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Caloric Intake and the Risk of Alzheimer Disease
Jose A. Luchsinger, MD;
Ming-Xing Tang, PhD;
Steven Shea, MD;
Richard Mayeux, MD
Arch Neurol. 2002;59:1258-1263.
Background Diet may play a role in Alzheimer disease (AD).
Objective To examine the association between caloric intake and AD.
Methods Elderly individuals free of dementia at baseline (N = 980) were followed
for a mean of 4 years. Daily intake of calories, carbohydrates, fats, and
protein were recalled using a semiquantitative food frequency questionnaire
administered between the baseline and first follow-up visits. Proportional
hazards models were used to examine the associations of quartiles of intake
and incident AD, adjusting for confounders.
Results There were 242 incident cases of AD during 4023 years of follow-up (6
cases per 100 person-years). Compared with individuals in the lowest quartile
of caloric intake, those in the highest quartile had an increased risk of
AD (hazard ratio, 1.5; 95% confidence interval [CI], 1.0-2.2). Among individuals
with the apolipoprotein E  4 allele, the hazard ratios of AD for the
highest quartiles of calorie and fat intake were 2.3 (95% CI, 1.1-4.7) and
2.3 (95% CI, 1.1-4.9), respectively, compared with the lowest quartiles. The
hazard ratios of AD for the highest quartiles of calorie and fat intake compared
with the lowest quartiles in individuals without the apolipoprotein E 4
allele were close to 1 and were not statistically significant (P = .83 and P = .61, respectively).
Conclusion Higher intake of calories and fats may be associated with higher risk
of AD in individuals carrying the apolipoprotein E 4 allele.
From the Taub Institute for Research of Alzheimer's Disease and the
Aging Brain (Drs Luchsinger, Tang, and Mayeux), the Divisions of Biostatistics
(Dr Tang) and Epidemiology (Drs Shea and Mayeux), Joseph P. Mailman School
of Public Health, and the Gertrude H. Sergievsky Center (Dr Mayeux), Columbia
University, the Division of General Medicine, Department of Medicine (Drs
Luchsinger and Shea), and the Departments of Neurology (Dr Mayeux) and Psychiatry
(Dr Mayeux), Columbia University College of Physicians and Surgeons, New York,
NY.
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