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Dietary Antioxidants, Cognitive Function and Dementia - A Systematic Review

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Abstract

Antioxidant compounds, contained in fruit, vegetables and tea, have been postulated to have a protective effect against age-related cognitive decline by combating oxidative stress. However, recent research on this subject has been conflicting. The aim of this systematic review was to consider current epidemiological and longitudinal evidence for an association between habitual dietary intake of antioxidants and cognition, with consideration given to both cognitive functioning and risk for dementia and its subtypes, including Alzheimer’s disease and vascular dementia. Searches of electronic databases were undertaken to identify peer-reviewed journal articles that reported on associations between antioxidant intakes (vitamins C, E, flavonoids, carotenoids) and cognitive function or risk for dementia. Eight cross-sectional and 13 longitudinal studies were identified and included in the review. There were mixed findings for the association between antioxidant intake, cognition and risk of dementia and Alzheimer’s disease. Large heterogeneity in study design, differential control of confounders, insufficient measures of cognitive performance, and difficulties associated with dietary assessment may contribute to the inconsistent findings. Overall, findings do not consistently show habitual intakes of dietary antioxidants are associated with better cognitive performance or a reduced risk for dementia. Future intervention trials are warranted to elucidate the effects of a high intake of dietary antioxidants on cognitive functioning, and to explore effects within a whole dietary pattern.

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Abbreviations

AD:

Alzheimer’s disease

ARIC:

Atherosclerosis risk in communities

BLSA:

Baltimore longitudinal study of aging

BMI:

Body mass index

CAMDEX:

Cambridge examination of mental disorders in the elderly

CHAP:

Chicago health and aging project

CHS:

Cardiovascular health study

CLUE:

Campaign against cancer and heart disease

DSMIII-R:

Diagnostic and statistical manual of mental disorders, third edition revised

DSST:

Digit-symbol substitution test

FFQ:

Food frequency questionnaire

FUD:

Follow-up duration

GMS:

Geriatric mental state schedule

HRT:

Hormone replacement therapy

MMSE:

Mini-mental state examination

MMSE-K:

Mini-mental state examination for Koreans

NA:

Not applicable

PAQUID:

Personnes agees quid

PMSQ:

Pfeiffer’s mental status questionnaire

VaD:

Vascular dementia

RDA:

Recommended daily allowance

ROS:

Reactive oxygen species

SITE:

Western Sydney stroke in the elderly

WAIS:

Wechsler adult intelligence scale

WFR:

Weighed food record

WHICAP:

Washington heights-inwood Columbia aging project

WMS:

Wechsler memory scale

References

  1. Ferri CP, Prince M, Brayne C, Brodaty H, Fratiglioni L, Ganguli M, Hall K, Hasegawa K, Hendrie H, Huang Y, Jorm A, Mathers C, Menezes PR, Rimmer E, Scazufca M (2005) Global prevalence of dementia: a Delphi consensus study. Lancet 366(9503):2112–2117

    Article  Google Scholar 

  2. Bryan J (2004) Mechanisms and evidence for the role of nutrition in cognitive ageing. Ageing Int 29(1):28–45

    Article  Google Scholar 

  3. Solfrizzi V, Panza F, Capurso A (2003) The role of diet in cognitive decline. J Neural Transm 110(1):95–110

    CAS  Google Scholar 

  4. Van Dyk K, Sano M (2007) The impact of nutrition on cognition in the elderly. Neurochem Res 32(4–5):893–904

    Article  CAS  Google Scholar 

  5. Crichton GE, Bryan J, Murphy KJ, Buckley J et al (2010) Review of dairy consumption and cognitive performance in adults: findings and methodological issues. Dement Geriatr Cogn Disord 30(4):352–361

    Google Scholar 

  6. Crichton GE, Elias MF, Buckley J, Murphy KJ, Bryan J, Frisardi V (2011) Metabolic syndrome, cognitive performance, and dementia. J Alzheimers Dis 2:S77–S87

    Google Scholar 

  7. Haider S, Batool Z, Tabassum S, Perveen T, Saleem S, Naqvi F, Javed H, Haleem DJ (2011) Effects of walnuts (Juglans regia) on learning and memory functions. Plant Foods Hum Nutr 66(4):335–340

