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- W2897018565 abstract "Nutritional status and nutrient interaction are underappreciated in the design and interpretation of clinical nutrition trials. Nutritional biomarkers are objective measures of diet and metabolism readily available to the brain. We created a nutritional risk index (NRI) to test the hypothesis that nutritional status and nutrient interaction explain the heterogeneity in rates of cognitive decline in the MAPT. Erythrocyte omega 3 fatty acids measured by GC-FID, plasma homocysteine by enzymatic assay and serum 25-hydroxyvitamin D by electrochemiluminescence in samples from a subset of participants from each trial arm (n = 780). The cutoffs for each were based on existing literature. NRI scores ranged from 0 (all 3 optimum) to 3 (all 3 suboptimum). The cognitive composite Z scores collected over 3 years in the parent MAPT were fit with linear mixed-effects models. Mean age was 75 (4.5), 67% were women, mean MMSE was 28 (1.6) and 20.7% carried an APOE4 allele. Over half of the population presented with nutritional risk (57.1% with NRI = 1) and 31.6% with NRI = 2. In adjusted mixed models, each unit increase in the NRI was associated with an annual incremental increase in rates of cognitive decline compared to those without nutritional risk (NRI = 0) (e.g., NRI = 1 (β = -0.04, p = 0.0325); NRI = 2 (β = -0.08, p < 0.0001); NRI = 3 (β = -0.10, p = 0.0017). Subjects with NRI = 0 appreciated a 0.03 annual unit increase in their cognitive composite Z score over 3 years. Further controlling for APOE4, trial arm, baseline cognitive state and their interactions with time did not materially change the results. This biomarker-based Nutritional Risk Index that includes omega 3 fatty acids, vitamin D and homocysteine explains the heterogeneity observed in rates of cognitive decline in older non-demented adults with subjective memory concerns. Whether reducing nutritional risk by optimizing these nutritional biomarkers can slow cognitive decline will require formal clinical trial testing. The prudent deployment of nutritional biomarkers will advance clinical trials and deepen our understanding of nutrition and brain health." @default.
- W2897018565 created "2018-10-26" @default.
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- W2897018565 date "2018-07-01" @default.
- W2897018565 modified "2023-10-02" @default.
- W2897018565 title "F4‐01‐03: A BIOMARKER‐BASED NUTRITIONAL RISK INDEX EXPLAINS THE HETEROGENEITY IN RATES OF COGNITIVE DECLINE IN THE MULTI‐DOMAIN ALZHEIMER PREVENTION TRIAL (MAPT)" @default.
- W2897018565 doi "https://doi.org/10.1016/j.jalz.2018.06.2866" @default.
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