Choline alfoscerate may slow cognitive decline in frail, hypertensive adults
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Key takeaways:
- Choline alfoscerate could improve cognitive function in older, frail hypertensive adults.
- The drug’s effects may be linked to its attenuation of angiotensin II-induced endothelial dysfunction.
Choline alfoscerate may improve cognitive function among frail patients with hypertension and attenuate angiotensin II-induced endothelial dysfunction, according to a small study published in the European Journal of Preventive Cardiology.
“Frailty is a prevailing condition in hypertensive older adults, increasing the risk of cognitive impairment and adverse outcomes,” Pasquale Mone, MD, of the department of medicine, division of cardiology at the Einstein Institute for Aging Research at Albert Einstein College of Medicine, Montefiore University Hospital in New York, and the local health authority of the Italian Ministry of Health in Avellino, Italy, and colleagues wrote. “Choline supplementation has shown beneficial effects on cognitive impairment. However, the exact mechanisms have not been explored. We hypothesized that choline could improve endothelial dysfunction, a well-established hallmark of hypertension and frail aging and attenuate endothelial cell senescence.”
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Mone and colleagues designed the INTERVENTIONIST trial and tested their hypothesis within a cohort of 51 consecutive older adults with hypertension and frailty at the local health unit of the Italian Ministry of Health of Avellino. Impaired global cognitive performance was defined as Montreal Cognitive Assessment score less than 26. A total of 26 patients received choline alfoscerate (mean age, 78 years) and 25 did not (mean age, 77 years). Participants were followed up for 6 months.
Baseline characteristics, including age, BMI, BP, blood glucose, serum creatinine, therapies and parameters to describe frailty, were similar between groups.
Mone and colleagues reported that choline alfoscerate significantly improved cognitive function at 6-month follow-up and was well tolerated with no major adverse events reported. Average Montreal Cognitive Assessment score did not reach or surpass 26.
In human umbilical vascular endothelial cells, the researchers performed preliminary dose-response and six time-course experiments to evaluate cell migration and to quantify angiogenesis.
The researchers observed that at 24 hours, 10 nM choline alfoscerate significantly attenuated senescence induced by angiotensin II and improved cell proliferation, migration and angiogenesis.
“To our knowledge, this is the first study demonstrating the favorable effects of [choline alfoscerate] on cognitive dysfunction in frail hypertensive older adults, also showing that [choline alfoscerate] significantly attenuates angiotensin II-induced endothelial dysfunction,” the researchers wrote. “These findings are relevant especially considering the previously reported fundamental role of angiotensin II in the pathophysiology of cognitive impairment and vascular senescence. For instance, Anton Wellstein and collaborators recently demonstrated that low-dose chronic angiotensin II induces senescence of endothelial cells, a process by which cell age and permanently stop dividing but do not die.”
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