The Gray Matters App Targeting Health Behaviors Associated with Alzheimer's Risk: Improvements in Intrinsic Motivation and Impact on Diet Quality and Physical Activity.

OBJECTIVE: We examine if the Gray Matters intervention (education and behavioral self-monitoring app targeting lifestyle risks for Alzheimer's disease [AD]) affected participants' motivation for change and whether high motivation predicts improved diet and physical activity over 6 months. DESIGN: In this 6-month randomized controlled trial (treatment n=104; control n=42; assessed pre/post intervention) amotivation, external regulation, identified regulation, and intrinsic motivation were assessed via the Situational Motivation Scale (SIMS). Diet quality was assessed via adherence to the DASH diet, and physical activity was assessed in minutes. PARTICIPANTS: Eligibility criteria included not having significant cognitive impairment. Participants were aged 39-64 (M = 54.17, SD = 6.9), 66% female, 81% married, 90% White, and 80% had a college degree. INTERVENTION: Treatment included an activity tracker, Gray Matters app, access to booster sessions, contact with a student health coach, and study website. SETTING: Participants were in the general community. RESULTS: Independent samples t-tests determined that intrinsic motivation (IM) increased significantly for the treatment group (M = 2.09 SD = 4.82), compared to the control group (M = 1.00 SD = 5.52; t (130) = -3.04, p = .003). Comparing subgroups of people with High vs Low IM we found that High IM males increased vigorous physical activity more than Lower IM males (F(1,42)=5.053, p=.030). Comparing persons aged 58-64 years with High vs Lower IM, High IM persons had less improvement in diet quality F(1,48)=4.538; p=0.038). CONCLUSION: RCT results support that the Gray Matters AD-focused intervention increased IM, and IM was associated with improved physical activity and diet quality for some subgroups.

Weight and body composition change over a six-week holiday period.

Change in weight and body composition was assessed over a six-week holiday period. Baseline testing occurred the Monday or Tuesday prior to Thanksgiving Day (November 24 or 25, 2008), and the post-holiday assessment was the Monday or Tuesday after New Year's Day (January 5 or 6, 2009). Thirteen men and 21 women ranging in age from 23-61 years completed the study. The majority of participants (24 of 34) perceived that they had gained weight, and four did gain ≥2 kg. However, despite some changes to dietary and exercise habits, on average there was no difference between pre-holiday weight (74.0±17.8 kg) and post-holiday weight (73.9±18.1 kg), nor between pre-holiday body fat percentage (25.4±9.0%) and post-holiday body fat percentage (25.4±8.9%). Despite a perception of substantial weight gain, body weight and body fat remained unchanged over a six-week holiday period.

Prospective study of ready-to-eat breakfast cereal consumption and cognitive decline among elderly men and women.

OBJECTIVE: To examine associations between frequency of ready-to-eat-cereal (RTEC) consumption and cognitive function among elderly men and women of the Cache County Study on Memory Health and Aging in Utah. DESIGN: A population-based prospective cohort study established in Cache County, Utah in 1995. SETTING AND PARTICIPANTS: 3831 men and women > 65 years of age who were living in Cache County, Utah in 1995. MEASUREMENT: Diet was assessed using a 142-item food frequency questionnaire at baseline. Cognitive function was assessed using an adapted version of the Modified Mini-Mental State examination (3MS) at baseline and three subsequent interviews over 11 years. RTEC consumption was defined as daily, weekly, or infrequent use. RESULTS: In multivariable models, more frequent RTEC consumption was not associated with a cognitive benefit. Those consuming RTEC weekly but less than daily scored higher on their baseline 3MS than did those consuming RTEC more or less frequently (91.7, 90.6, 90.6, respectively; p-value < 0.001). This association was maintained across 11 years of observation such that those consuming RTEC weekly but less than daily declined on average 3.96 points compared to an average 5.13 and 4.57 point decline for those consuming cereal more or less frequently (p-value = 0.0009). CONCLUSION: Those consuming RTEC at least daily had poorer cognitive performance at baseline and over 11 years of follow-up compared to those who consumed cereal more or less frequently. RTEC is a nutrient dense food, but should not replace the consumption of other healthy foods in the diets' of elderly people. Associations between RTEC consumption, dietary patterns, and cognitive function deserve further study.

Dietary folate, vitamin B-12, vitamin B-6 and incident Alzheimer's disease: the cache county memory, health and aging study.

OBJECTIVE: To examine associations between dietary and supplemental folate, vitamin B-12 and vitamin B-6 and incident Alzheimer's disease (AD) among elderly men and women. DESIGN, SETTING AND PARTICIPANTS: Data collected were from participants of the Cache County Memory, Health and Aging Study, a longitudinal study of 5092 men and women 65 years and older who were residents of Cache County, Utah in 1995. MEASUREMENTS: Multistage clinical assessment procedures were used to identify incident cases of AD. Dietary data were collected using a 142-item food frequency questionnaire. Cox Proportional Hazards (CPH) modeling was used to determine hazard ratios across quintiles of micronutrient intake. RESULTS: 202 participants were diagnosed with incident AD during follow-up (1995-2004). In multivariable CPH models that controlled for the effects of gender, age, education, and other covariates there were no observed differences in risk of AD or dementia by increasing quintiles of total intake of folate, vitamin B-12, or vitamin B-6. Similarly, there were no observed differences in risk of AD by regular use of either folate or B6 supplements. CONCLUSION: Dietary intake of B-vitamins from food and supplemental sources appears unrelated to incidence of dementia and AD. Further studies examining associations between dietary intakes of B-vitamins, biomarkers of B-vitamin status and cognitive endpoints are warranted.

