Skip to main content
PMC home page
Journal of Neurology, Neurosurgery, and Psychiatry logoLink to Journal of Neurology, Neurosurgery, and Psychiatry
. 2004 Aug;75(8):1093–1099. doi: 10.1136/jnnp.2003.025858

Dietary niacin and the risk of incident Alzheimer's disease and of cognitive decline

M Morris 1, D Evans 1, J Bienias 1, P Scherr 1, C Tangney 1, L Hebert 1, D Bennett 1, R Wilson 1, N Aggarwal 1
PMCID: PMC1739176  PMID: 15258207

Abstract

Background: Dementia can be caused by severe niacin insufficiency, but it is unknown whether variation in intake of niacin in the usual diet is linked to neurodegenerative decline. We examined whether dietary intake of niacin was associated with incident Alzheimer's disease (AD) and cognitive decline in a large, prospective study.

Methods: This study was conducted in 1993–2002 in a geographically defined Chicago community of 6158 residents aged 65 years and older. Nutrient intake was determined by food frequency questionnaire. Four cognitive tests were administered to all study participants at 3 year intervals in a 6 year follow up. A total of 3718 participants had dietary data and at least two cognitive assessments for analyses of cognitive change over a median 5.5 years. Clinical evaluations were performed on a stratified random sample of 815 participants initially unaffected by AD, and 131 participants were diagnosed with 4 year incident AD by standardised criteria.

Results: Energy adjusted niacin intake had a protective effect on development of AD and cognitive decline. In a logistic regression model, relative risks (95% confidence intervals) for incident AD from lowest to highest quintiles of total niacin intake were: 1.0 (referent) 0.3 (0.1 to 0.6), 0.3 (0.1 to 0.7), 0.6 (0.3 to 1.3), and 0.3 (0.1 to 0.7) adjusted for age, sex, race, education, and ApoE e4 status. Niacin intake from foods was also inversely associated with AD (p for linear trend = 0.002 in the adjusted model). In an adjusted random effects model, higher food intake of niacin was associated with a slower annual rate of cognitive decline, by 0.019 standardised units (SU) per natural log increase in intake (mg) (p = 0.05). Stronger associations were observed in analyses that excluded participants with a history of cardiovascular disease (ß = 0.028 SU/year; p = 0.008), those with low baseline cognitive scores (ß = 0.023 SU/year; p = 0.02), or those with fewer than 12 years' education (ß = 0.035 SU/year; p = 0.002)

Conclusion: Dietary niacin may protect against AD and age related cognitive decline.

Full Text

The Full Text of this article is available as a PDF (105.5 KB).

