Plasma free choline, betaine and cognitive performance: the Hordaland Health Study
Abstract
Choline and betaine are nutrients involved in one-carbon metabolism. Choline is essential for neurodevelopment and brain function. We studied the associations between cognitive function and plasma concentrations of free choline and betaine. In a cross-sectional study, 2195 subjects (55 % women), aged 70–74 years, underwent extensive cognitive testing including the Kendrick Object Learning Test (KOLT), Trail Making Test (part A, TMT-A), modified versions of the Digit Symbol Test (m-DST), Block Design (m-BD), Mini-Mental State Examination (m-MMSE) and Controlled Oral Word Association Test (COWAT). Compared with low concentrations, high choline (>8·4 μmol/l) was associated with better test scores in the TMT-A (56·0 v . 61·5, P = 0·004), m-DST (10·5 v . 9·8, P = 0·005) and m-MMSE (11·5 v . 11·4, P = 0·01). A generalised additive regression model showed a positive dose–response relationship between the m-MMSE and choline ( P = 0·012 from a corresponding linear regression model). Betaine was associated with the KOLT, TMT-A and COWAT, but after adjustments for potential confounders, the associations lost significance. Risk ratios (RR) for poor test performance roughly tripled when low choline was combined with either low plasma vitamin B 12 ( ≤ 257 pmol/l) concentrations (RR KOLT = 2·6, 95 % CI 1·1, 6·1; RR m-MMSE = 2·7, 95 % CI 1·1, 6·6; RR COWAT = 3·1, 95 % CI 1·4, 7·2) or high methylmalonic acid (MMA) ( ≥ 3·95 μmol/l) concentrations (RR m-BD = 2·8, 95 % CI 1·3, 6·1). Low betaine ( ≤ 31·1 μmol/l) combined with high MMA was associated with elevated RR on KOLT (RR KOLT = 2·5, 95 % CI 1·0, 6·2). Low plasma free choline concentrations are associated with poor cognitive performance. There were significant interactions between low choline or betaine and low vitamin B 12 or high MMA on cognitive performance.
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Studies have shown benefits of dietary choline intake and supplementation on cognitive performance in human individuals and in animal models.
“This finding aligns with studies showing benefits of dietary choline intake and supplementation on cognitive performance in human individuals and in animal models71–78.”
From Single-cell multiregion dissection of Alzheimer’s disease (2024) · cites this paper as [74]
The passages indexed under Abstract (page unavailable) report improved memory performance after choline supplementation in rats and an association between higher dietary choline intake and better cognitive performance in a human cohort. They do not establish that choline intake caused the human benefit; they also say controlled trials found no clinical value for choline or phosphatidylcholine in treating cognitive dysfunction in Alzheimer’s disease. This source therefore supports the animal supplementation finding and a human dietary association, but not a general claim of supplementation benefits in humans. (LLM, conf=0.87)
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- Lee Y, Back JH, Kim J, et al. (2010) Systematic review of health behavioral risks and cognitive health in older adults. Int Psychogeriatr 22, 174 -187.
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Single-cell multiregion dissection of Alzheimer’s disease
Mathys, H., Boix, C. A., Akay, L. A., Xia, Z., Davila-Velderrain, J., Ng, A. P., Jiang, X., Abdelhady, G., Galani, K., Mantero, J., et al. (2024) · Nature · doi:10.1038/s41586-024-07606-7 · Cited by 343 · see citing works
- Authors
- Nurk, E., Refsum, H., Bjelland, I., Drevon, C. A., Tell, G. S., Ueland, P. M., Vollset, S. E., Engedal, K., Nygaard, H. A., & Smith, D. A.
- Venue
- British Journal of Nutrition
- Publisher
- Cambridge University Press (CUP)
- Published
- 2012-05-01
- Volume
- 109
- Issue
- 3
- Pages
- 511-519
- ISSN
- 0007-1145
- 1475-2662
- Cited by
- 70
- References
- 0
- Language
- en
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