Antioxidant intake and cognitive function of elderly men and women: the Cache County Study.

OBJECTIVE: We prospectively examined associations between intakes of antioxidants (vitamins C, vitamin E, and carotene) and cognitive function and decline among elderly men and women of the Cache County Study on Memory and Aging in Utah. PARTICIPANTS AND DESIGN: In 1995, 3831 residents 65 years of age or older completed a baseline survey that included a food frequency questionnaire and cognitive assessment. Cognitive function was assessed using an adapted version of the Modified Mini-Mental State examination (3MS) at baseline and at three subsequent follow-up interviews spanning approximately 7 years. Multivariable-mixed models were used to estimate antioxidant nutrient effects on average 3MS score over time. RESULTS: Increasing quartiles of vitamin C intake alone and combined with vitamin E were associated with higher baseline average 3MS scores (p-trend = 0.013 and 0.02 respectively); this association appeared stronger for food sources compared to supplement or food and supplement sources combined. Study participants with lower levels of intake of vitamin C, vitamin E and carotene had a greater acceleration of the rate of 3MS decline over time compared to those with higher levels of intake. CONCLUSION: High antioxidant intake from food and supplement sources of vitamin C, vitamin E, and carotene may delay cognitive decline in the elderly.

Vitamin D receptor genotype and risk of osteoporotic hip fracture in elderly women of Utah: an effect modified by parity.

INTRODUCTION: The associations between vitamin D receptor (VDR) Bsm I and Fok I genotypes, parity, and risk of osteoporotic hip fracture were evaluated in a statewide population-based case-control study in Utah. METHODS: Women age 50-89 years with hip fracture (n=882) were ascertained via surveillance of 18 Utah hospitals from 1997 to 2001. Age-matched controls were randomly selected (n=897). Participants were interviewed in their homes, and blood samples were collected for genotyping. RESULTS: In logistic regression analyses that controlled for multiple confounders, Bsm I VDR genotype but not Fok I genotype was associated with risk of osteoporotic hip fracture (OR bb vs. BB genotype: 0.68; 95% CI: 0.50, 0.95). In similar analyses, no overall association was observed between parity status and risk of osteoporotic hip fracture. However, the effect of VDR genotype was modified by parity status. Among nulliparous women (n=140), Bsm I genotype was not associated with risk of hip fracture (OR bb vs. BB: 0.82; 95% CI: 0.28, 2.4); among primiparous women (n=133), bb genotype was associated with increased risk of hip fracture (OR bb vs. BB: 3.30; 95% CI: 0.96, 11.29); among multiparous women (n=1,400), bb genotype was associated with decreased risk of hip fracture (OR bb vs. BB: 0.59; 95% CI: 0.42, 0.84). CONCLUSION: VDR Bsm I genotype was associated with risk of hip fracture in Utah women, and this effect was modified by parity status. Hormonal or lifestyle factors related to parity may underlie this interaction.

Comparison of a picture-sort food-frequency questionnaire with 24-hour dietary recalls in an elderly Utah population.

OBJECTIVE: To evaluate the 137-item Utah Picture-sort Food-frequency Questionnaire (FFQ) in the measurement of usual dietary intake in older adults. DESIGN: The picture-sort FFQ was administered at baseline and again one year later. Three seasonal 24-hour dietary recall interviews were collected during the year between the two FFQs. Mean nutrient intakes were compared between methods and between administrations of the FFQ. SETTING: The FFQ interviews were administered in respondents' homes or care-centres. The 24-hour diet recalls were conducted by telephone interview on random days of the week. SUBJECTS: Two-hundred-and-eight men and women aged 55-84 years were recruited by random sample of controls from a case-control study of nutrition and bone health in Utah. RESULTS: After adjustment for total energy intake, median Spearman rank correlation coefficients between the two picture-sort FFQs were 0.69 for men aged < or = 69 years, 0.66 for men aged > 69 years; and 0.68 for women aged < or = 69 years, 0.67 for women aged > 69 years. Median correlation coefficients between methods were 0.50 for men < or = 69 years old, 0.52 for men > 69 years old; 0.55 for women < or = 69 years old, 0.46 for women > 69 years old. CONCLUSIONS: We report intake correlations between methods and administrations comparable to those reported in the literature for traditional paper-and-pencil FFQs and one other picture-sort method of FFQ. This dietary assessment method may improve ease and accuracy of response in this and other populations with low literacy levels, poor memory skill, impaired hearing, or poor vision.