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Albert M. Neuropsychological and neurophysiological changes in healthy adult humans across the age range. Neurobiol Aging. 1993 Nov-Dec;14(6):623–625. doi: 10.1016/0197-4580(93)90049-h. [DOI] [PubMed] [Google Scholar]
  2. Albert M., Smith L. A., Scherr P. A., Taylor J. O., Evans D. A., Funkenstein H. H. Use of brief cognitive tests to identify individuals in the community with clinically diagnosed Alzheimer's disease. Int J Neurosci. 1991 Apr;57(3-4):167–178. doi: 10.3109/00207459109150691. [DOI] [PubMed] [Google Scholar]
  3. Battaglia A., Bruni G., Ardia A., Sacchetti G. Nicergoline in mild to moderate dementia. A multicenter, double-blind, placebo-controlled study. J Am Geriatr Soc. 1989 Apr;37(4):295–302. doi: 10.1111/j.1532-5415.1989.tb05494.x. [DOI] [PubMed] [Google Scholar]
  4. Chong Zhao Zhong, Lin Shi-Hua, Maiese Kenneth. Nicotinamide modulates mitochondrial membrane potential and cysteine protease activity during cerebral vascular endothelial cell injury. J Vasc Res. 2002 Mar-Apr;39(2):131–147. doi: 10.1159/000057762. [DOI] [PubMed] [Google Scholar]
  5. Engelhart Marianne J., Geerlings Mirjam I., Ruitenberg Annemieke, van Swieten John C., Hofman Albert, Witteman Jacqueline C. M., Breteler Monique M. B. Dietary intake of antioxidants and risk of Alzheimer disease. JAMA. 2002 Jun 26;287(24):3223–3229. doi: 10.1001/jama.287.24.3223. [DOI] [PubMed] [Google Scholar]
  6. Evans Denis A., Bennett David A., Wilson Robert S., Bienias Julia L., Morris Martha Clare, Scherr Paul A., Hebert Liesi E., Aggarwal Neelum, Beckett Laurel A., Joglekar Rajiv. Incidence of Alzheimer disease in a biracial urban community: relation to apolipoprotein E allele status. Arch Neurol. 2003 Feb;60(2):185–189. doi: 10.1001/archneur.60.2.185. [DOI] [PubMed] [Google Scholar]
  7. Folstein M. F., Folstein S. E., McHugh P. R. "Mini-mental state". A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res. 1975 Nov;12(3):189–198. doi: 10.1016/0022-3956(75)90026-6. [DOI] [PubMed] [Google Scholar]
  8. Glynn R. J., Beckett L. A., Hebert L. E., Morris M. C., Scherr P. A., Evans D. A. Current and remote blood pressure and cognitive decline. JAMA. 1999 Feb 3;281(5):438–445. doi: 10.1001/jama.281.5.438. [DOI] [PubMed] [Google Scholar]
  9. Gorelick P. B., Mangone C. A. Vascular dementias in the elderly. Clin Geriatr Med. 1991 Aug;7(3):599–615. [PubMed] [Google Scholar]
  10. Hageman G. J., Stierum R. H. Niacin, poly(ADP-ribose) polymerase-1 and genomic stability. Mutat Res. 2001 Apr 18;475(1-2):45–56. doi: 10.1016/s0027-5107(01)00078-1. [DOI] [PubMed] [Google Scholar]
  11. Hebert L. E., Scherr P. A., Beckett L. A., Albert M. S., Pilgrim D. M., Chown M. J., Funkenstein H. H., Evans D. A. Age-specific incidence of Alzheimer's disease in a community population. JAMA. 1995 May 3;273(17):1354–1359. [PubMed] [Google Scholar]
  12. Herrmann W. M., Stephan K., Gaede K., Apeceche M. A multicenter randomized double-blind study on the efficacy and safety of nicergoline in patients with multi-infarct dementia. Dement Geriatr Cogn Disord. 1997 Jan-Feb;8(1):9–17. doi: 10.1159/000106595. [DOI] [PubMed] [Google Scholar]
  13. Hixson J. E., Vernier D. T. Restriction isotyping of human apolipoprotein E by gene amplification and cleavage with HhaI. J Lipid Res. 1990 Mar;31(3):545–548. [PubMed] [Google Scholar]
  14. Jacobson M. K., Amé J. C., Lin W., Coyle D. L., Jacobson E. L. Cyclic ADP-ribose. A new component of calcium signaling. Receptor. 1995 Spring;5(1):43–49. [PubMed] [Google Scholar]
  15. Laird N. M., Ware J. H. Random-effects models for longitudinal data. Biometrics. 1982 Dec;38(4):963–974. [PubMed] [Google Scholar]
  16. Melo S. S., Meirelles M. S., Jordão Júnior A. A., Vannucchi H. Lipid peroxidation in nicotinamide-deficient and nicotinamide-supplemented rats. Int J Vitam Nutr Res. 2000 Dec;70(6):321–323. doi: 10.1024/0300-9831.70.6.321. [DOI] [PubMed] [Google Scholar]
  17. Morris M. C., Colditz G. A., Evans D. A. Response to a mail nutritional survey in an older bi-racial community population. Ann Epidemiol. 1998 Jul;8(5):342–346. doi: 10.1016/s1047-2797(97)00236-6. [DOI] [PubMed] [Google Scholar]
  18. Morris Martha Clare, Evans Denis A., Bienias Julia L., Tangney Christine C., Bennett David A., Aggarwal Neelum, Schneider Julie, Wilson Robert S. Dietary fats and the risk of incident Alzheimer disease. Arch Neurol. 2003 Feb;60(2):194–200. doi: 10.1001/archneur.60.2.194. [DOI] [PubMed] [Google Scholar]
  19. Morris Martha Clare, Evans Denis A., Bienias Julia L., Tangney Christine C., Bennett David A., Aggarwal Neelum, Wilson Robert S., Scherr Paul A. Dietary intake of antioxidant nutrients and the risk of incident Alzheimer disease in a biracial community study. JAMA. 2002 Jun 26;287(24):3230–3237. doi: 10.1001/jama.287.24.3230. [DOI] [PubMed] [Google Scholar]
