(P25-036-24) Relationship Between Dietary Choline and Betaine Intake and Cognitive Impairment Risk Among Older Adults in Taiwan

Objectives: To understand the impact of dietary choline and betaine intake on cognitive impairment among older adults. Whether the current intake levels of both one-carbon nutrients can predict cognitive dysfunction in Taiwanese older people is explored.

Methods: This is a case-cohort design to select Taiwanese older adults from the One-Carbon Nutrition and Alzheimer’s Disease Prevention cohort study. Between 2019-2024, 154 participants aged 50 and above were recruited from the Department of Neurology of National Taiwan University Hospital and at Fu Jen Catholic University Hospital. Among them, there were 75 individuals with subjective cognitive decline (SCD), 47 patients with mild cognitive impairment (MCI) or very mild Alzheimer’s disease (VMAD), and 32 patients with Alzheimer’s disease (AD). One carbon nutrients were evaluated using a validated quantitative food frequency questionnaire. Cognitive dysfunction screening tools including the Mini-Mental State Examination (MMSE), Clinical Dementia Rating (CDR), or/and MRI were utilized. Blood tests included measuring homocysteine (Hcy).

Results: In SCD, MCI/VMAD, and AD groups, the dietary insufficiency rates were 53%, 62%, and 75% for choline (below age-sex-dependent adequate intake (AI)), and 63%, 77%, and 69% for betaine (below the mean intake), respectively. MCI/VMAD group had significantly lower intake of free choline compared to SCD group (p < 0.05). Compared to the lowest tertile, older females in the highest tertile of choline intake (693±272 mg/d, p< 0.05) exhibited higher MMSE scores. Total choline (r= -0.42, p< 0.05) and phosphatidylcholine (r= -0.44, p< 0.05) intake showed inversely associated with MMSE scores in the AD group. Choline intake at the level below 404 mg/d can predict cognitive impairment (MMSE < 26) (AUC=0.684, p< 0.01). Choline intake over age-sex AI levels was associated with reduced risk of cognitive impairment (MMSE < 26) after adjusting for age, sex, education levels, energy intake and blood Hcy (OR: 0.15, 95% CI = 0.04–0.6).

Conclusions: High prevalence of insufficient choline and betaine intake was found among older adults in Taiwan. Increased choline intake was associated with improved cognitive function and reduced risk of cognitive impairment above age-sex-dependent AI levels.

Funding Sources: This research was funded by the Ministration of Science and Technology, Taiwan, ROC.