Intake of niacin, folate, vitamin B-6, and vitamin B-12 through young adulthood and cognitive function in midlife: the Coronary Artery Risk Development in Young Adults (CARDIA) study [Vitamins, minerals, and phytochemicals]

  1. Bo Qin1,
  2. Pengcheng Xun2,
  3. David R Jacobs Jr.3,
  4. Na Zhu3,
  5. Martha L Daviglus4,
  6. Jared P Reis5,
  7. Lyn M Steffen3,
  8. Linda Van Horn6,
  9. Stephen Sidney7, and
  10. Ka He2
  1. 1Department of Population Science, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ;
  2. 2Department of Epidemiology and Biostatistics, School of Public Health, Indiana University Bloomington, Bloomington, IN;
  3. 3Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN;
  4. 4Department of Medicine, University of Illinois at Chicago, Chicago, IL;
  5. 5Division of Cardiovascular Sciences, National Heart, Lung, and Blood Institute, Bethesda, MD;
  6. 6Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL; and
  7. 7Division of Research, Kaiser Permanente Northern California, Oakland, CA
  1. Address correspondence to KH (e-mail: kahe{at}
  • Supported by grants from the National Heart, Lung, and Blood Institute (NHLBI) in collaboration with the University of Alabama
    at Birmingham (HHSN268201300025C and HHSN268201300026C), Northwestern University (HHSN268201300027C), University of Minnesota
    (HHSN268201300028C), Kaiser Foundation Research Institute (HHSN268201300029C), and Johns Hopkins University School of Medicine
    (HHSN268200900041C). CARDIA is also partially supported by the Intramural Research Program of the National Institute on Aging
    (NIA) and an intra-agency agreement between NIA and NHLBI (grant AG0005).

  • The views expressed in this article are those of the authors and do not necessarily represent the views of the NHLBI, NIH,
    or US Department of Health and Human Services. The manuscript was reviewed by the CARDIA study committee for scientific content.

  • Supplemental Figure 1 and Supplemental Tables 1–4 are available from the “Online Supporting Material” link in the online posting
    of the article and from the same link in the online table of contents at


Background: Epidemiologic evidence regarding niacin, folate, vitamin B-6, and vitamin B-12 intake in relation to cognitive function is
limited, especially in midlife.

Objective: We hypothesize that higher intake of these B vitamins in young adulthood is associated with better cognition later in life.

Design: This study comprised a community-based multicenter cohort of black and white men and women aged 18–30 y in 1985–1986 (year
0, i.e., baseline) from the Coronary Artery Risk Development in Young Adults (CARDIA) study (n = 3136). We examined participants’ CARDIA diet history at years 0, 7, and 20 to assess nutrient intake, including dietary
and supplemental B vitamins. We measured cognitive function at year 25 (mean ± SD age: 50 ± 4 y) through the use of the Rey
Auditory Verbal Learning Test (RAVLT) for verbal memory, the Digit Symbol Substitution Test (DSST) for psychomotor speed,
and a modified Stroop interference test for executive function. Higher RAVLT and DSST scores and a lower Stroop score indicated
better cognitive function. We used multivariable-adjusted linear regressions to estimate mean differences in cognitive scores
and 95% CIs.

Results: Comparing the highest quintile with the lowest (quintile 5 compared with quintile 1), cumulative total intake of niacin was
significantly associated with 3.92 more digits on the DSST (95% CI: 2.28, 5.55; P-trend < 0.01) and 1.89 points lower interference score on the Stroop test (95% CI: −3.10, −0.68; P-trend = 0.05). Total folate was associated with 2.56 more digits on the DSST (95% CI: 0.82, 4.31; P-trend = 0.01). We also found that higher intakes of vitamin B-6 (quartile 5 compared with quartile 1: 2.62; 95% CI: 0.97,
4.28; P-trend = 0.02) and vitamin B-12 (quartile 5 compared with quartile 1: 2.08; 95% CI: 0.52, 3.65; P-trend = 0.02) resulted in better psychomotor speed measured by DSST scores.

Conclusion: Higher intake of B vitamins throughout young adulthood was associated with better cognitive function in midlife.



  • Abbreviations used: AD, Alzheimer disease; CARDIA, Coronary Artery Risk Development in Young Adults; CES-D, Center for Epidemiologic
    Studies Depression; DSST, Digit Symbol Substitution Test; RAVLT, Rey Auditory Verbal Learning Test; RCT, randomized controlled

  • Received March 28, 2017.
  • Accepted July 10, 2017.

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