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Antioxidant nutrients and age-related cognitive decline: a systematic review of population-based cohort studies

Abstract

Purpose

To further inform the debate on the possible cognitive benefits of antioxidant nutrients in the elderly, we systematically reviewed available prospective studies while paying a special attention to their methodological quality.

Methods

This is a systematic review of studies involving major antioxidant nutrients and change in cognitive performance. Abstracts were independently reviewed; studies were selected based on prespecified criteria. Methodological quality of primary studies was assessed using a methodological checklist for cohort studies. Findings were presented using a narrative synthesis and tabulation of results.

Results

Eight-hundred and fifty potentially eligible studies were identified; 10 met the inclusion criteria and were retained for data extraction and appraisal. The main supportive evidence came from two studies, both judged to be of high quality: The first observed an accelerated decline in global cognition, attention, and psychomotor speed over 9 years, concomitant to a decrease in plasma selenium levels over the same period; the second study reported a slower rate of global cognitive decline over 3 years in persons in the highest quartile of intake of vitamins C, E, and carotenes. All associations persisted after adjustment for confounding factors. Evidence in favor of beneficial associations of higher dietary intake of vitamin E and flavonoids, as well as higher serum beta carotene levels, came from further studies of only adequate quality.

Conclusions

There is a possibility for protective effects of antioxidant nutrients against decline in cognition in older people although the supportive evidence is still limited in number. This association deserves further examination in additional quality investigations.

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Acknowledgments

This work was supported by the CHANCES (Consortium on Health and Ageing: Network of Cohorts in Europe and the United States) project (Grant Agreement number: 242244) funded by the European Commission under the FP7 framework programme. The authors would like to thank Professor Dimitrios Trichopoulos, Harvard School of Public Health, and Dr. Roger Humphry, Epidemiology Research Unit, Scottish Agricultural College, for providing valuable comments on earlier versions of this paper. Also, we thank the referees assigned to this paper for their constructive comments and suggestions which considerably helped improve the manuscript.

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The authors declare that they have no conflict of interest.

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Correspondence to Snorri Bjorn Rafnsson.

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Rafnsson, S.B., Dilis, V. & Trichopoulou, A. Antioxidant nutrients and age-related cognitive decline: a systematic review of population-based cohort studies. Eur J Nutr 52, 1553–1567 (2013). https://doi.org/10.1007/s00394-013-0541-7

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  • DOI: https://doi.org/10.1007/s00394-013-0541-7

Keywords

  • Antioxidants
  • Cognition
  • Elderly
  • Systematic review