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Anderson C, Bucholc M, McClean PL, Zhang SD. The Potential of a Stratified Approach to Drug Repurposing in Alzheimer's Disease. Biomolecules 2023; 14:11. [PMID: 38275752 PMCID: PMC10813465 DOI: 10.3390/biom14010011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Revised: 12/13/2023] [Accepted: 12/15/2023] [Indexed: 01/27/2024] Open
Abstract
Alzheimer's disease (AD) is a complex neurodegenerative condition that is characterized by the build-up of amyloid-beta plaques and neurofibrillary tangles. While multiple theories explaining the aetiology of the disease have been suggested, the underlying cause of the disease is still unknown. Despite this, several modifiable and non-modifiable factors that increase the risk of developing AD have been identified. To date, only eight AD drugs have ever gained regulatory approval, including six symptomatic and two disease-modifying drugs. However, not all are available in all countries and high costs associated with new disease-modifying biologics prevent large proportions of the patient population from accessing them. With the current patient population expected to triple by 2050, it is imperative that new, effective, and affordable drugs become available to patients. Traditional drug development strategies have a 99% failure rate in AD, which is far higher than in other disease areas. Even when a drug does reach the market, additional barriers such as high cost and lack of accessibility prevent patients from benefiting from them. In this review, we discuss how a stratified medicine drug repurposing approach may address some of the limitations and barriers that traditional strategies face in relation to drug development in AD. We believe that novel, stratified drug repurposing studies may expedite the discovery of alternative, effective, and more affordable treatment options for a rapidly expanding patient population in comparison with traditional drug development methods.
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Affiliation(s)
- Chloe Anderson
- Personalised Medicine Centre, School of Medicine, Altnagelvin Hospital Campus, Ulster University, Glenshane Road, Derry/Londonderry BT47 6SB, UK;
| | - Magda Bucholc
- School of Computing, Engineering and Intelligent Systems, Magee Campus, Ulster University, Northland Road, Derry/Londonderry BT48 7JL, UK
| | - Paula L. McClean
- Personalised Medicine Centre, School of Medicine, Altnagelvin Hospital Campus, Ulster University, Glenshane Road, Derry/Londonderry BT47 6SB, UK;
| | - Shu-Dong Zhang
- Personalised Medicine Centre, School of Medicine, Altnagelvin Hospital Campus, Ulster University, Glenshane Road, Derry/Londonderry BT47 6SB, UK;
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Abstract
Alzheimer's disease (AD) is a progressive neurodegenerative disease characterized by the accumulation of amyloid β in the form of extracellular plaques and by intracellular neurofibrillary tangles, with eventual neurodegeneration and dementia. There is currently no disease-modifying treatment though several symptomatic medications exist with modest benefit on cognition. Acetylcholinesterase inhibitors have a consistent benefit across all stages of dementia; their benefit in mild cognitive impairment and prodromal AD is unproven. Memantine has a smaller benefit on cognition overall which is limited to the moderate to severe stages, and the combination of a cholinesterase inhibitor and memantine may have additional efficacy. Evidence for the efficacy of vitamin E supplementation and medical foods is weak but might be considered in the context of cost, availability, and safety in individual patients. Apparently promising disease-modifying interventions, mostly addressing the amyloid cascade hypothesis of AD, have recently failed to demonstrate efficacy so novel approaches must be considered.