    Article  CAS  Google Scholar 

  8. Berr C, Balansard B, Arnaud J, Roussel AM, Alperovitch A (2000) Cognitive decline is associated with systemic oxidative stress: the EVA study. J Am Geriatr Soc 48(10):1285–1291

    CAS  Google Scholar 

  9. Lopez V, Calvo MI (2011) White tea (Camellia sinensis Kuntze) exerts neuroprotection against hydrogen peroxide-induced toxicity in PC12 cells. Plant Foods Hum Nutr 66(1):22–26

    Article  Google Scholar 

  10. Agostinho P, Cunha RA, Oliveira C (2010) Neuroinflammation, oxidative stress and the pathogenesis of Alzheimer’s disease. Curr Pharm Des 16(25):2766–2778

    Article  CAS  Google Scholar 

  11. Markesbery WR (1997) Oxidative stress hypothesis in Alzheimer’s disease. Free Radic Biol Med 23(1):134–147

    Article  CAS  Google Scholar 

  12. Esposito K, Maiorino MI, Ceriello A, Giugliano D (2010) Prevention and control of type 2 diabetes by Mediterranean diet: a systematic review. Diabetes Res Clin Pract 89(2):97–102

    Article  CAS  Google Scholar 

  13. Luchsinger JA, Noble JM, Scarmeas N (2007) Diet and Alzheimer’s disease. Curr Neurol Neurosci Rep 7(5):366–372

    Article  CAS  Google Scholar 

  14. Miller HE, Rigelhof F, Marquart L, Prakash A, Kanter M (2000) Antioxidant content of whole grain breakfast cereals, fruits and vegetables. J Am Coll Nutr 19(3 Suppl):312S–319S

    CAS  Google Scholar 

  15. Bayram B, Esatbeyoglu T, Schulze N, Ozcelik B, Frank J, Rimbach G (2012) Comprehensive analysis of polyphenols in 55 extra virgin olive oils by HPLC-ECD and their correlation with antioxidant activities. Plant Foods Hum Nutr 67(4):326–336

    Article  CAS  Google Scholar 

  16. Coelho RC, Hermsdorff HH, Bressan J (2013) Anti-inflammatory properties of orange juice: possible favorable molecular and metabolic effects. Plant Foods Hum Nutr 68(1):1–10

    Article  CAS  Google Scholar 

  17. Farina N, Isaac MG, Clark AR, Rusted J, Tabet N (2012) Vitamin E for Alzheimer’s dementia and mild cognitive impairment. Cochrane database of systematic reviews 11:CD002854

  18. Loef M, Schrauzer GN, Walach H (2011) Selenium and Alzheimer’s disease: a systematic review. J Alzheimers Dis 26(1):81–104

    CAS  Google Scholar 

  19. Harrison FE (2012) A critical review of vitamin C for the prevention of age-related cognitive decline and Alzheimer’s disease. Journal of Alzheimers Disease 29(4):711–726

    CAS  Google Scholar 

  20. Li FJ, Shen L, Ji HF (2012) Dietary intakes of vitamin E, vitamin C, and beta-carotene and risk of Alzheimer’s disease: a meta-analysis. J Alzheimer’s Dis 31(2):253–258

    CAS  Google Scholar 

  21. Loef M, Walach H (2012) Fruit, vegetables and prevention of cognitive decline or dementia: a systematic review of cohort studies. J Nutr Health Aging 16(7):626–630

    Article  CAS  Google Scholar 

  22. Elias MF, Beiser A, Wolf PA, Au R, White RF, D’Agostino RB (2000) The preclinical phase of Alzheimer disease: A 22-year prospective study of the Framingham cohort. Arch Neurol 57(6):808–813

    Article  CAS  Google Scholar 

  23. Tierney MC, Moineddin R, McDowell I (2010) Prediction of all-cause dementia using neuropsychological tests within 10 and 5 years of diagnosis in a community-based sample. J Alzheimers Dis 22(4):1231–1240

    Google Scholar 

  24. Tierney MC, Yao C, Kiss A, McDowell I (2005) Neuropsychological tests accurately predict incident Alzheimer disease after 5 and 10 years. Neurology 64(11):1853–1859

