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Calderon Martinez E, Zachariah Saji S, Salazar Ore JV, Borges-Sosa OA, Srinivas S, Mareddy NSR, Manzoor T, Di Vanna M, Al Shanableh Y, Taneja R, Arruarana VS. The effects of omega-3, DHA, EPA, Souvenaid® in Alzheimer's disease: A systematic review and meta-analysis. Neuropsychopharmacol Rep 2024. [PMID: 38924283 DOI: 10.1002/npr2.12455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2024] [Revised: 04/19/2024] [Accepted: 05/21/2024] [Indexed: 06/28/2024] Open
Abstract
BACKGROUND Alzheimer's disease (AD) is the most common cause of dementia worldwide. Omega-3 fatty acids (n-3-PUFA) are essential to normal neural development and function. Souvenaid®, a medical supplement that contains n-3-PUFA's: eicosatetraenoic acid (EPA) and docosahexaenoic acid (DHA), has emerged as an alternative, slowing cognitive decline in AD patients. In this study, we investigated the effect of dietary supplementation with n-3-PUFA, EPA, DHA, and Souvenaid® in AD patients. AIM This systematic review and meta-analysis aim to establish the relationship between n-3-PUFA, EPA, DHA, and Souvenaid® with cognitive effects, ventricular volume and adverse events in AD patients. METHODS A systematic search of randomized control trials (RCT), cohorts, and case-control studies was done in PubMed, Scopus, Web of Science, Cochrane, and Embase for AD adult patients with dietary supplementation with n-3-PUFA, EPA, DHA, or Souvenaid® between 2003 and 2024. RESULTS We identified 14 studies with 2766 subjects aligned with our criteria. Most publications described positive cognitive outcomes from supplements (58%). The most common adverse events reported were gastrointestinal symptoms. CDR scale showed reduced progression of cognitive decline (SMD = -0.4127, 95% CI: [-0.5926; -0.2327]), without subgroup differences between different dietary supplement interventions. ADCS-ADL, MMSE, ADAS-cog, adverse events, and ventricular volume did not demonstrate significant differences. However, Souvenaid® showed a significant negative effect (SMD = -0.3593, 95% CI: -0.5834 to -0.1352) in ventricular volumes. CONCLUSIONS The CDR scale showed reduced progression of cognitive decline among patients with n-3-PUFA supplemental interventions, with no differences between different n-3-PUFA supplements.
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Affiliation(s)
| | | | | | | | - Samyuktha Srinivas
- Manipal Academy of Higher Education, Kasturba Medical College, Mangalore, Karnataka, India
| | | | - Tanseem Manzoor
- College of Medicine University of Sharjah, Sharjah, United Arab Emirates
| | - Mariela Di Vanna
- Department of Internal Medicine, RWJBH Rutgers Health CMC, Toms River, New Jersey, USA
| | | | - Rishabh Taneja
- Government Medical College and Hospital, Chandigarh, India
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Kocatürk RR, Temizyürek A, Özcan ÖÖ, Ergüzel TT, Karahan M, Konuk M, Tarhan N. Effect of nutritional supports on malnutrition, cognition, function and biomarkers of Alzheimer's disease: a systematic review. Int J Neurosci 2023; 133:1355-1373. [PMID: 35686376 DOI: 10.1080/00207454.2022.2079506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Accepted: 05/12/2022] [Indexed: 10/18/2022]
Abstract
AIM To summarize the nutritional supplementation on biochemical parameters, cognition, function, Alzheimer's Disease (AD) biomarkers and nutritional status. MATERIALS AND METHODS PubMed, Web of Science, Korean Journal Database, Russian Science Citation Index, SciELO Citation Index, Cochrane Library and Scopus databases were searched until 16 April 2021. 22.193 records in total were reached according to inclusion and exclusion criteria. Included Studies were evaluated through the Modified Jadad Scale and gathered under four subheadings. RESULTS Forty-eight studies with a total of 7009 AD patients were included. Souvenaid, ONS (368 ± 69 kcal), Vegenat-med, 500 mg Resveratrol, ONS (200 mL) were effective nutritional supplements on promoting weight gain and protecting malnutrition status but showed conflicting results in Body mass index, Mid-Upper-Arm Circumference and Triceps Skin Fold Thickness. ONS and a lyophilized whole supplementation Vegenat-med intake made an increase in MNA scores. While all nutritional supplements showed controversial results in biochemical parameters but caused a decrease in Hcy levels which caused reductions in brain Aβ plaque (increase serum Aβ), p-Tau and cognitive improvement. Folic acid and vitamin D decreased serum APP, BACE1, BACE1mRNA. Resveratrol, Hericium erinaceus mycelia, vitamin D and Betaine supplements improved cognitive, functional prognosis and quality of life unlike other nutritional supplements had no effect on cognitive scales. CONCLUSIONS Better designed trials with holistic measures are needed to investigate the effect of nutritional support on the AD biomarkers, cognitive status, biochemical parameters and functional states. Also, more beneficial results can be obtained by examining the simultaneous effects of nutritional supplements with larger sample groups.
