The relationship of vitamin E to cognition, white matter hyperintensities and vascular risk factors in elderly Latinos

Higher levels of serum vitamin E are thought to be preventive in vascular disease, white matter hyperintensities, and cognitive decline. Vascular disease and dementia are thought to co-exist but the underlying pathology between the two is unknown. Mexican-Americans have been shown to have lower serum vitamin E and higher prevalence of vascular disease than non-Latino whites, but little is known about the vitamin E-vascular disease-cognitive relationship in this rapidly increasing segment of the population.; The goals of this dissertation were (1) to develop and validate a tool for measuring white matter hyperintensities, (2) to investigate the cross-sectional relationship between vitamin E and cognitive functioning in a population of elderly community dwelling Latinos 60 years or older residing in the Sacramento Tri-County area, and (3) to determine whether this relationship was moderated by the presence of WMH along with an array of vascular disease risk factors.; The dissertation introduction provides an overview of the previous work in this area including the hypothesized role of oxidative stress as the unifying factor between the variables of interest. Chapter one provides a summary of the available methods for measuring white matter hyperintensities and describes: (1) the methods used to develop and validate the white matter hyperintensity scale, (2) the psychometric properties of the developed scale, and (3) the generalizability of the white matter hyperintensity results. Chapter two describes the methods used to investigate the relationship between vitamin E and cognitive functioning along with white matter hyperintensities and array of vascular risk factors in this cohort along with the study results. The conclusion provides direction for future research in this area.; Results demonstrated that subjects with decreased vitamin E had decreased cognition that remained after controlling for age, education, and smoking. This relationship was modulated by the presence of white matter hyperintensities. After accounting for white matter hyperintensities, the effects of vitamin E on cognition were decreased, suggesting that vitamin E works through the prevention of white matter hyperintensities in preventing cognitive decline. Vascular disease in general was not directly associated with cognition.