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Affiliation(s)
- Elizabeth Joe
- Alzheimer Disease Research Center, Department of Neurology, Keck School of Medicine at USC, 1520 San Pablo Street Suite 3000, Los Angeles, CA 90033, USA
| | - John M Ringman
- Alzheimer Disease Research Center, Department of Neurology, Keck School of Medicine at USC, 1520 San Pablo Street Suite 3000, Los Angeles, CA 90033, USA
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Mediterranean and MIND Diets Containing Olive Biophenols Reduces the Prevalence of Alzheimer's Disease. Int J Mol Sci 2019; 20:ijms20112797. [PMID: 31181669 PMCID: PMC6600544 DOI: 10.3390/ijms20112797] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2019] [Revised: 06/05/2019] [Accepted: 06/06/2019] [Indexed: 02/07/2023] Open
Abstract
The risk of Alzheimer’s disease (AD) increases with nonmodifiable conditions including age and lack of effective efficacious pharmacotherapy. During the past decades, the non-pharmacotherapy mode of treatment of dietary modification received extensive attention in AD research. In order to reduce the AD pathology and cognitive decline, various dietary patterns have been attempted including caloric restriction (CR), dietary approaches to stop hypertension (DASH), ketogenic diets (KD), Mediterranean diet (MedDi) and Mediterranean-DASH diet Intervention for Neurological Delay (MIND) diet. Higher adherence to the MedDi diet was associated with decreases in cardiovascular and neurological disorders including AD and related cognitive decline. However, another emerging healthy dietary pattern MIND diet has also been associated with slower rates of cognitive decline and significant reduction of AD rate. Olive serves as one of the building block components of MedDi and MIND diets and the exerted potential health beneficial might be suggested due to the presence of its bioactive constituents such as oleic acids and phenolic compounds (biophenols). A few trials using medical food showed an optimal result in presymptomatic or early stages of AD. The review supports the notion that MedDi and MIND diets display potential for maintaining the cognitive function as nonpharmacological agents against AD pathology and proposed preventative mechanism through the presence of olive biophenols and presents the gaps along with the future directions.
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Lange KW, Guo J, Kanaya S, Lange KM, Nakamura Y, Li S. Medical foods in Alzheimer’s disease. FOOD SCIENCE AND HUMAN WELLNESS 2019. [DOI: 10.1016/j.fshw.2019.02.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Hudd F, Shiel A, Harris M, Bowdler P, McCann B, Tsivos D, Wearn A, Knight M, Kauppinen R, Coulthard E, White P, Conway ME. Novel Blood Biomarkers that Correlate with Cognitive Performance and Hippocampal Volumetry: Potential for Early Diagnosis of Alzheimer’s Disease. J Alzheimers Dis 2019; 67:931-947. [PMID: 30689581 DOI: 10.3233/jad-180879] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Affiliation(s)
- Fred Hudd
- Faculty of Health and Life Sciences, University of the West of England, Bristol, UK
| | - Anna Shiel
- Faculty of Health and Life Sciences, University of the West of England, Bristol, UK
| | - Matthew Harris
- Faculty of Health and Life Sciences, University of the West of England, Bristol, UK
| | - Paul Bowdler
- Faculty of Health and Life Sciences, University of the West of England, Bristol, UK
| | - Bryony McCann
- Clinical Research and Imaging Centre (CRICBristol), University of Bristol, Bristol, UK
| | - Demitra Tsivos
- Dementia Research Group, Faculty of Medicine and Dentistry, University of Bristol, Bristol, UK
| | - Alfie Wearn
- Dementia Research Group, Faculty of Medicine and Dentistry, University of Bristol, Bristol, UK
| | - Michael Knight
- Clinical Research and Imaging Centre (CRICBristol), University of Bristol, Bristol, UK
| | - Risto Kauppinen
- Clinical Research and Imaging Centre (CRICBristol), University of Bristol, Bristol, UK
| | - Elizabeth Coulthard
- Dementia Research Group, Faculty of Medicine and Dentistry, University of Bristol, Bristol, UK
| | - Paul White
- Faculty of Health and Life Sciences, University of the West of England, Bristol, UK
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Li X, Jiang X, Sun J, Zhu C, Bai W. Recent advances of medical foods in China: The opportunities and challenges under standardization. Food Chem Toxicol 2018; 119:342-354. [PMID: 29452191 DOI: 10.1016/j.fct.2018.02.024] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2017] [Revised: 02/06/2018] [Accepted: 02/08/2018] [Indexed: 12/24/2022]
Abstract
Malnutrition with high incidence in hospitalized patients in China has brought a significant burden of disease. Although many clinical studies have demonstrated the importance of nutritional for patients with malnutrition, the application of medical foods in China is still restricted. For the classification, limits, production and registration of medical foods, the Chinese government newly enacted a series of regulations. In this review, comparing the policy, researches, and product variety of medical foods in China with other countries, although the current status of the development of medical foods in China is still far behind that of developed countries, some of regulations are stricter than those of many other countries or organizations. The medical foods in China are divided into four categories, the nutrients and environmental contaminants are limited to ensure the safety. As a prospect, the development of medical foods in China is expected to get out of the predicament of lack of emphasis, shortage of supply, backward of local processing technology and the imperfect management system. After all, in view of the huge population and the increasing demand of nutrition in China, there must be a very good prospect for the future development of the medical foods industry in China.