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Affiliation(s)
- Rümeysa Rabia Kocatürk
- Department of Molecular Biology, Institute of Science, Üsküdar University, Istanbul, Turkey
| | - Arzu Temizyürek
- Department of Physiology, Faculty of Medicine, Altınbaş University, Istanbul, Turkey
| | - Öznur Özge Özcan
- Department of Molecular Neuroscience, Health Sciences Institute, Üsküdar University, Istanbul, Turkey
| | - Türker Tekin Ergüzel
- Department of Software Engineering, Faculty of Engineering and Natural Sciences, Üsküdar University, Istanbul, Turkey
| | - Mesut Karahan
- Department of Molecular Biology, Institute of Science, Üsküdar University, Istanbul, Turkey
- Department of Biomedical Device Technology, Vocational School of Health Sciences, Üsküdar University, Istanbul, Turkey
| | - Muhsin Konuk
- Department of Molecular Biology and Genetics, Faculty of Engineering and Natural Sciences, Üsküdar University, Istanbul, Turkey
| | - Nevzat Tarhan
- NP Istanbul Brain Hospital, Istanbul, Turkey
- Department of Psychiatry, School of Medicine, Üsküdar University, Istanbul, Turkey
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Fujisawa C, Umegaki H, Sugimoto T, Nakashima H, Nagae M, Komiya H, Watanabe K, Yamada Y, Sakurai T. Relationship Between Non-Cognitive Intrinsic Capacity and Activities of Daily Living According to Alzheimer's Disease Stage. J Alzheimers Dis 2023; 96:1115-1127. [PMID: 37927265 DOI: 10.3233/jad-230786] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2023]
Abstract
BACKGROUND Few studies have examined the relationship between non-cognitive factors and activities of daily living (ADL) according to Alzheimer's disease (AD) stage. OBJECTIVE We aimed to identify the differences in non-cognitive factors according to AD stages and their involvement in basic and instrumental ADL performance by using intrinsic capacity (IC) in groups with cognition ranging from normal to moderate or severe AD. METHODS We enrolled 6397 patients aged≥65 years who visited our memory clinic. Non-cognitive IC was assessed using the locomotion, sensory, vitality, and psychological domains. Multiple logistic regression was performed to identify how non-cognitive IC declines over the AD course and examine the correlation between non-cognitive IC and basic and instrumental ADL performance. RESULTS Non-cognitive IC declined from the initial AD stage and was significantly correlated with both basic and instrumental ADL performance from the aMCI stage through all AD stages. In particular, the relationship between IC and basic ADL was stronger in mild and moderate to severe AD than in the aMCI stage. On the other hand, the relationship between IC and instrumental ADL was stronger in aMCI than in later AD stages. CONCLUSIONS The results show non-cognitive factors, which decline from the aMCI stage, are correlated with ADL performance from the aMCI stage to almost all AD stages. Considering that the relationship strength varied by ADL type and AD stage, an approach tailored to ADL type and AD stage targeting multiple risk factors is likely needed for effectively preventing ADL performance declines.
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Affiliation(s)
- Chisato Fujisawa
- Department of Community Healthcare and Geriatrics, Graduate School of Medicine, Nagoya University, Nagoya, Japan
- Department of Prevention and Care Science, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Hiroyuki Umegaki
- Department of Community Healthcare and Geriatrics, Graduate School of Medicine, Nagoya University, Nagoya, Japan
- Institute of Innovation for Future Society Nagoya University, Nagoya, Japan
| | - Taiki Sugimoto
- Department of Prevention and Care Science, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Hirotaka Nakashima
- Department of Community Healthcare and Geriatrics, Graduate School of Medicine, Nagoya University, Nagoya, Japan
| | - Masaaki Nagae
- Department of Community Healthcare and Geriatrics, Graduate School of Medicine, Nagoya University, Nagoya, Japan
| | - Hitoshi Komiya
- Department of Community Healthcare and Geriatrics, Graduate School of Medicine, Nagoya University, Nagoya, Japan
| | - Kazuhisa Watanabe
- Department of Community Healthcare and Geriatrics, Graduate School of Medicine, Nagoya University, Nagoya, Japan
| | - Yosuke Yamada
- Department of Community Healthcare and Geriatrics, Graduate School of Medicine, Nagoya University, Nagoya, Japan
| | - Takashi Sakurai
- Department of Prevention and Care Science, National Center for Geriatrics and Gerontology, Obu, Japan
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Martins LB, Malheiros Silveira AL, Teixeira AL. The link between nutrition and Alzheimer's disease: from prevention to treatment. Neurodegener Dis Manag 2021; 11:155-166. [PMID: 33550870 DOI: 10.2217/nmt-2020-0023] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Alzheimer's disease (AD) is the most common cause of dementia. To date, there is no effective pharmacological strategy to slow or stop disease progression. In this context, multiple alternative therapeutic strategies have been investigated for AD. This review addresses the potential role of nutrition interventions in AD prevention and treatment. Nutritional strategies for AD have been based on four pillars: maintaining a healthy weight (i.e., prevention and/or treatment of obesity, especially in midlife and prevention of weight loss in the later stages of AD); correction of nutritional deficiencies; adequate consumption of micronutrients (vitamins and minerals), especially those implicated in the pathways of AD pathophysiology; and microbiota modulation.
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Affiliation(s)
- Laís Bhering Martins
- Department of Psychiatry & Behavioral Sciences, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX 77054, USA.,Departamento de Nutrição, Escola de Enfermagem, Universidade Federal de Minas Gerais, Belo Horizonte, MG, 30130-100, Brazil
| | - Ana Letícia Malheiros Silveira
- Departamento de Nutrição, Escola de Enfermagem, Universidade Federal de Minas Gerais, Belo Horizonte, MG, 30130-100, Brazil.,Departamento de Bioquímica e Imunologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, MG, 31270-901, Brazil
| | - Antonio Lúcio Teixeira
- Department of Psychiatry & Behavioral Sciences, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX 77054, USA
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Pilipovich AA, Vorob'eva OV. [Mild cognitive impairment: modern aspects of diagnostics and therapy]. Zh Nevrol Psikhiatr Im S S Korsakova 2020; 120:124-130. [PMID: 33340307 DOI: 10.17116/jnevro2020120111124] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The article provides a review of current literature on the diagnosis and treatment of mild cognitive impairment (MCI). MCI is not a common outcome of brain aging; it is an intermediate state between normal cognitive status and mild dementia. The MCI concept has been actively developing over the past few decades, a lot of knowledge and clinical experience has been accumulated, and numerous clinical trials are being conducted to develop effective methods of diagnosis and therapy. Treatment of pre-dementia cognitive disorders differs in many ways from therapy for dementia and has a better prognosis, therefore, it is recommended to diagnose and begin treating cognitive disorders as early as possible. The main possibilities of drug and non-drug therapy are described, with an emphasis on the use of the dopamine receptor agonist piribedil in the treatment of MCI and sensory deficit in elderly patients. The mechanisms of action of the drug are analyzed, data from the main clinical studies of the efficacy and safety of piribedil are presented: the positive effect of the drug on cognitive functions has been shown in more than 10 international clinical trials including about 7000 patients and in a number of post-marketing works performed on the Russian population of patients. Piribedil is successfully used for various types of cognitive disorders, both neurodegenerative and vascular, of mild to moderate severity.
