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April 21, 2020; 94 (16) Article

Dietary flavonols and risk of Alzheimer dementia

Thomas M. Holland, Puja Agarwal, Yamin Wang, View ORCID ProfileSue E. Leurgans, David A. Bennett, Sarah L. Booth, Martha Clare Morris
First published January 29, 2020, DOI: https://doi.org/10.1212/WNL.0000000000008981
Thomas M. Holland
From Rush Institute for Healthy Aging (T.M.H., P.A., Y.W., M.C.M.), Rush Alzheimer's Disease Center (S.E.L., D.A.B.), and Neurological Sciences (S.E.L., D.A.B.), Rush University Medical Center, Chicago, IL; and Jean Mayer USDA Human Nutrition Research Center on Aging (S.L.B.), Tufts University, Boston, MA.
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Puja Agarwal
From Rush Institute for Healthy Aging (T.M.H., P.A., Y.W., M.C.M.), Rush Alzheimer's Disease Center (S.E.L., D.A.B.), and Neurological Sciences (S.E.L., D.A.B.), Rush University Medical Center, Chicago, IL; and Jean Mayer USDA Human Nutrition Research Center on Aging (S.L.B.), Tufts University, Boston, MA.
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Yamin Wang
From Rush Institute for Healthy Aging (T.M.H., P.A., Y.W., M.C.M.), Rush Alzheimer's Disease Center (S.E.L., D.A.B.), and Neurological Sciences (S.E.L., D.A.B.), Rush University Medical Center, Chicago, IL; and Jean Mayer USDA Human Nutrition Research Center on Aging (S.L.B.), Tufts University, Boston, MA.
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Sue E. Leurgans
From Rush Institute for Healthy Aging (T.M.H., P.A., Y.W., M.C.M.), Rush Alzheimer's Disease Center (S.E.L., D.A.B.), and Neurological Sciences (S.E.L., D.A.B.), Rush University Medical Center, Chicago, IL; and Jean Mayer USDA Human Nutrition Research Center on Aging (S.L.B.), Tufts University, Boston, MA.
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  • ORCID record for Sue E. Leurgans
David A. Bennett
From Rush Institute for Healthy Aging (T.M.H., P.A., Y.W., M.C.M.), Rush Alzheimer's Disease Center (S.E.L., D.A.B.), and Neurological Sciences (S.E.L., D.A.B.), Rush University Medical Center, Chicago, IL; and Jean Mayer USDA Human Nutrition Research Center on Aging (S.L.B.), Tufts University, Boston, MA.
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Sarah L. Booth
From Rush Institute for Healthy Aging (T.M.H., P.A., Y.W., M.C.M.), Rush Alzheimer's Disease Center (S.E.L., D.A.B.), and Neurological Sciences (S.E.L., D.A.B.), Rush University Medical Center, Chicago, IL; and Jean Mayer USDA Human Nutrition Research Center on Aging (S.L.B.), Tufts University, Boston, MA.
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Martha Clare Morris
From Rush Institute for Healthy Aging (T.M.H., P.A., Y.W., M.C.M.), Rush Alzheimer's Disease Center (S.E.L., D.A.B.), and Neurological Sciences (S.E.L., D.A.B.), Rush University Medical Center, Chicago, IL; and Jean Mayer USDA Human Nutrition Research Center on Aging (S.L.B.), Tufts University, Boston, MA.
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Dietary flavonols and risk of Alzheimer dementia
Thomas M. Holland, Puja Agarwal, Yamin Wang, Sue E. Leurgans, David A. Bennett, Sarah L. Booth, Martha Clare Morris
Neurology Apr 2020, 94 (16) e1749-e1756; DOI: 10.1212/WNL.0000000000008981

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Abstract

Objective To determine whether dietary intake of flavonols is associated with Alzheimer dementia.

Methods The study was conducted among 921 participants of the Rush Memory and Aging Project (MAP), an ongoing community-based, prospective cohort. Participants completed annual neurologic evaluations and dietary assessments using a validated food frequency questionnaire.

Results Among 921 MAP participants who initially had no dementia in the analyzed sample, 220 developed Alzheimer dementia. The mean age of the sample was 81.2 years (SD 7.2), with the majority (n = 691, 75%) being female. Participants with the highest intake of total flavonols had higher levels of education and more participation in physical and cognitive activities. In Cox proportional hazards models, dietary intakes of flavonols were inversely associated with incident Alzheimer dementia in models adjusted for age, sex, education, APOE ɛ4, and participation in cognitive and physical activities. Hazard ratios (HRs) for the fifth vs first quintiles of intake were as follows: for total flavonol, 0.52 (95% confidence interval [CI], 0.33–0.84); for kaempferol, 0.49 (95% CI, 0.31–0.77); for myricetin, 0.62 (95% CI, 0.4–0.97); and for isorhamnetin, 0.62 (95% CI, 0.39–0.98). Quercetin was not associated with Alzheimer dementia (HR, 0.69; 95% CI, 0.43–1.09).

Conclusion Higher dietary intakes of flavonols may be associated with reduced risk of developing Alzheimer dementia.

Glossary

AD=
Alzheimer disease;
BMI=
body mass index;
CI=
confidence interval;
DASH=
Dietary Approaches to Stop Hypertension;
FFQ=
food frequency questionnaire;
HR=
hazard ratio;
MAP=
Rush Memory and Aging Project;
RADC=
Rush Alzheimer's Disease Center;
USDA=
US Department of Agriculture

Footnotes

  • Presented at the Alzheimer's Association International Conference, Chicago, IL, 2018.

  • Go to Neurology.org/N for full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the article.

  • Received May 24, 2019.
  • Accepted in final form November 12, 2019.
  • © 2020 American Academy of Neurology
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Disputes & Debates: Rapid online correspondence

  • Author response: Dietary flavonols and risk of Alzheimer dementia
    • Thomas M. Holland, MD, MS, Faculty, College of Health Sciences, Rush University Post-Doctoral Fellow, Rush Institute for Healthy Aging, RUMC
    • Puja Agarwal, PhD, Rush University Medical Center, Rush Institute for Healthy Aging
    • Yamin Wang, PhD, Rush Institute for Healthy Aging
    • Sarah L. Booth, PhD, Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University (Boston, MA)
    Submitted May 22, 2020
  • Reader response: Dietary flavonols and risk of Alzheimer dementia
    • Tomoyuki Kawada, Professor, Nippon Medical School
    Submitted May 19, 2020
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