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Affiliation(s)
- Xusheng Li
- Department of Food Science and Engineering, Institute of Food Safety and Nutrition, Guangdong Engineering Technology Center of Food Safety Molecular Rapid Detection, Jinan University, Guangzhou 510632, PR China
| | - Xinwei Jiang
- Department of Food Science and Engineering, Institute of Food Safety and Nutrition, Guangdong Engineering Technology Center of Food Safety Molecular Rapid Detection, Jinan University, Guangzhou 510632, PR China
| | - Jianxia Sun
- School of Chemical Engineering and Light Industry, Guangdong University of Technology, Guangzhou 510090, PR China
| | - Cuijuan Zhu
- Department of Food Science and Engineering, Institute of Food Safety and Nutrition, Guangdong Engineering Technology Center of Food Safety Molecular Rapid Detection, Jinan University, Guangzhou 510632, PR China
| | - Weibin Bai
- Department of Food Science and Engineering, Institute of Food Safety and Nutrition, Guangdong Engineering Technology Center of Food Safety Molecular Rapid Detection, Jinan University, Guangzhou 510632, PR China.
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Batarseh YS, Kaddoumi A. Oleocanthal-rich extra-virgin olive oil enhances donepezil effect by reducing amyloid-β load and related toxicity in a mouse model of Alzheimer's disease. J Nutr Biochem 2017; 55:113-123. [PMID: 29413486 DOI: 10.1016/j.jnutbio.2017.12.006] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2017] [Revised: 10/30/2017] [Accepted: 12/21/2017] [Indexed: 01/09/2023]
Abstract
Previous evidence suggested that extra-virgin olive oil (EVOO) is linked to attenuating amyloid-β (Aβ) pathology and improving cognitive function in Alzheimer's disease (AD) mouse models. In addition, we recently reported the beneficial effect of oleocanthal, a phenolic compound in EVOO, against AD pathology. Currently, medications available to target AD pathology are limited. Donepezil is an acetylcholine esterase inhibitor approved for use for all AD stages. Donepezil has been reported to have limited Aβ-targeting mechanisms beside its acetylcholine esterase inhibition. The aim of this study was to investigate the consumption of EVOO rich with oleocanthal (hereafter EVOO) as a medical food on enhancing the effect of donepezil on attenuating Aβ load and related toxicity in 5xFAD mouse model of AD. Our results showed that EVOO consumption in combination with donepezil significantly reduced Aβ load and related pathological changes. Reduced Aβ load could be explained, at least in part, by enhancing Aβ clearance pathways including blood-brain barrier (BBB) clearance and enzymatic degradation, and shifting amyloid precursor protein processing toward the nonamyloidogenic pathway. Furthermore, EVOO combination with donepezil up-regulated synaptic proteins, enhanced BBB tightness and reduced neuroinflammation associated with Aβ pathology. In conclusion, EVOO consumption as a medical food combined with donepezil offers an effective therapeutic approach by enhancing the noncholinergic mechanisms of donepezil and by providing additional mechanisms to attenuate Aβ-related pathology in AD patients.