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Affiliation(s)
- A A Pilipovich
- Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - O V Vorob'eva
- Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
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Abstract
BACKGROUND Souvenaid is a dietary supplement with a patented composition (Fortasyn Connect™)which is intended to be used by people with Alzheimer's disease (AD). It has been designed to support the formation and function of synapses in the brain, which are thought to be strongly correlated with cognitive function. If effective, it might improve symptoms of Alzheimer's disease and also prevent the progression from prodromal Alzheimer's disease to dementia. We sought in this review to examine the evidence for this proposition. OBJECTIVES To assess the effects of Souvenaid on incidence of dementia, cognition, functional performance, and safety in people with Alzheimer's disease. SEARCH METHODS We searched ALOIS, i.e. the specialised register of the Cochrane Dementia and Cognitive Improvement Group, MEDLINE (Ovid SP), Embase (Ovid SP), PsycINFO (Ovid SP), Web of Science (ISI Web of Science), Cinahl (EBSCOhost), Lilacs (BIREME), and clinical trials registries up to 24 June 2020. We also reviewed citations of reference lists of landmark papers, reviews, and included studies for additional studies and assessed their suitability for inclusion in the review. SELECTION CRITERIA We included randomised, placebo-controlled trials which evaluated Souvenaid in people diagnosed with mild cognitive impairment (MCI) due to AD (also termed prodromal AD) or with dementia due to AD, and with a treatment duration of at least 16 weeks. DATA COLLECTION AND ANALYSIS Our primary outcome measures were incidence of dementia, global and specific cognitive function, functional performance, combined cognitive-functional outcomes and adverse events. We selected studies, extracted data, assessed the quality of trials and intended to conduct meta-analyses according to the Cochrane Handbook for Systematic Reviews of Interventions. We rated the quality of the evidence using the GRADE approach. We present all outcomes grouped by stage of AD. MAIN RESULTS We included three randomised, placebo-controlled trials investigating Souvenaid in 1097 community-dwelling participants with Alzheimer's disease. One study each included participants with prodromal AD, mild AD dementia and mild-to-moderate AD dementia. We rated the risks of bias of all trials as low. One study (in prodromal AD) was funded by European grants. The other two studies were funded by the manufacturer of Souvenaid. One trial investigated the incidence of dementia in people with prodromal AD at baseline, and found little to no difference between the Souvenaid group and the placebo group after 24 months (RR 1.09, 95% CI 0.82 to 1.43; 1 trial, 311 participants; moderate quality of evidence). In prodromal AD, and in mild and mild-to-moderate Alzheimer's disease dementia, Souvenaid probably results in little or no difference in global or specific cognitive functions (moderate quality of evidence). Everyday function, or the ability to perform activities of daily living, were measured in mild and mild-to-moderate AD dementia. Neither study found evidence of a difference between the groups after 24 weeks of treatment (moderate quality of evidence). Two studies investigated combined cognitive-functional outcomes with the Clinical Dementia Rating Sum of Boxes and observed conflicting results. Souvenaid probably results in slight improvement, which is below estimates of meaningful change, in participants with prodromal Alzheimer's disease after 24 months (moderate quality of evidence), but probably has little to no effect in mild-to-moderate Alzheimer's disease dementia after 24 weeks (moderate quality of evidence). Adverse effects observed were low in all trials, and the available data were insufficient to determine any connection with Souvenaid. AUTHORS' CONCLUSIONS Two years of treatment with Souvenaid probably does not reduce the risk of progression to dementia in people with prodromal AD. There is no convincing evidence that Souvenaid affects other outcomes important to people with AD in the prodromal stage or mild-to-moderate stages of dementia. Conflicting evidence on combined cognitive-functional outcomes in prodromal AD and mild AD dementia warrants further investigation. Adverse effects of Souvenaid seem to be uncommon, but the evidence synthesised in this review does not permit us to make a definitive statement on the long-term tolerability of Souvenaid. The effects of Souvenaid in more severe AD dementia or in people with AD at risk of nutritional deficiencies remain unclear.
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Affiliation(s)
| | - Stefan Watzke
- Department of Psychiatry, Psychotherapy and Psychosomatics, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
| | - Andreas Wienke
- Institute of Medical Epidemiology, Biostatistics and Informatics, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
| | - Gero Langer
- Institute of Health and Nursing Sciences, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
| | - Astrid Fink
- Institute for Medical Sociology, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
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Albrahim T. The potential role of nutritional components in improving brain function among patients with Alzheimers disease: a meta-analysis of RCT studies. ACTA ACUST UNITED AC 2020; 25:4-17. [PMID: 31982903 PMCID: PMC8015632 DOI: 10.17712/nsj.2020.1.20190037] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
OBJECTIVE To find out the potential role of nutritional components in improving brain function among patients with Alzheimer`s disease (AD). METHODS The correlation between nutrition and cerebral function in cases of AD has been the focus of 19 prospective randomised controlled trials (RCTs) with a combined research sample of 2297 patients. These RCTs are subject to systematic review and meta-analysis in the current paper RESULTS: Findings showed that chain-free secondary saturated fatty acids (SFA) and trans fatty acids (TFA) occurred in higher concentrations in AD patients` brains than in controls. Furthermore, neuroinflammation was caused by remodelling of the lipid membrane and AD patients` cognitive function was impacted by alterations in tyrosine, tryptophan, purine, and tocopherol pathway metabolomics. Moreover, in cases of mild-to-moderate AD, reduction in functionality was induced by administration of alpha-tocopherol for more than 12 months. Consumption of Souvenaid helps in synaptic synthesis, which enhances functional connectivity. Furthermore, consumption of the B vitamins folate, cobalamin and pyridoxine at dosages of 0.8 mg, 0.5 mg and 20 mg per day, respectively, over a period of one year resulted in lower plasma tHcy levels and brain atrophy. CONCLUSION Chain-free SFA and TFA occur in greater amounts in the brains of individuals with AD than in those without AD.