    Article  Google Scholar 

  25. Butchart C, Kyle J, McNeill G, Corley J, Gow AJ, Starr JM, Deary IJ (2011) Flavonoid intake in relation to cognitive function in later life in the Lothian birth cohort 1936. Br J Nutr 106(1):141–148

    Article  CAS  Google Scholar 

  26. McNeill G, Jia X, Whalley LJ, Fox HC, Corley J, Gow AJ, Brett CE, Starr JM, Deary IJ (2011) Antioxidant and B vitamin intake in relation to cognitive function in later life in the Lothian birth cohort 1936. Eur J Clin Nutr 65(5):619–626

    Article  CAS  Google Scholar 

  27. Devore EE, Grodstein F, van Rooij FJA, Hofman A, Stampfer MJ, Witteman JCM, Breteler MMB (2010) Dietary antioxidants and long-term risk of dementia. Arch Neurol 67(7):819–825

    Article  Google Scholar 

  28. Engelhart MJ, Geerlings MI, Ruitenberg A, van Swieten JC, Holman A, Witteman JCM, Breteler MMB (2002) Dietary intake of antioxidants and risk of Alzheimer disease. J Am Med Assoc 287(24):3223–3229

    Article  CAS  Google Scholar 

  29. Jama JW, Launer LJ, Witteman JCM, den Breeijen JH, Breteler MMB, Grobbee DE, Hofman A (1996) Dietary antioxidants and cognitive function in a population-based sample of older persons—The Rotterdam study. Am J Epidemiol 144(3):275–280

    Article  CAS  Google Scholar 

  30. Commenges D, Scotet V, Renaud S, Jacqmin-Gadda H, Barberger-Gateau P, Dartigues JF (2000) Intake of flavonoids and risk of dementia. Eur J Epidemiol 16(4):357–363

    Article  CAS  Google Scholar 

  31. Letenneur L, Proust-Lima C, Le Gouge A, Dartigues JF, Barberger-Gateau P (2007) Flavonoid intake and cognitive decline over a 10-year period. Am J Epidemiol 165(12):1364–1371

    Article  CAS  Google Scholar 

  32. Morris MC, Evans DA, Bienias JL, Tangney CC, Bennett DA, Aggarwal N, Wilson RS, Scherr PA (2002) Dietary intake of antioxidant nutrients and the risk of incident Alzheimer disease in a biracial community study. JAMA 287(24):3230–3237

    Article  CAS  Google Scholar 

  33. Morris MC, Evans DA, Tangney CC, Bienias JL, Wilson RS, Aggarwal NT, Scherr PA (2005) Relation of the tocopherol forms to incident Alzheimer disease and to cognitive change. Am J Clin Nutr 81(2):508–514

    CAS  Google Scholar 

  34. Kalmijn S, Feskens EJM, Launer LJ, Kromhout D (1997) Polyunsaturated fatty acids, antioxidants, and cognitive function in very old men. Am J Epidemiol 145(1):33–41

    Article  CAS  Google Scholar 

  35. Laurin D, Masaki KH, Foley DJ, White LR, Launer LJ (2004) Midlife dietary intake of antioxidants and risk of late-life incident dementia—the Honolulu-Asia aging study. Am J Epidemiol 159(10):959–967

    Article  Google Scholar 

  36. Paleologos M, Cumming RG, Lazarus R (1998) Cohort study of vitamin C intake and cognitive impairment. Am J Epidemiol 148(1):45–50

    Article  CAS  Google Scholar 

  37. Peacock JM, Folsom AR, Knopman DS, Mosley TH, Goff DC Jr, Szklo M (2000) Dietary antioxidant intake and cognitive performance in middle-aged adults. The atherosclerosis risk in communities (ARIC) study investigators. Public Health Nutr 3(3):337–343

    Article  CAS  Google Scholar 

  38. Lee L, Kang SA, Lee HO, Lee BH, Park JS, Kim JH, Jung IK, Park YJ, Lee JE (2001) Relationships between dietary intake and cognitive function level in Korean elderly people. Public Health 115(2):133–138

    CAS  Google Scholar 

  39. Ortega RM, Requejo AM, Andres P, Lopez-Sobaler AM, Quintas ME, Redondo MR, Navia B, Rivas T (1997) Dietary intake and cognitive function in a group of elderly people. Am J Clin Nutr 66(4):803–809

