Association of dietary choline intake with incidence of dementia, Alzheimer's disease and mild cognitive impairment: a large population-based prospective cohort study

Abstract

ObjectiveExplore the associations between dietary choline intake and the incidence of dementia, Alzheimer's disease (AD), mild cognitive impairment (MCI), and current cognitive performance in the UK Biobank cohort. MethodsDietary choline intake was categorized into quartiles of consumption based on 24-hour dietary recalls, with units expressed as milligrams per day. Diagnoses of dementia, AD, and MCI were identified using ICD-9/10 codes. Current cognitive performance was assessed via the computerized touchscreen interface. After adjusting for sociodemographic factors, dietary and lifestyle behaviors, and comorbid conditions, Cox proportional hazards regression, logistic regression, and restricted cubic splines were used to analyze the association between choline intake and dementia or cognitive performance. ResultsAmong 125,594 participants (55.8% female), with a mean age of 56.1 years (range: 40 to 70 years) at baseline, and a median follow-up of 11.8 years, 1,103 cases of dementia (including 385 AD) and 87 cases of MCI were recorded. U-shaped associations were observed between choline intake and dementia and AD. Participants in the 2nd quartile of total choline intake had lower risks compared to those in the lowest quartile, with HR of 0.80 (95% CI: 0.67, 0.96) for dementia and 0.76 (0.58, 1.00) for AD. Moderate intake of choline derivative, including free choline (HR, 0.77; 95%CI, 0.65, 0.92), phosphatidylcholine (0.82; 0.68, 0.98), sphingomyelin (0.82; 0.69, 0.98) and glycerophosphocholine (0.83; 0.70, 1.00), were associated with a 17% to 23% lower odds of dementia. Additionally, moderate total choline intake was associated with an 8% to 13% lower odds of poor cognitive performance in visual attention (OR, 0.92; 95%CI, 0.86, 0.99), fluid intelligence (0.87; 0.82, 0.92), and complex processing speed (0.90; 0.84, 0.95). ConclusionsIn conclusion, our findings suggest that moderate dietary choline intake, ranging from 332.89 mg/d to 353.93 mg/d, is associated with lower odds of dementia and better cognitive performance.