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Affiliation(s)
- Tarfa Albrahim
- Department of Health Sciences, College of Health and Rehabilitation Sciences, Princess Nourah Bint Abdulrahman University, Riyadh, Kingdom of Saudi Arabia. E-mail:
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Efficacy of Mealtime Interventions for Malnutrition and Oral Intake in Persons With Dementia: A Systematic Review. Alzheimer Dis Assoc Disord 2020; 34:366-379. [PMID: 32530831 DOI: 10.1097/wad.0000000000000387] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Malnutrition and weight loss are highly prevalent in persons with Alzheimer's disease and related dementias. Oral intake is an important interventional target for addressing these nutritional consequences. However, the efficacy of interventions remains poorly understood as prior syntheses have failed to examine the impact of intervention approaches on malnutrition and hypothesized mechanisms of action in persons with dementia. This review aimed to determine the efficacy of mealtime interventions to improve oral intake and nutritional outcomes in persons with dementia. Four databases yielded 1712 studies, resulting in 32 studies that met inclusion criteria. Studies included education, environmental modifications, feeding, oral supplementation, and other pharmacologic/ecopsychological interventions. While the majority of studies reported statistically significant improvements in at least 1 nutritional outcome, study design and outcome measures were heterogenous with many lacking adequate statistical power or blinding. Collectively, we found moderate evidence to suggest the efficacy of oral supplementation, and preliminary evidence to suggest that feeding interventions, education, and environmental modifications may confer improvements. Findings clarify the state of existing evidence regarding various interventional strategies for improving malnutrition in persons with dementia. While some approaches are promising, adequately powered and rigorously designed multidimensional intervention trials are needed to inform clinical decision-making in real-world contexts.
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Vlachos GS, Scarmeas N. Dietary interventions in mild cognitive impairment and dementia. DIALOGUES IN CLINICAL NEUROSCIENCE 2020. [PMID: 31607782 PMCID: PMC6780358 DOI: 10.31887/dcns.2019.21.1/nscarmeas] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Dietary intervention is an enticing approach in the fight against cognitive impairment. Nutritional supplements and dietetic counseling are relatively easy and benign interventions, but research has not yet yielded irrefutable evidence as to their clinical utility. Heterogeneity in the results of available clinical studies, as well as methodological and practical issues, does not allow replication and generalization of findings. The paper at hand reviews only randomized clinical trials of single nutrients, multi-nutrient formulations and dietary counseling in mild cognitive impairment and dementia of the Alzheimer's type focusing on both cognitive and functional outcomes. Thus far, folate, vitamin E, Ω-3 fatty acids, and certain multi-nutrient formulations have shown some preliminary promising results; larger, well-designed trials are needed to confirm these findings before nutritional elements can be incorporated in recommended clinical guidelines.
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Affiliation(s)
- George S Vlachos
- 1st Department of Neurology, Aiginition Hospital, National and Kapodistrian University of Athens Medical School, Greece
| | - Nikolaos Scarmeas
- 1st Department of Neurology, Aiginition Hospital, National and Kapodistrian University of Athens Medical School, Greece; Taub Institute for Research in Alzheimer's Disease and the Aging Brain, The Gertrude H. Sergievsky Center, Department of Neurology, Columbia University, New York, USA
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10
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Li KX, Sun Q, Wei LL, Du GH, Huang X, Wang JK. ERα Gene Promoter Methylation in Cognitive Function and Quality of Life of Patients With Alzheimer Disease. J Geriatr Psychiatry Neurol 2019; 32:221-228. [PMID: 30947592 DOI: 10.1177/0891988719835325] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
OBJECTIVE Alzheimer disease (AD) has been recognized as a progressive neurodegenerative disorder. This study aims to investigate the effects of estrogen receptor α (ERα) gene promoter methylation on the cognitive function and quality of life (QOL) of patients with AD. METHODS A total of 132 patients with AD and 135 healthy individuals were recruited for this study. The DNA in the peripheral blood was extracted and treated with bisulfite; then methylation-specific polymerase chain reaction and reverse transcription quantitative polymerase chain reaction were performed to determine the methylation status of ERα and ERα messenger RNA (mRNA) expression, respectively. Mini-Mental State Examination (MMSE), activities of daily living (ADL), and Quality of Life-Alzheimer Disease scale were employed to evaluate the cognitive functions, ADL, and QOL of the participants. RESULTS The methylation group showed a decrease in ERα mRNA expression. The MMSE and ADL scores were indicative of a worse cognitive function in the methylation group. The ERα promoter methylated patients showed a higher rate of abnormal ADL score, while patients in the nonmethylation group enjoyed a better QOL. CONCLUSIONS The ERα promoter methylation is related to impaired cognitive function and QOL of patients with AD by inhibiting ERα mRNA expression and transcription.