    CAS  Google Scholar 

  40. Sato R, Helzlsouer KJ, Comstock GW, Hoffman SC, Norkus EP, Fried LP (2006) A cross-sectional study of vitamin C and cognitive function in older adults: the differential effects of gender. J Nutr Health Aging 10(1):37–44

    CAS  Google Scholar 

  41. LaRue A, Koehler KM, Wayne SJ, Chiulli SJ, Haaland KY, Garry PJ (1997) Nutritional status and cognitive functioning in a normally aging sample: a 6-y reassessment. Am J Clin Nutr 65(1):20–29

    CAS  Google Scholar 

  42. Goodwin JS, Goodwin JM, Garry PJ (1983) Association between nutritional status and cognitive functioning in a healthy elderly population. JAMA 249(21):2917–2921

    Article  CAS  Google Scholar 

  43. Corrada MM, Breitner JCS, Brookmeyer R, Hallfrisch J, Muller DC, Kawas CH (2002) Reduced risk of Alzheimer’s disease with antioxidant vitamin intake: the Baltimore longitudinal study of aging. Neurobiol Aging 23(1):S272–S272, ISSN is 0197–4580

    Google Scholar 

  44. Luchsinger JA, Tang MX, Shea S, Mayeux R (2003) Antioxidant vitamin intake and risk of Alzheimer disease. Arch Neurol 60(2):203–208

    Article  Google Scholar 

  45. Gale CR, Martyn CN, Cooper C (1996) Cognitive impairment and mortality in a cohort of elderly people. Br Med J 312(7031):608–611

    Article  CAS  Google Scholar 

  46. National Health and Medical Research Council (2012) Nutrient reference values for Australia and New Zealand. http://www.nrv.gov.au/index.htm. Accessed 16 December 2012

  47. United States Department of Agriculture (2012) Dietary reference intakes: recommended intakes for individuals. http://fnic.nal.usda.gov/dietary-guidance/dietary-reference-intakes/dri-tables. Accessed 17 December 2012

  48. Ng TP, Feng L, Niti M, Kua EH, Yap KB (2008) Tea consumption and cognitive impairment and decline in older Chinese adults. Am J Clin Nutr 88(1):224–231

    CAS  Google Scholar 

  49. Nurk E, Refsum H, Drevon CA, Tell GS, Nygaard HA, Engedal K, Smith AD (2009) Intake of flavonoid-rich wine, tea, and chocolate by elderly men and women is associated with better cognitive test performance. J Nutr 139(1):120–127

    CAS  Google Scholar 

  50. Sabia S, Nabi H, Kivimaki M, Shipley MJ, Marmot MG, Singh-Manoux A (2009) Health behaviors from early to late midlife as predictors of cognitive function: the Whitehall II study. Am J Epidemiol 170(4):428–437

    Article  Google Scholar 

  51. Akbaraly TN, Singh-Manoux A, Marmot MG, Brunner EJ (2009) Education attenuates the association between dietary patterns and cognition. Dement Geriatr Cogn Disord 27(2):147–154

    Article  Google Scholar 

  52. Ames BN, Gold LS (1991) Endogenous mutagens and the causes of aging and cancer. Mutat Res 250(1–2):3–16

    CAS  Google Scholar 

  53. Paredes-Lopez O, Cervantes-Ceja ML, Vigna-Perez M, Hernandez-Perez T (2010) Berries: improving human health and healthy aging, and promoting quality life–a review. Plant Foods Hum Nutr 65(3):299–308

    Article  CAS  Google Scholar 

  54. Bryan J, Calvaresi E (2004) Associations between dietary intake of folate and vitamins B-12 and B-6 and self-reported cognitive function and psychological well-being in Australian men and women in midlife. J Nutr Health Aging 8(4):226–232

    CAS  Google Scholar 

  55. Eskelinen MH, Ngandu T, Helkala EL, Tuomilehto J, Nissinen A, Soininen H, Kivipelto M (2008) Fat intake at midlife and cognitive impairment later in life: a population-based CAIDE study. Int J Geriatr Psychiatry 23(7):741–747

