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Objectives To understand the association between strawberries or anthocyanidins intake and Alzheimer's disease neuropathology in human brains. Methods The study was conducted in 508 deceased participants (mean age: 91.2 ± 7.2 years, mean education: 14.6 ± 3 years) of the Rush Memory and Aging Project (a clinicopathologic longitudinal cohort) who completed a food frequency questionnaire and had completed neuropathological evaluations. Strawberry consumption was assessed as a continuous variable for the frequency of intake (never or less than once a month, 1–3 times/month, once/week, 2–4 times/week). Anthocyanidin and its subclass intakes were energy-adjusted and modeled in quartiles with the lowest quartile as the referent category. Diffuse and neuritic plaques and neurofibrillary tangles were assessed in multiple brain regions and summarized as standard measures of AD pathology, including Braak, CERAD, NIA-Reagan, global AD pathology. Linear regression models adjusted for age, sex, and education were used. Results In the study population mean pelargonidin intake was 1.6 ± 1.9 mg/day and strawberries contributed to 75% of this total intake. Higher pelargonidin intake was associated with less amyloid plaques (P for trend = 0.03) and neurofibrillary tangles (P for trend = 0.008). Participants in the highest quartile of pelargonidin intake had overall less AD neuropathology as assessed by standardized measure (Braak: β = −0.33, P = 0.02; NIA-Regan: β = −0.19, P = 0.02; global AD pathology: β = −0.10, P = 0.03) compared to those in the lowest quartile. Strawberry intake indicated a trend of association only with neurofibrillary tangles (β = −0.33, P = 0.09) and no other significant association otherwise. Other anthocyanidins assessed had no association with AD neuropathology. Conclusions Higher pelargonidin intake may reduce the risk of Alzheimer's Disease. Strawberries being a rich source of pelargonidin, should be further assessed for its role to maintain brain health in older adults. Funding Sources National Institute of Aging and California Strawberry Commission.

Pelargonidin in Strawberries May Reduce Alzheimer’s Disease Neuropathology: A Community-Based Study