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Association Between Serum Beta-Carotene Levels and Decline of Cognitive Function in High-Functioning Older Persons With or Without Apolipoprotein E 4 Alleles: MacArthur Studies of Successful Aging

¹ Multicampus Program in Geriatric Medicine and Gerontology, UCLA School of Medicine, Los Angeles.
² USC/Norris Comprehensive Cancer Center, Department of Preventive Medicine, Keck School of Medicine of the University of Southern California, Los Angeles.
³ Andrus Gerontology Center, University of Southern California, Los Angeles.
⁴ Laboratory of Epidemiology, Demography, and Biometry, National Institute on Aging, Bethesda, Maryland.

Address correspondence to Peifeng Hu, MD, PhD, Multicampus Program in Geriatric Medicine and Gerontology, UCLA School of Medicine, 10945 Le Conte Avenue, Suite 2339, Los Angeles, CA 90095-1687. E-mail: phu{at}mednet.ucla.edu.

Abstract

Background. Growing evidence from animal studies suggests an interaction between antioxidants and apolipoprotein E (APOE) alleles on cognitive functioning. We used data from a 7-year cohort study of high-functioning older persons to explore whether the associations between serum beta-carotene level and subsequent decline of cognitive function differed by APOE 4 genotype.

Methods. Baseline information on sociodemographic characteristics, serum beta-carotene level, inflammation markers, APOE genotype, and cognitive functioning measured by a 9-item Short Portable Mental Status Questionnaire (SPMSQ) was obtained in 455 survivors. Multivariable logistic regression analyses were used to examine the relation between high serum beta-carotene level and risk of SPMSQ score decline in participants with or without APOE 4 alleles, while adjusting for age, sex, race, baseline SPMSQ score, and other covariates.

Results. Nine (2%) study participants had homozygous and 97 (21%) had heterozygous APOE 4 alleles. Two hundred forty-nine (55%) had decline of SPMSQ scores during the follow-up. The presence of an APOE 4 allele was associated with higher risk and larger magnitude of SPMSQ score decline. The adjusted odds ratio of high beta-carotene level for cognitive decline was 0.11 (95% confidence interval, 0.02–0.57) in participants with at least one APOE 4 allele and 0.89 (95% confidence interval, 0.54–1.47) among those who were APOE 4 negative.

Conclusion. Among high-functioning older persons, antioxidants and beta-carotene in particular may offer protection from cognitive decline in persons with greater genetic susceptibility as evidenced by the presence of the APOE 4 allele.