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P2–072: Antioxidant use at enrollment predicts transitions from normal to amnestic MCI and dementia
Author(s) -
Mendiondo Marta S.,
Kryscio Richard J.,
Schmitt Frederick A.
Publication year - 2006
Publication title -
alzheimer's and dementia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 6.713
H-Index - 118
eISSN - 1552-5279
pISSN - 1552-5260
DOI - 10.1016/j.jalz.2006.05.909
Subject(s) - dementia , cohort , medicine , confidence interval , odds ratio , neuropsychology , psychology , cognition , psychiatry , disease
Background: The effect of antioxidants on transitions from normal to mild cognitive impairment (MCI) and later dementia is unknown. Oxidative stress, however, is a key pathophysiological mechanism in AD and has been observed in MCI. Further, oxidative damage may be modifiable with antioxidant supplements. Objective: To model transitions between normal, MCI, and dementia in persons taking antioxidant supplements. We examined the annual cognitive test results from the BRAiNS cohort, a group of 785 initially cognitively normal adults longitudinally followed at the University of Kentucky ADC. This cohort contains continuously enrolled subjects over the age of 65, with subjects in the present analysis having 2 to 17 annual assessments (mean years of follow-up 8). Results from the clinical exams and neuropsychological tests were used to classify participants into one of three transient states at each assessment: cognitively normal, amnestic mild cognitive impairment (MCI), and mixed MCI. Conversion to dementia or death are treated as absorbing states. Baseline use of any of the antioxidants Beta Carotene, Selenium, Vitamin C, or Vitamin E was determined for each participant. A multi-state Markov chain based on a series of polytomous logistic regressions was used to model transitions among these states. Conclusions: After controlling for age, gender, education, family history of dementia, and the presence of an APOE 4 allele, baseline antioxidant use increases the odds of a transition from normal to amnestic MCI (adjusted odds ratio: 1.5; 95% Confidence interval: 1.04 2.1) and from amnestic MCI to dementia (OR 4.0; 95 % C.I.: 1.6-10.1). These data suggest that other pathophysiologic mechanisms may be more prominent in transitions to and from MCI.