    Article  Google Scholar 

  56. Morris MC, Evans DA, Bienias JL, Tangney CC, Wilson RS (2004) Dietary fat intake and 6-year cognitive change in an older biracial community population. Neurology 62(9):1573–1579

    Article  CAS  Google Scholar 

  57. Solfrizzi V, D’Introno A, Colacicco AM, Capurso C, Del Parigi A, Capurso S, Gadaleta A, Capurso A, Panza F (2005) Dietary fatty acids intake: possible role in cognitive decline and dementia. Exp Gerontol 40(4):257–270

    Article  CAS  Google Scholar 

  58. Crichton GE, Elias MF, Dore GA, Robbins MA (2012) Relation between dairy food intake and cognitive function: the Maine-Syracuse longitudinal study. Int Dairy J 22:15–23

    Article  Google Scholar 

  59. Crichton GE, Murphy KJ, Bryan J (2010) Dairy intake and cognitive health in middle-aged South Australians. Asia Pac J Clin Nutr 19(2):161–171

    CAS  Google Scholar 

  60. Crichton GE, Murphy KJ, Howe PR, Buckley JD, Bryan J (2012) Dairy consumption and working memory performance in overweight and obese adults. Appetite 59:34–40

    Article  Google Scholar 

  61. Appel LJ, Moore TJ, Obarzanek E, Vollmer WM, Svetkey LP, Sacks FM, Bray GA, Vogt TM, Cutler JA, Windhauser MM, Lin PH, Karanja N (1997) A clinical trial of the effects of dietary patterns on blood pressure. DASH collaborative research group. N Engl J Med 336(16):1117–1124

    Article  CAS  Google Scholar 

  62. Smith PJ, Blumenthal JA, Babyak MA, Craighead L, Welsh-Bohmer KA, Browndyke JN, Strauman TA, Sherwood A (2010) Effects of the dietary approaches to stop hypertension diet, exercise, and caloric restriction on neurocognition in overweight adults with high blood pressure. Hypertension 55(6):1331–1338

    Article  CAS  Google Scholar 

  63. Fisher ND, Sorond FA, Hollenberg NK (2006) Cocoa flavanols and brain perfusion. J Cardiovasc Pharmacol 47(Suppl 2):S210–S214

    Article  CAS  Google Scholar 

  64. Fuentes F, Lopez-Miranda J, Sanchez E, Sanchez F, Paez J, Paz-Rojas E, Marin C, Gomez P, Jimenez-Pereperez J, Ordovas JM, Perez-Jimenez F (2001) Mediterranean and low-fat diets improve endothelial function in hypercholesterolemic men. Ann Intern Med 134(12):1115–1119

    Article  CAS  Google Scholar 

  65. Gu Y, Luchsinger JA, Stern Y, Scarmeas N (2010) Mediterranean diet, inflammatory and metabolic biomarkers, and risk of Alzheimer’s disease. J Alzheimer’s Dis: JAD 22(2):483–492

    CAS  Google Scholar 

  66. Vogel RA (2000) The Mediterranean diet and endothelial function: why some dietary fats may be healthy. Cleve Clin J Med 67(4):232, 235–236

    Google Scholar 

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Acknowledgments

KJ Murphy is an NHMRC Industry Research Fellow (399396).

Conflict of Interest

The authors have no conflict of interest to declare.

Funding

University of South Australia Division of Health Sciences post-submission scholarship

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Authors and Affiliations

  1. Nutritional Physiology Research Centre, University of South Australia, Adelaide, Australia

    Georgina E. Crichton & Karen J. Murphy

  2. School of Psychology, Social Work and Social Policy, University of South Australia, Adelaide, Australia

    Janet Bryan

  3. Nutritional Physiology Research Centre, University of South Australia, GPO Box 2471, Adelaide, SA, 5001, Australia

    Karen J. Murphy

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  1. Georgina E. Crichton
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  2. Janet Bryan
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Correspondence to Karen J. Murphy.

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Crichton, G.E., Bryan, J. & Murphy, K.J. Dietary Antioxidants, Cognitive Function and Dementia - A Systematic Review. Plant Foods Hum Nutr 68, 279–292 (2013). https://doi.org/10.1007/s11130-013-0370-0

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