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Affiliation(s)
- Kai-Xiu Li
- 1 Department of Geratology, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, Chengdu, People's Republic of China
| | - Qin Sun
- 2 School of Medicine, University of Electronic Science and Technology of China, Chengdu, People's Republic of China
| | - Ling-Ling Wei
- 2 School of Medicine, University of Electronic Science and Technology of China, Chengdu, People's Republic of China.,3 Center of Diabetes Mellitus, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, Chengdu, People's Republic of China
| | - Guang-Hui Du
- 4 Outpatient Department, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, Chengdu, People's Republic of China
| | - Xue Huang
- 1 Department of Geratology, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, Chengdu, People's Republic of China
| | - Jun-Kang Wang
- 4 Outpatient Department, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, Chengdu, People's Republic of China
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Freijer K, Volger S, Pitter JG, Molsen-David E, Cooblall C, Evers S, Hiligsmann M, Danel A, Lenoir-Wijnkoop I. Medical Nutrition Terminology and Regulations in the United States and Europe-A Scoping Review: Report of the ISPOR Nutrition Economics Special Interest Group. VALUE IN HEALTH : THE JOURNAL OF THE INTERNATIONAL SOCIETY FOR PHARMACOECONOMICS AND OUTCOMES RESEARCH 2019; 22:1-12. [PMID: 30661624 DOI: 10.1016/j.jval.2018.07.879] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/12/2017] [Revised: 06/12/2018] [Accepted: 07/03/2018] [Indexed: 06/09/2023]
Abstract
BACKGROUND The term medical nutrition (MN) refers to nutritional products used under medical supervision to manage disease- or condition-related dietary needs. Standardized MN definitions, aligned with regulatory definitions, are needed to facilitate outcomes research and economic evaluation of interventions with MN. OBJECTIVES Ascertain how MN terms are defined, relevant regulations are applied, and to what extent MN is valued. METHODS ISPOR's Nutrition Economics Special Interest Group conducted a scoping review of scientific literature on European and US MN terminology and regulations, published between January 2000 and August 2015, and pertinent professional and regulatory Web sites. Data were extracted, reviewed, and reconciled using two-person teams in a two-step process. The literature search was updated before manuscript completion. RESULTS Of the initial 1687 literature abstracts and 222 Web sites identified, 459 records were included in the analysis, of which 308 used MN terms and 100 provided definitions. More than 13 primary disease groups as per International Classification of Disease, Revision 10 categories were included. The most frequently mentioned and defined terms were enteral nutrition and malnutrition. Less than 5% of the records referenced any MN regulation. The health economic impact of MN was rarely and insufficiently (n = 19 [4.1%]) assessed, although an increase in economic analyses was observed. CONCLUSIONS MN terminology is not consistently defined, relevant European and US regulations are rarely cited, and economic evaluations are infrequently conducted. We recommend adopting consensus MN terms and definitions, for example, the European Society for Clinical Nutrition and Metabolism consensus guideline 2017, as a foundation for developing reliable and standardized medical nutrition economic methodologies.
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Affiliation(s)
- Karen Freijer
- School for Public Health and Primary Care (CAPHRI), Maastricht University, Maastricht, The Netherlands.
| | - Sheri Volger
- Clinical Development Immunology Gastroenterology, Janssen R&D, Spring House, PA, USA
| | | | | | - Clarissa Cooblall
- Scientific & Health Policy Initiatives, ISPOR, Lawrenceville, NJ, USA
| | - Silvia Evers
- School for Public Health and Primary Care (CAPHRI), Maastricht University, Maastricht, The Netherlands
| | - Mickaël Hiligsmann
- Department of Health Services Research of Maastricht University, Maastricht, Netherlands
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Muñoz Fernández SS, Ivanauskas T, Lima Ribeiro SM. Nutritional Strategies in the Management of Alzheimer Disease: Systematic Review With Network Meta-Analysis. J Am Med Dir Assoc 2017; 18:897.e13-897.e30. [DOI: 10.1016/j.jamda.2017.06.015] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2017] [Accepted: 06/16/2017] [Indexed: 01/09/2023]
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Franx BAA, Arnoldussen IAC, Kiliaan AJ, Gustafson DR. Weight Loss in Patients with Dementia: Considering the Potential Impact of Pharmacotherapy. Drugs Aging 2017; 34:425-436. [PMID: 28478593 DOI: 10.1007/s40266-017-0462-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Unintentional body weight loss is common in patients with dementia and is linked to cognitive impairment and poorer disease outcomes. It is proposed that some dementia medications with market approval, while aiming to improve cognitive and functional outcomes of a patient with dementia, are associated with reported body weight or body mass index loss. This review presents evidence in the published literature on body weight loss in dementia, describes selected theories behind body weight loss, evaluates the potential impact of approved dementia pharmacotherapies on body weight, considers the potential role for medical foods, understands the potential influence of treatments for neuropsychiatric symptoms and signs, and finally, summarizes this important area.
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Affiliation(s)
- Bart A A Franx
- Department of Anatomy, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Ilse A C Arnoldussen
- Department of Anatomy, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Amanda J Kiliaan
- Department of Anatomy, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Deborah R Gustafson
- Department of Neurology, Section for NeuroEpidemiology, State University of New York, Downstate Medical Center, 450 Clarkson Avenue, Box 1213, Brooklyn, NY, 11203, USA. .,Neuropsychiatric Epidemiology Unit (EPINEP), Institute for Neuroscience and Physiology, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden. .,Department of Health and Education, University of Skövde, Skövde, Sweden.
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14
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Fraga VG, Carvalho MDG, Caramelli P, de Sousa LP, Gomes KB. Resolution of inflammation, n-3 fatty acid supplementation and Alzheimer disease: A narrative review. J Neuroimmunol 2017; 310:111-119. [PMID: 28778434 DOI: 10.1016/j.jneuroim.2017.07.005] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2016] [Revised: 07/09/2017] [Accepted: 07/10/2017] [Indexed: 12/25/2022]
Abstract
In patients with Alzheimer's disease (AD), a persistent and unresolved neuroinflammatory process can contribute to neuronal loss and a decline in their cognitive and functional abilities. Recent studies have demonstrated that the ability to resolve inflammation is impaired in the brains of patients with AD. Preclinical evidence demonstrates the potential of therapeutic interventions on the resolution phase of inflammation in AD. Supplementation of omega-3 fatty acids (n-3 FAs), precursors for specialized pro-resolving mediators, emerged as a possibility for prevention and management of AD. Here, we provide a narrative review of resolving inflammation in AD and the role of n-3 FA supplementation in AD.
