Choline supplementation improves markers of cognitive function in older adults with hypertension and frailty, according to study findings published in The European Journal of Preventive Cardiology.
The risk for cognitive impairment is increased among older adults with hypertension and frailty. Previous studies have shown that choline supplementation can improve cognitive impairment. Researchers conducted a study to assess the effects of choline on endothelial dysfunction, a marker of hypertension and frail aging.
The researchers tested the hypothesis that “cholINe alfosceraTE impRoVEs cogNiTIve perfOrmance iN fraIl hypertenSive paTients (INTERVENTIONIST).” The researchers enrolled older patients presenting with hypertension from March 2021 to June 2022 at the Italian Ministry of Health in Avellino, Italy.
The inclusion criteria were adults older than 65 years of age with a confirmed hypertension diagnosis and frailty. Participants had their global cognitive performance assessed and they all had a Montreal Cognitive Assessment (MoCA) score of less than 26. Frailty was diagnosed based on the Fried Criteria.
The participants were divided into 2 groups, with one group receiving 1,200 mg of choline alfoscerate (α-GPC) daily and one control group.
There were 51 patients who completed the study and followed up at 6 months. Of these patients, 26 received α-GPC (78.2±7.4 years old) and 25 did not (77.1±7.1 years old). The body mass index (BMI), age, blood pressure, blood glucose, serum creatinine, and frailty were comparable between both groups. There were no major side effects reported for α-GPC.
The researchers used a wound-healing assay to assess cell migration and a network-like assay to examine angiogenesis. Attenuation of cell senescence was assessed by measuring p21 through reverse transcription quantitative real-time polymerase chain reaction (RT-qPCR), immunoblot, immunofluorescence, and quantification of SA-β-gal. Cell proliferation was examined by quantifying Ki-67 expression.
These assays were performed on human umbilical vascular endothelial cells (HUVECs). Results from a preliminary dose show that within 24 hours, 10 nM α-GPC significantly improved senescence caused by angiotensin II. The same concentration of α-GPC also improved cell proliferation, migration, and angiogenesis.
“To our knowledge, this is the first study demonstrating the favorable effects of α-GPC on cognitive dysfunction in frail hypertensive older adults, also showing that α-GPC significantly attenuates Ang II [angiotensin II]-induced endothelial dysfunction,” the researchers noted.
They concluded, “These findings are relevant especially considering the previously reported fundamental role of Angiotensin II in the pathophysiology of cognitive impairment and vascular senescence.”
Study limitations included small samples sizes and only performing analysis in one cell type.
Mone P, Kansakar U, Lucariello A, et al. Choline supplementation improves cognitive performance in frail hypertensive patients: novel insights on endothelial function from the INTERVENTIONIST study. Eur J Prev Cardiol. Published online April 18, 2023. doi:10.1093/eurjpc/zwad120