title: The relation of dietary choline to cognitive performance and white-matter hyperintensity in the Framingham Offspring Cohort.
abstract: BACKGROUND
  Choline is the precursor to the neurotransmitter acetylcholine. Loss of cholinergic neurons is associated with impaired cognitive function, particularly memory loss and Alzheimer disease (AD). Brain atrophy and white-matter hyperintensity (WMH) are also associated with impaired cognitive function and AD.
  
  
  OBJECTIVE
  The objective was to determine whether a relation exists between dietary choline intake, cognitive function, and brain morphology in a large, nondemented community-based cohort.
  
  
  METHODS
  A dementia-free cohort of 1391 subjects (744 women, 647 men; age range: 36-83 y; mean ± SD age: 60.9 ± 9.29 y) from the Framingham Offspring population completed a food-frequency questionnaire administered from 1991 to 1995 (exam 5; remote intake) and from 1998 to 2001 (exam 7; concurrent intake). Participants underwent neuropsychological evaluation and brain MRI at exam 7. Four neuropsychological factors were constructed: verbal memory (VM), visual memory (VsM), verbal learning, and executive function. MRI measures included WMH volume (WMHV).
  
  
  RESULTS
  Performance on the VM and VsM factors was better with higher concurrent choline intake in multivariable-adjusted models for VM (average change in neuropsychological factor per 1-unit change in choline = 0.60; 95% CI: 0.29, 0.91; P < 0.01) and VsM (0.66; 95% CI: 0.19, 1.13; P < 0.01). Remote choline intake was inversely related to log-transformed WMHV (average change in log WMHV per 1-unit change in choline = -0.05; 95% CI: -0.10, -0.01; P = 0.02). Furthermore, an inverse association was observed between remote higher choline intake and presence of large WMVH (OR: 0.56; 95% CI: 0.34, 0.92; P = 0.01).
  
  
  CONCLUSIONS
  In this community-based population of nondemented individuals, higher concurrent choline intake was related to better cognitive performance, whereas higher remote choline intake was associated with little to no WMHV.
authors.affiliation: Department of Neurology, Boston University School of Medicine, MA, 02118-2526, USA.
authors.forename: Coreyann
authors.initials: C
authors.lastname: Poly
authors.forename: Joseph M
authors.initials: JM
authors.lastname: Massaro
authors.forename: Sudha
authors.initials: S
authors.lastname: Seshadri
authors.forename: Philip A
authors.initials: PA
authors.lastname: Wolf
authors.forename: Eunyoung
authors.initials: E
authors.lastname: Cho
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Krall
authors.forename: Paul F
authors.initials: PF
authors.lastname: Jacques
authors.forename: Rhoda
authors.initials: R
authors.lastname: Au
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001921:Brain / Q000033:anatomy & histology / Q000187:drug effects*; D002794:Choline / Q000494:pharmacology*; D003071:Cognition / Q000187:drug effects*; D003072:Cognition Disorders / Q000209:etiology* / Q000517:prevention & control; D015331:Cohort Studies; D004032:Diet; D004034:Diet Surveys; D056344:Executive Function / Q000187:drug effects*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008568:Memory / Q000187:drug effects*; D008875:Middle Aged; D015999:Multivariate Analysis; D011795:Surveys and Questionnaires
chemical_list: D002794:Choline
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