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Affiliation(s)
- Vanessa Gomes Fraga
- Departamento de Análises Clínicas e Toxicológicas, Faculdade de Farmácia, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Maria das Graças Carvalho
- Departamento de Análises Clínicas e Toxicológicas, Faculdade de Farmácia, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Paulo Caramelli
- Departamento de Clínica Médica, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Lirlândia Pires de Sousa
- Departamento de Análises Clínicas e Toxicológicas, Faculdade de Farmácia, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Karina Braga Gomes
- Departamento de Análises Clínicas e Toxicológicas, Faculdade de Farmácia, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.
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15
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Onakpoya IJ, Heneghan CJ. The efficacy of supplementation with the novel medical food, Souvenaid, in patients with Alzheimer's disease: A systematic review and meta-analysis of randomized clinical trials. Nutr Neurosci 2015; 20:219-227. [DOI: 10.1080/1028415x.2015.1110899] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- Igho J. Onakpoya
- Centre for Evidence-Based Medicine, Nuffield Department of Primary Care Health Sciences, University of Oxford, UK
| | - Carl J. Heneghan
- Centre for Evidence-Based Medicine, Nuffield Department of Primary Care Health Sciences, University of Oxford, UK
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16
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Volkert D, Chourdakis M, Faxen-Irving G, Frühwald T, Landi F, Suominen MH, Vandewoude M, Wirth R, Schneider SM. ESPEN guidelines on nutrition in dementia. Clin Nutr 2015; 34:1052-73. [PMID: 26522922 DOI: 10.1016/j.clnu.2015.09.004] [Citation(s) in RCA: 225] [Impact Index Per Article: 25.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2015] [Accepted: 09/10/2015] [Indexed: 12/15/2022]
Abstract
BACKGROUND Older people suffering from dementia are at increased risk of malnutrition due to various nutritional problems, and the question arises which interventions are effective in maintaining adequate nutritional intake and nutritional status in the course of the disease. It is of further interest whether supplementation of energy and/or specific nutrients is able to prevent further cognitive decline or even correct cognitive impairment, and in which situations artificial nutritional support is justified. OBJECTIVE It is the purpose of these guidelines to cover these issues with evidence-based recommendations. METHODS The guidelines were developed by an international multidisciplinary working group in accordance with officially accepted standards. The GRADE system was used for assigning strength of evidence. Recommendations were discussed, submitted to Delphi rounds and accepted in an online survey among ESPEN members. RESULTS 26 recommendations for nutritional care of older persons with dementia are given. In every person with dementia, screening for malnutrition and close monitoring of body weight are recommended. In all stages of the disease, oral nutrition may be supported by provision of adequate, attractive food in a pleasant environment, by adequate nursing support and elimination of potential causes of malnutrition. Supplementation of single nutrients is not recommended unless there is a sign of deficiency. Oral nutritional supplements are recommended to improve nutritional status but not to correct cognitive impairment or prevent cognitive decline. Artificial nutrition is suggested in patients with mild or moderate dementia for a limited period of time to overcome a crisis situation with markedly insufficient oral intake, if low nutritional intake is predominantly caused by a potentially reversible condition, but not in patients with severe dementia or in the terminal phase of life. CONCLUSION Nutritional care and support should be an integral part of dementia management. In all stages of the disease, the decision for or against nutritional interventions should be made on an individual basis after carefully balancing expected benefit and potential burden, taking the (assumed) patient will and general prognosis into account.
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Affiliation(s)
- Dorothee Volkert
- Institute for Biomedicine of Aging (IBA), Friedrich-Alexander-Universität (FAU) Erlangen-Nürnberg, Nuremberg, Germany.
| | - Michael Chourdakis
- Department of Medicine, Aristotle University of Thessaloniki (AUTH), Greece
| | - Gerd Faxen-Irving
- Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - Thomas Frühwald
- Department of Geriatric Acute Care, Krankenhaus Hietzing, Vienna, Austria
| | - Francesco Landi
- Department of Geriatrics, Neurosciences and Orthopedics, Catholic University of the Sacred Heart, Rome, Italy
| | - Merja H Suominen
- Unit of Primary Health Care, Helsinki University Central Hospital, Helsinki, Finland
| | - Maurits Vandewoude
- Department of Geriatrics, Medical School, University of Antwerp, Belgium
| | - Rainer Wirth
- Institute for Biomedicine of Aging (IBA), Friedrich-Alexander-Universität (FAU) Erlangen-Nürnberg, Nuremberg, Germany; St. Marien-Hospital Borken, Department for Internal Medicine and Geriatrics, Borken, Germany
| | - Stéphane M Schneider
- Nutritional Support Unit, Centre Hospitalier Universitaire de Nice, Nice, France
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17
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Cummings JL, Isaacson RS, Schmitt FA, Velting DM. A practical algorithm for managing Alzheimer's disease: what, when, and why? Ann Clin Transl Neurol 2015; 2:307-23. [PMID: 25815358 PMCID: PMC4369281 DOI: 10.1002/acn3.166] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2014] [Revised: 11/21/2014] [Accepted: 12/04/2014] [Indexed: 12/02/2022] Open
Abstract
Alzheimer's disease (AD) is the most common form of dementia and its prevalence is increasing. Recent developments in AD management provide improved ways of supporting patients and their caregivers throughout the disease continuum. Managing cardiovascular risk factors, maintaining an active lifestyle (with regular physical, mental and social activity) and following a Mediterranean diet appear to reduce AD risk and may slow cognitive decline. Pharmacologic therapy for AD should be initiated upon diagnosis. All of the currently available cholinesterase inhibitors (ChEIs; donepezil, galantamine, and rivastigmine) are indicated for mild-to-moderate AD. Donepezil (10 and 23 mg/day) and rivastigmine transdermal patch (13.3 mg/24 h) are indicated for moderate-to-severe AD. Memantine, an N-methyl-d-aspartate receptor antagonist, is approved for moderate-to-severe AD. ChEIs have been shown to improve cognitive function, global clinical status and patients' ability to perform activities of daily living. There is also evidence for reduction in emergence of behavioral symptoms with ChEI therapy. Treatment choice (e.g., oral vs. transdermal) should be based on patient or caregiver preference, ease of use, tolerability, and cost. Treatment should be individualized; patients can be switched from one ChEI to another if the initial agent is poorly tolerated or ineffective. Memantine may be introduced in moderate-to-severe disease stages. Clinicians will regularly monitor symptoms and behaviors, manage comorbidities, assess function, educate and help caregivers access information and support, evaluate patients' fitness to drive or own firearms, and provide advice about the need for legal and financial planning. Review of caregiver well-being and prompt referral for support is vital.
