T that diets with adequate nutrients are associated with better verbal

T that diets with adequate nutrients are associated with better verbal memory (58) and selective attention (52), which is consistent with our findings of better baseline performance on verbal memory and slower rates of decline on verbal memory and attention. In fact, rodent models suggest that higher intakes of saturated fats and simple carbohydrates are associated with neurophysiologic changes (i.e., insulin signaling, synaptic plasticity, and neurogenesis) in the hippocampus and hippocampal-dependent learning and memory (95). Our investigation has many strengths, which include the use of a large and long-term prospective cohort study with repeated measurements on dietary intake and a comprehensive battery of cognitive performance, allowing us to assess effects of baseline diet on baseline cognitive performance and on cognitive change over time. Specifically, associations of caffeine and BLU-554 manufacturer Alcohol intake and NAS with cognitive performance over time were examined while controlling for key potential confounders, including each of those 3 exposures and socio-demographic and lifestyle factors. Moreover, use of advanced statistical techniques such as time-interval, mixed-effects linear regression models is a major study strength. Our findings, however, should be interpreted with caution in light of several limitations. First, the BLSA is an open-cohort study of participants selected as a convenience sample, with continuous recruitment and dropout throughout the follow-up. Second, sample selectivity was noted whereby the final analytic sample differed from the original eligible BLSA cohort. To reduce selection biases, we used a 2-stage Heckman selection model (80). Third, although observation frequency for dietary intakes and cognitive function was adequate, data structure was largely unbalanced, given that first-visit age and duration between visits varied across participants. Consequently, we used time-interval, mixed-effects linear regression models, assuming missingness at random (79). Fourth, other covariates such as cardiovascular risk factors were not considered given their potential mediating effects between diet and cognition. Additionally, chance findings may be caused by the number of hypotheses being tested and the subgroup. However, for theTABLE 3 Analysis of baseline caffeine intake (continuous, 100 mg/d), alcohol intake (g/d), and the NAS, and longitudinal change in cognitive performance (Agebase-stratified), time-interval, mixed-effects linear regression analysis, BLSA, 1962?Baseline age ,70 y: model 4 g 6 SEE2 MMSE, total score4 Fixed effects Intercept (g 00 for p0i) Time (g 10 for p1i) LT-253 biological activity Agebase Agebase 3 time Gender (women vs. men) Gender 3 time Caffeine (g01 for p0i) Caffeine 3 time (g 11 for p1i) NAS (g 02 for p0i) NAS 3 time (g12 for p1i) Alcohol (g 03 for p0i) Alcohol 3 time (g 13 for p1i) Random effects Level 1 residuals (Rij) Level 2 residuals Intercept (j0i) Linear slope (j1i) CVLT-List A, total score Intercept (g00 for p0i) Time (g 10 for p1i) Agebase Agebase 3 time Gender (women vs. men) Gender 3 time Caffeine (g 01 for p0i) Caffeine 3 time (g 11 for p1i) NAS (g 02 for p0i) NAS 3 time (g 12 for p1i) Alcohol (g03 for p0i) Alcohol 3 time (g 13 for p1i) CVLT-delayed recall, total score Intercept (g00 for p0i) Time (g 10 for p1i) Agebase Agebase 3 time Gender (women vs. men) Gender 3 time Caffeine (g 01 for p0i) Caffeine 3 time (g 11 for p1i) NAS (g 02 for p0i) NAS 3 time (g 12 for p1i) Alcohol (g03 for p0i) Alcohol 3 tim.T that diets with adequate nutrients are associated with better verbal memory (58) and selective attention (52), which is consistent with our findings of better baseline performance on verbal memory and slower rates of decline on verbal memory and attention. In fact, rodent models suggest that higher intakes of saturated fats and simple carbohydrates are associated with neurophysiologic changes (i.e., insulin signaling, synaptic plasticity, and neurogenesis) in the hippocampus and hippocampal-dependent learning and memory (95). Our investigation has many strengths, which include the use of a large and long-term prospective cohort study with repeated measurements on dietary intake and a comprehensive battery of cognitive performance, allowing us to assess effects of baseline diet on baseline cognitive performance and on cognitive change over time. Specifically, associations of caffeine and alcohol intake and NAS with cognitive performance over time were examined while controlling for key potential confounders, including each of those 3 exposures and socio-demographic and lifestyle factors. Moreover, use of advanced statistical techniques such as time-interval, mixed-effects linear regression models is a major study strength. Our findings, however, should be interpreted with caution in light of several limitations. First, the BLSA is an open-cohort study of participants selected as a convenience sample, with continuous recruitment and dropout throughout the follow-up. Second, sample selectivity was noted whereby the final analytic sample differed from the original eligible BLSA cohort. To reduce selection biases, we used a 2-stage Heckman selection model (80). Third, although observation frequency for dietary intakes and cognitive function was adequate, data structure was largely unbalanced, given that first-visit age and duration between visits varied across participants. Consequently, we used time-interval, mixed-effects linear regression models, assuming missingness at random (79). Fourth, other covariates such as cardiovascular risk factors were not considered given their potential mediating effects between diet and cognition. Additionally, chance findings may be caused by the number of hypotheses being tested and the subgroup. However, for theTABLE 3 Analysis of baseline caffeine intake (continuous, 100 mg/d), alcohol intake (g/d), and the NAS, and longitudinal change in cognitive performance (Agebase-stratified), time-interval, mixed-effects linear regression analysis, BLSA, 1962?Baseline age ,70 y: model 4 g 6 SEE2 MMSE, total score4 Fixed effects Intercept (g 00 for p0i) Time (g 10 for p1i) Agebase Agebase 3 time Gender (women vs. men) Gender 3 time Caffeine (g01 for p0i) Caffeine 3 time (g 11 for p1i) NAS (g 02 for p0i) NAS 3 time (g12 for p1i) Alcohol (g 03 for p0i) Alcohol 3 time (g 13 for p1i) Random effects Level 1 residuals (Rij) Level 2 residuals Intercept (j0i) Linear slope (j1i) CVLT-List A, total score Intercept (g00 for p0i) Time (g 10 for p1i) Agebase Agebase 3 time Gender (women vs. men) Gender 3 time Caffeine (g 01 for p0i) Caffeine 3 time (g 11 for p1i) NAS (g 02 for p0i) NAS 3 time (g 12 for p1i) Alcohol (g03 for p0i) Alcohol 3 time (g 13 for p1i) CVLT-delayed recall, total score Intercept (g00 for p0i) Time (g 10 for p1i) Agebase Agebase 3 time Gender (women vs. men) Gender 3 time Caffeine (g 01 for p0i) Caffeine 3 time (g 11 for p1i) NAS (g 02 for p0i) NAS 3 time (g 12 for p1i) Alcohol (g03 for p0i) Alcohol 3 tim.