Test Assessment Description Ref. Global Deterioration Rating Scale Dementia severity Rating scale of dementia stages (2) (4) delayed recognition

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1 Table S. Cognitive tests used in the Georgia Centenarian Study. Test Assessment Description Ref. Mini-Mental State Examination Global cognitive performance A brief screening of orientation, memory, executive function, language, praxis () Global Deterioration Rating Scale Dementia severity Rating scale of dementia stages () Severe Impairment Battery Global cognitive performance (significantly cognitively impaired individuals) Direct performance-based assessment of a variety of low-level tasks () Fuld Object Memory Evaluation delayed recall delayed recall Number of objects recalled after a min delay () delayed recognition delayed recognition Objects not recalled that were recognized delayed retention delayed retention Sum of delayed recall and recognition Controlled Oral Word Association Test Verbal fluency Participants are required to name as many words as they can in one minute Adapted from: () WAIS-III Similarities Concept formation, abstraction Participants are given a series of comparisons and are asked how two things are alike (6) Behavioral Dyscontrol Scale Executive function A brief multidimensional screening of working memory, motor learning, and behavioral inhibition (7) Geriatric Depression Scale - Short Form Depressive symptoms Participants are asked a series of questions about how they felt over the past week. (8) Direct Assessment of Functional Status Cognitive and behavioral functional status Behavioral rating scale that directly assesses functional capacity (9) CERAD (Consortium to Establish a Registry for Alzheimer s Disease): Clinical evidence for dementia Standardized procedure for the clinical evaluation and diagnosis of patients with Alzheimer s disease (AD). ()

2 Verbal Fluency Boston Naming Test Mini-Mental State Examination Constructional Praxis Word List Memory

3 Table S. Cognitive function status in subjects from the Georgia Centenarian Study (mean + SD). >8 to <89y (n=78) >98 y (n=) P value* Community dwelling (n=) Institutionalized (n=8) P value* Total (n=98) Mini Mental State Examination.6 ± ± 8.7 <..±6.8.8±9. <. 8.±9. Global Deterioration Rating Scale. ±.. ±.7 <..±..±.7 <..7±.8 FOME Recall 6.±..±. <..±..±.8 <..9±. FOME Recognition. ±.. ±..67.±..7±.6..±. FOME Retention 8.7 ±. 6. ±.. 8.6±.8.9±. <. 6.7±. Controlled Oral Word Association Test Wechsler Adult Intelligence Scale- III Similarities subtest Behavioral Dyscontrol Scale Total Score 7.9 ±.8. ±.6 <. 6.9±..±. <..±.. ± ± 8. <..±8.8.±7. <. 9.±9..9 ±.7 8. ± 6. <..±6. 7.±6. <..±7. FOME: Fuld Object Memory Evaluation; *Significant difference between groups. Means were compared using Student s t-test.

4 Table S. Partial correlation coefficients between cognition indices and serum carotenoids, α-tocopherol and retinol in octogenarians and centenarians (adjusted with age, sex, education years, BMI, smoking, alcohol, hypertension and diabetes). Mini Mental State Exam Global Deterioration Rating Scale FOME Recall FOME Recognition FOME Retention Controlled Oral Word Association Test WAIS-III Similarities Subtest Behavioral Dyscontrol Scale Total Score OCTOGENARIANS, n = 78 Lutein,.7 a -.8 a a Zeaxanthin, Cryptoxanthin α-carotene β-carotene, Lycopene, α-tocopherol Retinol CENTENARIANS, n = Lutein, b.6 a a.66 b. a Zeaxanthin,.8 -. c a.88 a.8 a.8 a Cryptoxanthin a.6 α-carotene β-carotene,. -.8 b. b.9.9 c. c.7 a. c Lycopene,

5 α-tocopherol.8 -. c a..9.8 c Retinol a FOME: Fuld Object Memory Evaluation; WAIS-III Similarities subtest: Wechsler Adult Intelligence Scale-III Similarities subtest Significantly related (P <): a., b., c.