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Affiliation(s)
- Jeffrey L Cummings
- Cleveland Clinic Lou Ruvo Center for Brain Health Las Vegas, Nevada and Cleveland, Ohio
| | | | - Frederick A Schmitt
- Sanders-Brown Center on Aging, University of Kentucky Medical Center Lexington, Kentucky
| | - Drew M Velting
- Novartis Pharmaceuticals Corporation East Hanover, New Jersey
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18
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Morley JE. New Horizons in the Management of Alzheimer Disease. J Am Med Dir Assoc 2015; 16:1-5. [DOI: 10.1016/j.jamda.2014.10.022] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2014] [Accepted: 10/29/2014] [Indexed: 12/21/2022]
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19
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Ritchie CW, Bajwa J, Coleman G, Hope K, Jones RW, Lawton M, Marven M, Passmore P. Souvenaid®: a new approach to management of early Alzheimer's disease. J Nutr Health Aging 2014; 18:291-9. [PMID: 24626757 DOI: 10.1007/s12603-013-0411-2] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Synaptic loss correlates closely with cognitive deficits in Alzheimer's disease and represents a new target for intervention. Souvenaid® is the first medical nutrition product to be designed to support synapse formation and function in early Alzheimer's disease, and has undergone an extensive, 12-year development programme. The relatively large amount of clinical data available for Souvenaid® is unusual for a medical nutrition product. Souvenaid® contains omega-3 polyunsaturated fatty acids (docosahexaenoic acid and eicosapentaenoic acid), uridine (as uridine monophosphate) and choline which are nutritional precursors required for synaptic membrane phospholipid synthesis, together with phospholipids and other cofactors. Souvenaid® has demonstrated cognitive benefits in patients with mild Alzheimer's disease but not in patients with mild-to-moderate Alzheimer's disease. Two randomised, double-blind, controlled trials (duration 12 and 24 weeks) in patients with mild Alzheimer's disease untreated with acetylcholinesterase inhibitors and/or memantine have demonstrated that Souvenaid® is well tolerated and improves episodic memory performance. The daily intake of Souvenaid® has not been associated with any harmful effects or interactions with medications and none are anticipated. The ongoing, 24-month, European Union-funded LipiDiDiet trial in subjects with prodromal Alzheimer's disease is evaluating the potential benefits of Souvenaid® on memory and in slowing progression to Alzheimer's dementia. If Souvenaid® induces synaptogenesis and improved synaptic function, it may provide benefits in other clinical conditions characterised by neurodegeneration. A number of trials are ongoing and planned to evaluate the potential wider benefits of Souvenaid®.
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Affiliation(s)
- C W Ritchie
- C Ritchie, Department of Medicine, Imperial College, London, UK, ;
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20
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Liu W, Cheon J, Thomas SA. Interventions on mealtime difficulties in older adults with dementia: A systematic review. Int J Nurs Stud 2014; 51:14-27. [DOI: 10.1016/j.ijnurstu.2012.12.021] [Citation(s) in RCA: 81] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2012] [Revised: 12/12/2012] [Accepted: 12/28/2012] [Indexed: 12/21/2022]
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21
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Morley JE. Mild Cognitive Impairment—A Treatable Condition. J Am Med Dir Assoc 2014; 15:1-5. [DOI: 10.1016/j.jamda.2013.11.001] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2013] [Accepted: 11/04/2013] [Indexed: 01/24/2023]
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22
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Abstract
PURPOSE OF REVIEW Aging is associated with a decline in cognition. This review examines the available data on the effects of nutrition on cognitive impairment. It also explores the mechanism(s) by which food may enhance memory. RECENT FINDINGS An increasing body of evidence has supported the role of the Mediterranean diet and extra-virgin olive oil in protecting cognition. A number of nutritional formulations to improve deteriorating memory are being studied. Undernutrition is associated with cognitive decline. Hyperglycemia and hypertriglyceridemia cause cognitive impairment. SUMMARY There are increasing data to support the role of nutrition in maintaining cognition.