  20. Morris Martha Clare, Evans Denis A., Bienias Julia L., Tangney Christine C., Bennett David A., Aggarwal Neelum, Wilson Robert S., Scherr Paul A. Dietary intake of antioxidant nutrients and the risk of incident Alzheimer disease in a biracial community study. JAMA. 2002 Jun 26;287(24):3230–3237. doi: 10.1001/jama.287.24.3230. [DOI] [PubMed] [Google Scholar]
  21. Morris Martha Clare, Evans Denis A., Bienias Julia L., Tangney Christine C., Wilson Robert S. Vitamin E and cognitive decline in older persons. Arch Neurol. 2002 Jul;59(7):1125–1132. doi: 10.1001/archneur.59.7.1125. [DOI] [PubMed] [Google Scholar]
  22. Morris Martha Clare, Tangney Christine C., Bienias Julia L., Evans Denis A., Wilson Robert S. Validity and reproducibility of a food frequency questionnaire by cognition in an older biracial sample. Am J Epidemiol. 2003 Dec 15;158(12):1213–1217. doi: 10.1093/aje/kwg290. [DOI] [PubMed] [Google Scholar]
  23. Nakashima Y., Esashi T. Effect of 3-acetylpyridine on the development of rat brain. J Nutr Sci Vitaminol (Tokyo) 1985 Jun;31(3):305–315. doi: 10.3177/jnsv.31.305. [DOI] [PubMed] [Google Scholar]
  24. Nakashima Y., Suzue R. Influence of nicotinic acid on cerebroside synthesis in the brain of developing rats. J Nutr Sci Vitaminol (Tokyo) 1984 Dec;30(6):525–534. doi: 10.3177/jnsv.30.525. [DOI] [PubMed] [Google Scholar]
  25. Rawling J. M., Jackson T. M., Driscoll E. R., Kirkland J. B. Dietary niacin deficiency lowers tissue poly(ADP-ribose) and NAD+ concentrations in Fischer-344 rats. J Nutr. 1994 Sep;124(9):1597–1603. doi: 10.1093/jn/124.9.1597. [DOI] [PubMed] [Google Scholar]
  26. Riggs K. M., Spiro A., 3rd, Tucker K., Rush D. Relations of vitamin B-12, vitamin B-6, folate, and homocysteine to cognitive performance in the Normative Aging Study. Am J Clin Nutr. 1996 Mar;63(3):306–314. doi: 10.1093/ajcn/63.3.306. [DOI] [PubMed] [Google Scholar]
  27. Rockett H. R., Breitenbach M., Frazier A. L., Witschi J., Wolf A. M., Field A. E., Colditz G. A. Validation of a youth/adolescent food frequency questionnaire. Prev Med. 1997 Nov-Dec;26(6):808–816. doi: 10.1006/pmed.1997.0200. [DOI] [PubMed] [Google Scholar]
  28. Scherr P. A., Albert M. S., Funkenstein H. H., Cook N. R., Hennekens C. H., Branch L. G., White L. R., Taylor J. O., Evans D. A. Correlates of cognitive function in an elderly community population. Am J Epidemiol. 1988 Nov;128(5):1084–1101. doi: 10.1093/oxfordjournals.aje.a115051. [DOI] [PubMed] [Google Scholar]
  29. Schneider F., Popa R., Mihalas G., Stefanigă P., Mihalas I. G., Măties R., Mateescu R. Superiority of antagonic-stress composition versus nicergoline in gerontopsychiatry. Ann N Y Acad Sci. 1994 Jun 30;717:332–342. doi: 10.1111/j.1749-6632.1994.tb12102.x. [DOI] [PubMed] [Google Scholar]
  30. Seshadri Sudha, Beiser Alexa, Selhub Jacob, Jacques Paul F., Rosenberg Irwin H., D'Agostino Ralph B., Wilson Peter W. F., Wolf Philip A. Plasma homocysteine as a risk factor for dementia and Alzheimer's disease. N Engl J Med. 2002 Feb 14;346(7):476–483. doi: 10.1056/NEJMoa011613. [DOI] [PubMed] [Google Scholar]
  31. Shaw D. M., Tidmarsh S. F., Karajgi B. M., Sweeney E. A., Williams S., Elameer M., Twining C. Pilot study of amino acids in senile dementia. Br J Psychiatry. 1981 Dec;139:580–582. doi: 10.1192/bjp.139.6.580. [DOI] [PubMed] [Google Scholar]
  32. Thomas D. E., Chung-A-On K. O., Dickerson J. W., Tidmarsh S. F., Shaw D. M. Tryptophan and nutritional status of patients with senile dementia. Psychol Med. 1986 May;16(2):297–305. doi: 10.1017/s0033291700009119. [DOI] [PubMed] [Google Scholar]
  33. Wang H. X., Wahlin A., Basun H., Fastbom J., Winblad B., Fratiglioni L. Vitamin B(12) and folate in relation to the development of Alzheimer's disease. Neurology. 2001 May 8;56(9):1188–1194. doi: 10.1212/wnl.56.9.1188. [DOI] [PubMed] [Google Scholar]
  34. Welsh K. A., Butters N., Mohs R. C., Beekly D., Edland S., Fillenbaum G., Heyman A. The Consortium to Establish a Registry for Alzheimer's Disease (CERAD). Part V. A normative study of the neuropsychological battery. Neurology. 1994 Apr;44(4):609–614. doi: 10.1212/wnl.44.4.609. [DOI] [PubMed] [Google Scholar]
  35. Wenham P. R., Price W. H., Blandell G. Apolipoprotein E genotyping by one-stage PCR. Lancet. 1991 May 11;337(8750):1158–1159. doi: 10.1016/0140-6736(91)92823-k. [DOI] [PubMed] [Google Scholar]
  36. Willett W., Stampfer M. J. Total energy intake: implications for epidemiologic analyses. Am J Epidemiol. 1986 Jul;124(1):17–27. doi: 10.1093/oxfordjournals.aje.a114366. [DOI] [PubMed] [Google Scholar]

Articles from Journal of Neurology, Neurosurgery, and Psychiatry are provided here courtesy of BMJ Publishing Group

RESOURCES