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Affiliation(s)
- Yazan S Batarseh
- Department of Basic Pharmaceutical Sciences, School of Pharmacy, University of Louisiana at Monroe, Monroe, LA, 71201, USA
| | - Amal Kaddoumi
- Department of Basic Pharmaceutical Sciences, School of Pharmacy, University of Louisiana at Monroe, Monroe, LA, 71201, USA.
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Gorji N, Moeini R, Memariani Z. Almond, hazelnut and walnut, three nuts for neuroprotection in Alzheimer's disease: A neuropharmacological review of their bioactive constituents. Pharmacol Res 2017; 129:115-127. [PMID: 29208493 DOI: 10.1016/j.phrs.2017.12.003] [Citation(s) in RCA: 74] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2017] [Revised: 12/01/2017] [Accepted: 12/01/2017] [Indexed: 01/13/2023]
Abstract
An increase in the prevalence of Alzheimer's disease (AD) as a multifactorial neurodegenerative disorder is an almost obvious issue in the world. Researches on natural products for finding effective drugs to prevent the disease are in progress. There is special attention to the three types of nuts including almond, hazelnut and walnut in manuscripts of traditional Persian medicine (PM) as the preventive agents against brainatrophy and memory loss. The purpose of this study is a pharmacological review of their bioactive constituents and introducing the value of these nuts as the effective supplements and natural medicinal foods in AD patients. Databases including PubMed and ScienceDirect were searched in title, abstract and keywords from year 2000 to present for AD-related researches on these tree nuts, their major phytochemicals and their mechanisms of action. As result, almond, hazelnut and walnut provide macronutrients, micronutrients, and phytochemicals which affect several pathways in AD pathogenesis such as amyloidogenesis, tau phosphorylation, oxidative stress, cholinergic pathways, and some non-target mechanisms including cholesterol lowering and anti-inflammatory properties, as well as effect on neurogenesis. These nuts are recommended in PM for their brain-protective activity and particularly reversing brain atrophy in case of hazelnut. The therapeutical statements of PM scholars mentioned in their books are based on their clinical observations with support of a long history of experiences. Beyond the molecular activities attributed to the phytochemicals, the use of these tree nuts could be more considered in scientific researches as the effective nutrients for prevention or even management of AD.
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Affiliation(s)
- Narjes Gorji
- Traditional Medicine & Medical History Research Center, Health Research Center, Department of Persian Medicine, Babol University of Medical Sciences, Babol, Islamic Republic of Iran
| | - Reihaneh Moeini
- Traditional Medicine & Medical History Research Center, Health Research Center, Department of Persian Medicine, Babol University of Medical Sciences, Babol, Islamic Republic of Iran
| | - Zahra Memariani
- Traditional Medicine & Medical History Research Center, Health Research Center, Department of Persian Medicine, Babol University of Medical Sciences, Babol, Islamic Republic of Iran.