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Affiliation(s)
- John E Morley
- Divisions of Geriatric Medicine and Endocrinology, Saint Louis University School of Medicine, St. Louis, Missouri, USA
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23
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Malmstrom TK, Morley JE. Frailty and cognition: linking two common syndromes in older persons. J Nutr Health Aging 2013; 17:723-5. [PMID: 24154641 DOI: 10.1007/s12603-013-0395-y] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Affiliation(s)
- T K Malmstrom
- John E. Morley, MB, BCh, Director, Divisions of Geriatric Medicine and Endocrinology, Saint Louis University School of Medicine, 1402 S. Grand Blvd., M238, St. Louis, Missouri 63104,
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24
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Droogsma E, van Asselt DZB, Schölzel-Dorenbos CJM, van Steijn JHM, van Walderveen PE, van der Hooft CS. Nutritional status of community-dwelling elderly with newly diagnosed Alzheimer's disease: prevalence of malnutrition and the relation of various factors to nutritional status. J Nutr Health Aging 2013; 17:606-10. [PMID: 23933871 DOI: 10.1007/s12603-013-0032-9] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
OBJECTIVES To determine the prevalence of malnutrition and its relation to various factors in community-dwelling elderly with newly diagnosed Alzheimer's disease (AD). DESIGN Retrospective cross-sectional study. SETTING Memory clinic in a rural part of the Netherlands. PARTICIPANTS 312 Community-dwelling AD patients, aged 65 years or older, were included. MEASUREMENTS At the time the diagnosis AD was made, socio-demographic characteristics and data on nutritional status (Mini Nutritional Assessment (MNA)), cognitive function (Mini Mental State Examination (MMSE), Cambridge Cognitive Examination (Camcog)), functional status (Interview for Deterioration in Daily Living Activities in Dementia (IDDD), Barthel Index (BI)) and behaviour (Revised Memory and Behaviour Problems Checklist (RMBPC)) were assessed. Characteristics of well-nourished patients (MNA score >23.5) were compared to characteristics of patients at risk of malnutrition (MNA score 17-23.5). Linear regression analysis was performed to assess the effect of various factors on nutritional status. RESULTS The prevalence of malnutrition was 0% and 14.1% was at risk of malnutrition. AD patients at risk of malnutrition were more impaired in basic and complex daily functioning than well-nourished AD patients (median IDDD score 41.5 [25th -75th percentile 38.8-48.0] versus median IDDD score 40.0 [25th -75th percentile 37.0-43.0], p = 0.028). The degree of impairment in basic and complex daily functioning (IDDD) was independently related to nutritional status (MNA) (p = 0.001, B = -0.062). CONCLUSION One in seven community-dwelling elderly with newly diagnosed AD is at risk of malnutrition. The degree of impairment in daily functioning is independently related to nutritional status. Therefore, assessment of the nutritional status should be included in the comprehensive assessment of AD patients. The relation between daily functioning, nutritional status and AD warrants further investigation.
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Affiliation(s)
- E Droogsma
- Geriatric Medicine, Medical Centre Leeuwarden, Po Box 888 Leeuwarden 8901 BR, The Netherlands
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25
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Barberger-Gateau P, Samieri C, Allès B, Féart C. Could nutrition prevent the onset of dementia? Current evidence from epidemiological and intervention studies. Neurodegener Dis Manag 2012. [DOI: 10.2217/nmt.12.24] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
SUMMARY Cardiovascular and metabolic risk factors for cognitive decline and dementia, such as hypertension, diabetes, metabolic syndrome and obesity, may be modified by diet. Moreover, several classes of nutrients, including long-chain ω-3 polyunsaturated fatty acids, antioxidants (i.e., vitamins C and E, carotenoids and polyphenols) and vitamins B and D can lower inflammation and oxidative stress associated with neurodegeneration, in addition to specific neuroprotective effects. However, most randomized clinical trials of supplementation with high doses of single nutrients have been disappointing. Healthy dietary patterns, such as the Mediterranean diet, combine several classes of nutrients that could work in synergy to slow down cognitive decline. Healthy dietary habits at midlife could contribute to decrease the risk of late-life dementia.
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Affiliation(s)
- Pascale Barberger-Gateau
- Univ. Bordeaux, ISPED, Center INSERM U897-Epidemiologie-Biostatistique, F-33000 Bordeaux, France
| | - Cécilia Samieri
- Univ. Bordeaux, ISPED, Center INSERM U897-Epidemiologie-Biostatistique, F-33000 Bordeaux, France
- INSERM, ISPED, Center INSERM U897-Epidemiologie-Biostatistique, F-33000 Bordeaux, France
| | - Benjamin Allès
- Univ. Bordeaux, ISPED, Center INSERM U897-Epidemiologie-Biostatistique, F-33000 Bordeaux, France
- INSERM, ISPED, Center INSERM U897-Epidemiologie-Biostatistique, F-33000 Bordeaux, France
| | - Catherine Féart
- Univ. Bordeaux, ISPED, Center INSERM U897-Epidemiologie-Biostatistique, F-33000 Bordeaux, France
- INSERM, ISPED, Center INSERM U897-Epidemiologie-Biostatistique, F-33000 Bordeaux, France
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26
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Thaipisuttikul P, Galvin JE. Use of medical foods and nutritional approaches in the treatment of Alzheimer's disease. ACTA ACUST UNITED AC 2012; 9:199-209. [PMID: 23362453 DOI: 10.2217/cpr.12.3] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Alzheimer's disease, the most common cause of dementia, has a high global economic impact. To date, there is no curative treatment; therefore, many efforts are directed not only at novel potential disease-modifying treatments and interventions, but also to develop alternative symptomatic and supportive treatments. Examples of these efforts include the medical foods. There are three medical foods that claim to offer symptomatic benefits: Axona(®), Souvenaid(®) and CerefolinNAC(®). Axona supplies ketone bodies as alternative energy source to neurons. Souvenaid provides precursors thought to enhance synaptic function. CerefolinNAC addresses the role of oxidative stress related to memory loss. The current scientific evidence on these medical foods is reviewed in this article. Furthermore, we also review the concept and evidence supporting use of the Mediterranean diet, a possible alternative to medical foods that, if implemented correctly, may have lower costs, fewer side effects and stronger epidemiological health outcomes.
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Affiliation(s)
- Papan Thaipisuttikul
- Departments of Neurology, Psychiatry, Nutrition & Public Health, Alzheimer Disease Center, New York University Langone Medical Center, 145 East 32nd Street, 2nd Floor, New York, NY 10016, USA
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