Association of Vitamin E and Cognitive Decline in Older Adults with and without the APOE ε4 Allele: A Biracial Population-Based Community Study

Background: The association of different types of tocopherols (vitamin E) with cognition might vary by the APOE epsilon 4 allele status. Objective: We examined the association of dietary tocopherols with cognitive decline among participants with and without the APOE epsilon 4 allele over a median of 12 years. Methods: 2,193 participants from the Chicago Health and Aging Project were included in the analyses. Global cognition was assessed in three-year cycles. We used a 144-item FFQ to assess dietary intakes of tocopherols and hME Sequenom mass-array platform to assess APOE genotype. We used linear mixed effects models to examine the relationship between tocopherol from food sources and global cognitive decline. Results: The mean baseline age was 74.1 (SD = 5.9) years. Among APOE epsilon 4 carriers, participants in the highest quintile of intakes of dietary vitamin E had a slower cognitive decline of 0.022 SDU (95% CI: 0.000, 0.043) compared to those in the lowest quintile. A higher intake of dietary alpha-tocopherol from food sources only was associated with slower cognitive decline in APOE epsilon 4 carriers (p for trend 0.002) but not among the non-carriers (p for trend 0.937). Among APOE epsilon 4 carriers, those in the highest quintile of intake of alpha-tocopherol had a 16.4% slower rate of decline of global cognition compared to those in the lowest quintile (beta = 0.034, 95% CI: 0.013, 0.054). Conclusions: Individuals consuming high alpha-tocopherol from food sources had slower cognitive decline among APOE epsilon 4 carriers. In older adults, different forms of vitamin E might moderate the relationship of APOE epsilon 4 with global cognition.