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Vauzour D, Camprubi-Robles M, Miquel-Kergoat S, Andres-Lacueva C, Bánáti D, Barberger-Gateau P, Bowman GL, Caberlotto L, Clarke R, Hogervorst E, Kiliaan AJ, Lucca U, Manach C, Minihane AM, Mitchell ES, Perneczky R, Perry H, Roussel AM, Schuermans J, Sijben J, Spencer JPE, Thuret S, van de Rest O, Vandewoude M, Wesnes K, Williams RJ, Williams RSB, Ramirez M. Nutrition for the ageing brain: Towards evidence for an optimal diet. Ageing Res Rev 2017; 35:222-240. [PMID: 27713095 DOI: 10.1016/j.arr.2016.09.010] [Citation(s) in RCA: 124] [Impact Index Per Article: 17.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2016] [Revised: 09/05/2016] [Accepted: 09/29/2016] [Indexed: 02/07/2023]
Abstract
As people age they become increasingly susceptible to chronic and extremely debilitating brain diseases. The precise cause of the neuronal degeneration underlying these disorders, and indeed normal brain ageing remains however elusive. Considering the limits of existing preventive methods, there is a desire to develop effective and safe strategies. Growing preclinical and clinical research in healthy individuals or at the early stage of cognitive decline has demonstrated the beneficial impact of nutrition on cognitive functions. The present review is the most recent in a series produced by the Nutrition and Mental Performance Task Force under the auspice of the International Life Sciences Institute Europe (ILSI Europe). The latest scientific advances specific to how dietary nutrients and non-nutrient may affect cognitive ageing are presented. Furthermore, several key points related to mechanisms contributing to brain ageing, pathological conditions affecting brain function, and brain biomarkers are also discussed. Overall, findings are inconsistent and fragmented and more research is warranted to determine the underlying mechanisms and to establish dose-response relationships for optimal brain maintenance in different population subgroups. Such approaches are likely to provide the necessary evidence to develop research portfolios that will inform about new dietary recommendations on how to prevent cognitive decline.
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Affiliation(s)
- David Vauzour
- University of East Anglia, Norwich Medical School, Norwich NR4 7UQ, United Kingdom
| | - Maria Camprubi-Robles
- Abbott Nutrition R&D, Abbott Laboratories, Camino de Purchil 68, 18004 Granada, Spain
| | | | | | - Diána Bánáti
- International Life Sciences Institute, Europe (ILSI Europe), Av E. Mounier 83, Box 6, 1200 Brussels, Belgium
| | | | - Gene L Bowman
- Nestlé Institute of Health Sciences, EPFL Innovation Park, 1015 Lausanne, Switzerland
| | - Laura Caberlotto
- The Microsoft Research-University of Trento, Centre for Computational and Systems Biology (COSBI), Piazza Manifattura 1, 38068 Rovereto, TN, Italy
| | - Robert Clarke
- Oxford University, Richard Doll Building, Old Road Campus, Roosevelt Drive, OX3 7LF Oxford, United Kingdom
| | - Eef Hogervorst
- Loughborough University, Brockington Building, Asby Road, LE11 3TU Loughborough, United Kingdom
| | - Amanda J Kiliaan
- Radboud University Medical Center, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands
| | - Ugo Lucca
- IRCCS-Instituto di Richerche Farmacologiche Mario Negri, Via G. La Masa 19, 20156 Milan, Italy
| | - Claudine Manach
- INRA, UMR 1019, Human Nutrition Unit, CRNH Auvergne, 63000 Clermont-Ferrand, France
| | - Anne-Marie Minihane
- University of East Anglia, Norwich Medical School, Norwich NR4 7UQ, United Kingdom
| | | | - Robert Perneczky
- Imperial College London, South Kensington Campus, SW7 2AZ London, United Kingdom
| | - Hugh Perry
- University of Southampton, Tremona Road, SO16 6YD Southampton, United Kingdom
| | - Anne-Marie Roussel
- Joseph Fourier University, Domaine de la Merci, 38706 La Tronche, France
| | - Jeroen Schuermans
- International Life Sciences Institute, Europe (ILSI Europe), Av E. Mounier 83, Box 6, 1200 Brussels, Belgium.
