speed, visuo-spatial, language/verbal, and executive function were conducted at v1 and/or v2 (2009–2013); mean ± SD follow-up: 4.66 ± 0.93 years. Mixed-effects linear regression models detected an interaction between vitamin E and total (and individual) carotenoids for three of 11 cognitive tests at v1, with only one meeting the statistical significance upon multiple testing correction whereby vitamin E was linked with greater verbal memory performance in the uppermost total carotenoid tertile (γ0a = +0.26 ± 0.08, p = 0.002), a synergism largely driven by carotenoid lycopene. Vitamins A and C showed no consistent interactions with carotenoids. In conclusion, we provide partial evidence for synergism between vitamin E and carotenoids in relation to better baseline cognitive performance, pending further studies with time-dependent exposures and randomized trials directly examining this synergism.
Highlights
Cognitive impairment, across various levels of severity, is a major determinant of disability and long-term institutionalization in old age [1,2]
In terms of v1 cognitive test performance, when compared with T1, with a linear dose-response relationship, T3 total carotenoid intake was characterized by better performance on MMSE, Benton Visual Retention Test (BVRT), Animal Fluency test (AF), and DS-B, even after adjusting for basic socio-demographics
While no antagonism was found between β-carotene and vitamin E, there was some evidence of synergism between α-carotene and vitamin E in relation to performance in multiple domains of cognition
Summary
Across various levels of severity, is a major determinant of disability and long-term institutionalization in old age [1,2]. To extend the intact cognitive functioning into old age, and reduce the costs of care in late life, a greater focus on and understanding of factors that may decelerate or accelerate cognitive decline is needed [3,4]. One such factor is oxidative stress, which has received considerable attention over the past few decades in studies uncovering etiology, treatment, and preventive measures against age-related cognitive decline. ROS exposure can trigger unfavorable DNA oxidative modifications within the brain that accumulate because of DNA repair impairment with age [9,10,11]
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