6 6 Table S. Partial correlation coefficients between cognition indices and serum carotenoids, α-tocopherol and retinol in community dwelling (n = ) and institutionalized subjects (n = 8), 8-89 and >98 yrs (adjusted w/ age, sex, education years, BMI, smoking, alcohol, hypertension and diabetes). Mini Mental State Exam Global Deterioration Rating Scale FOME Recall FOME Recognition FOME Retention Controlled Oral Word Association Test WAIS-III Similarities subtest Behavioral Dyscontrol Scale Total Score COMMUNITY DWELLING, n = Lutein,. a -. b.98 a -..9 a.6.. Zeaxanthin,.89 b -.9 c.7 a.9. a.9 a.7 a.6 Cryptoxanthin α-carotene β-carotene,.9 -. c.9 a.6. b.6 c.9.86 b Lycopene,. d -.9 a α-tocopherol a a Retinol INSTITUTIONALIZED, n = 8 Lutein, Zeaxanthin, Cryptoxanthin α-carotene b b.8 a. -. c a. a a a.68

7 7 β-carotene, Lycopene, α-tocopherol Retinol c a a a a FOME: Fuld Object Memory Evaluation; WAIS-III Similarities subtest: Wechsler Adult Intelligence Scale-III Similarities subtest Significantly related (P <): a., b., c.

8 8 Table S. Characteristics of centenarian subjects in the analysis of brain analytes and cognition. Characteristics Total Global Deterioration Scale (GDRS) a P value n=7 n= n=7 n= > n= Age, y (mean + SD) Sex, Male Female Race, Caucasian Black Living, Community dwelling Institutionalized Education (mean + SD) (highest grade completed, y) BMI, kg/m (mean + SD) Smoking (n) Never Past Present Alcohol use (n) Never Past Present Hypertension (n) Yes No Diabetes (n) Yes No a GDRS=: no subjective complaints or objective evidence of memory deficits; GDRS=: subject complaints, but no objective evidence of memory deficits; GDRS=: mild cognitive impairment and GDRS= to 7: different stages of dementia. Subject characteristics were compared using one-way ANOVA, for categorical variables Fisher s exact test was used.

9 9 REFERENCES (Supplementary Material). Folstein MR, Folstein SE. "Mini-Mental State" A Practical Method for Grading the Cognitive State of Patients for the Clinician. Journal of Psychiatriatric Research 97;.. Reisberg B, Ferris SH, de Leon MJ, Crook. T. The global deterioration scale for assessment of primary degenerative dementia. American Journal of Psychiatry 98;9:6-9.. Panisset M, Roudier M, Saxton J, Boller F. Severe impairment battery. A neuropsychological test for severely demented patients. Archives of Neurology 99;:-.. Fuld PA. Fuld Object Memory Evaluation instruction manual. Wood Dale, IL: Stoetling, 98.. Benton AL, Hamsher K. Multilingual aphasia examination. Iowa City, Iowa: University of Iowa, Wechsler D. Wechsler Adult Intelligence Scale-III. San Antonio, Texas: The Psychological Corporation, Grigsby J, Kaye K, Robbins LJ. Reliabilities, norms and factor structure of the Behavioral Dyscontrol Scale. Perceptual & Motor Skills 99;7: Sheikh JI, Yesavage JA. Geriatric Depresion Scale:Recent evidence and development of a shorter version. Clinical Gerontology: A Guide to Assessment and Intervention. New York: The Haworth Press, 986: Loewenstein DA, Amigo E, Duara R, et al. A new scale for the assessment of functional status in Alzheimer's disease and related disorders. Journal of Gerontology 989;:P-.. Morris JC, Heyman A, Mohs RC, et al. The consortium to establish a registry for Alzheimer's disease (CERAD). Part I. Clinical and neuropsychological assessment of Alzheimer's disease. Neurology 989;9:9-6.

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