| | - John Sijben
- Nutricia Research, Nutricia Advances Medical Nutrition, P.O. Box 80141, 3508TC Utrecht, The Netherlands
| | - Jeremy P E Spencer
- University of Reading, Whiteknights, P.O. Box 217, RG6 6AH Reading, Berkshire, United Kingdom
| | - Sandrine Thuret
- King's College London, Institute of Psychiatry, Psychology and Neuroscience, The Maurice Wohl Clinical Neuroscience Institute, 125 Coldharbour Lane, SE5 9NU London, United Kingdom
| | - Ondine van de Rest
- Wageningen University, P.O. Box 8129, 6700 EV Wageningen, The Netherlands
| | | | - Keith Wesnes
- Wesnes Cognition Ltd., Little Paddock, Streatley on Thames RG8 9RD, United Kingdom; Department of Psychology, Northumbria University, Newcastle, United Kingdom; Centre for Human Psychopharmacology, Swinburne University, Melbourne, Australia; Medicinal Plant Research Group, Newcastle University, United Kingdom
| | | | - Robin S B Williams
- Royal Holloway, University of London, Egham, TW20 0EX Surrey, United Kingdom
| | - Maria Ramirez
- Abbott Nutrition R&D, Abbott Laboratories, Camino de Purchil 68, 18004 Granada, Spain
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McClements DJ, Zou L, Zhang R, Salvia-Trujillo L, Kumosani T, Xiao H. Enhancing Nutraceutical Performance Using Excipient Foods: Designing Food Structures and Compositions to Increase Bioavailability. Compr Rev Food Sci Food Saf 2015. [DOI: 10.1111/1541-4337.12170] [Citation(s) in RCA: 89] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Affiliation(s)
- David Julian McClements
- Biopolymers and Colloids Laboratory, Dept. of Food Science; Univ. of Massachusetts Amherst; Amherst Mass 01003 U.S.A
- Biochemistry Dept., Faculty of Science, Production of Bioproducts for Industrial Applications Research Group and Experimental Biochemistry Unit; King Fahd Medical Research Center, King Abdulaziz Univ; Jeddah Saudi Arabia
| | - Liqiang Zou
- State Key Laboratory of Food Science and Technology; Nanchang Univ; Nanchang, No. 235 Nanjing East Road Nanchang 330047 Jiangxi China
| | - Ruojie Zhang
- State Key Laboratory of Food Science and Technology; Nanchang Univ; Nanchang, No. 235 Nanjing East Road Nanchang 330047 Jiangxi China
| | - Laura Salvia-Trujillo
- State Key Laboratory of Food Science and Technology; Nanchang Univ; Nanchang, No. 235 Nanjing East Road Nanchang 330047 Jiangxi China
| | - Taha Kumosani
- Biochemistry Dept., Faculty of Science, Production of Bioproducts for Industrial Applications Research Group and Experimental Biochemistry Unit; King Fahd Medical Research Center, King Abdulaziz Univ; Jeddah Saudi Arabia
| | - Hang Xiao
- Biopolymers and Colloids Laboratory, Dept. of Food Science; Univ. of Massachusetts Amherst; Amherst Mass 01003 U.S.A
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Affiliation(s)
- Michael C Woodward
- Aged & Residential Care Services; Heidelberg Repatriation Hospital; Heidelberg Victoria
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12
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Pouyssegur V, Brocker P, Schneider SM, Philip JL, Barat P, Reichert E, Breugnon F, Brunet D, Civalleri B, Solere JP, Bensussan L, Lupi-Pegurier L. An innovative solid oral nutritional supplement to fight weight loss and anorexia: open, randomised controlled trial of efficacy in institutionalised, malnourished older adults. Age Ageing 2015; 44:245-51. [PMID: 25324332 DOI: 10.1093/ageing/afu150] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND AND OBJECTIVE To evaluate the impact of a solid nutritional supplement on the weight gain of institutionalised older adults>70 years with protein-energy malnutrition. The innovation of these high-protein and high-energy cookies was the texture adapted to edentulous patients (Protibis®, Solidages, France). DESIGN An open, multicentre, randomised controlled trial. SETTING Seven nursing homes. PARTICIPANTS One hundred and seventy-five malnourished older adults, aged 86±8 years. INTERVENTION All participants received the standard institutional diet. In addition, Intervention group participants received eight cookies daily (11.5 g protein; 244 kcal) for 6 weeks (w0-w6). MEASUREMENTS Five visits (w-4, w0, w6, w10 and w18). MAIN OUTCOME Percentage of weight gain from w0 to w6 (body mass in kg). SECONDARY OUTCOMES Appetite, rated using a numerical scale (0: no appetite to 10: extremely good appetite); current episodes of pressure ulcers and diarrhea. RESULTS Average weight increased in Intervention group (n=88) compared with Control group (n=87) without cookies supplementation (+1.6 versus -0.7%, P=0.038). Weight gain persisted 1 month (+3.0 versus -0.2%, P=0.025) and 3 months after the end of cookies consumption (+3.9 versus -0.9%, P=0.003), with diarrhea reduction (P=0.027). There was a synergistic effect with liquid/creamy dietary supplements. Subgroup analysis confirmed the positive impact of cookies supplementation alone on weight increase (P=0.024), appetite increase (P=0.009) and pressure ulcers reduction (P=0.031). CONCLUSION The trial suggested that, to fight against anorexia, the stimulation of touch (finger food; chewing, even on edentulous gums) and hearing (intra-oral sounds) could be valuable alternatives to sight, smell and taste alterations.
