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F4‐01‐04: APOE GENOTYPE INFLUENCES BRAIN TO BLOOD GLUCOSE RATIOS AFTER HIGH FAT FEEDING
Author(s) -
Hanson Angela J.,
Stewart Kelly C.,
Subramaniyan Deepa,
Craft Suzanne,
Banks William A.
Publication year - 2018
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.2018.06.2867
Subject(s) - meal , medicine , glycemic , endocrinology , glycemic index , carbohydrate metabolism , insulin
25-hydroxyvitamin D by electrochemiluminescence in samples from a subset of participants from each trial arm (n1⁄4 780). 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 MAPTwere fit with linear mixed-effects models. Results: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 1⁄4 1) and 31.6% with NRI 1⁄4 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 1⁄4 0) (e.g., NRI 1⁄4 1 (b 1⁄4 -0.04, p 1⁄4 0.0325); NRI 1⁄4 2 (b 1⁄4 -0.08, p < 0.0001); NRI 1⁄4 3 (b 1⁄4 -0.10, p 1⁄4 0.0017). Subjects with NRI 1⁄4 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. Conclusions: 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.