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Affiliation(s)
- Valerie Pouyssegur
- MICORALIS Laboratory, School of Dentistry, University Nice Sophia Antipolis, Nice, France Department of Dentistry, Nice University Hospital, Nice, France
| | - Patrice Brocker
- Department of Geriatrics, Nice University Hospital, Nice, France
| | | | | | | | | | | | | | | | | | | | - Laurence Lupi-Pegurier
- MICORALIS Laboratory, School of Dentistry, University Nice Sophia Antipolis, Nice, France Department of Dentistry, Nice University Hospital, Nice, France
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13
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Feczko A. Dementia in the incarcerated elderly adult: Innovative solutions to promote quality care. J Am Assoc Nurse Pract 2014; 26:640-8. [DOI: 10.1002/2327-6924.12189] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2014] [Accepted: 07/24/2014] [Indexed: 11/06/2022]
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Sharma A, Bemis M, Desilets AR. Role of Medium Chain Triglycerides (Axona®) in the Treatment of Mild to Moderate Alzheimer's Disease. Am J Alzheimers Dis Other Demen 2014; 29:409-14. [PMID: 24413538 PMCID: PMC10852824 DOI: 10.1177/1533317513518650] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/03/2024]
Abstract
Treatment of Alzheimer's disease (AD) with acetylcholinesterase inhibitors or N-methyl-D-aspartate (NMDA) receptor antagonists provides symptomatic relief but do not prevent its progression. Thus, additional approaches aimed at slowing the progression of the disease have been investigated. Reports detailing reduced brain glucose metabolism in the early stages of AD led to the hypothesis that alternate energy sources aimed at increasing neuronal metabolism may protect neurons and thus benefit patients with AD. Medium-chain triglycerides (MCTs) are metabolized to ketone bodies that serve as an alternative source of energy for neurons. Data from clinical trials suggest that MCTs improve cognition in patients with mild to moderate AD in apolipoprotein E4-negative patients. Adverse events observed were mild and included minor gastrointestinal problems such as diarrhea, dyspepsia, and flatulence. However, since genomic profiles are not routinely conducted in patients with AD in a clinical setting, the role of MCTs in clinical practice seems to be minimal.
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Janssen CI, Kiliaan AJ. Long-chain polyunsaturated fatty acids (LCPUFA) from genesis to senescence: The influence of LCPUFA on neural development, aging, and neurodegeneration. Prog Lipid Res 2014; 53:1-17. [DOI: 10.1016/j.plipres.2013.10.002] [Citation(s) in RCA: 270] [Impact Index Per Article: 27.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2013] [Revised: 10/08/2013] [Accepted: 10/14/2013] [Indexed: 12/24/2022]
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McClements DJ. Utilizing food effects to overcome challenges in delivery of lipophilic bioactives: structural design of medical and functional foods. Expert Opin Drug Deliv 2013; 10:1621-32. [DOI: 10.1517/17425247.2013.837448] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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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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