Clinical Geriatrics - Reviews
Published: 2018-06-15

Nutritional interventions in patients with Alzheimer’s disease and other late-life cognitive disorders

Geriatric Medicine-Memory Unit and Rare Disease Centre, University of Bari “Aldo Moro”, Bari, Italy
Geriatric Medicine-Memory Unit and Rare Disease Centre, University of Bari “Aldo Moro”, Bari, Italy
Geriatric Medicine-Memory Unit and Rare Disease Centre, University of Bari “Aldo Moro”, Bari, Italy
Geriatric Medicine-Memory Unit and Rare Disease Centre, University of Bari “Aldo Moro”, Bari, Italy
Neurodegenerative Disease Unit, Department of Basic Medicine, Neuroscience, and Sense Organs, University of Bari “Aldo Moro”, Bari, Italy
Neurodegenerative Disease Unit, Department of Basic Medicine, Neuroscience, and Sense Organs, University of Bari “Aldo Moro”, Bari, Italy; Geriatric Unit & Laboratory of Gerontology and Geriatrics, Department of Medical Sciences, IRCCS “Casa Sollievo della Sofferenza”, San Giovanni Rotondo, Foggia, Italy
Interdisciplinary Department of Medicine (DIM), Section of Dentistry, University of Bari “Aldo Moro”, Bari, Italy
Psychiatric Unit, Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
Psychiatric Unit, Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
Geriatric Medicine-Memory Unit and Rare Disease Centre, University of Bari “Aldo Moro”, Bari, Italy
Geriatric Medicine-Memory Unit and Rare Disease Centre, University of Bari “Aldo Moro”, Bari, Italy
Alzheimer’s disease Dementia, Medical food Nutraceuticals Macronutrients Micronutrients

Abstract

Given the impact of nutrition on neuroprotection largely investigated in observational studies, in the present
article, we reviewed evidence from randomized clinical trials (RCTs) published in the last three years (2014-
2016) exploring nutritional intervention efficacy in slowing cognitive impairment progression and achieving
cognitive-related outcomes in patients aged 60 years and older with mild cognitive impairment (MCI), preclinical
Alzheimer’s disease (AD), prodromal AD, AD, unspecified dementia, and vascular dementia using different
levels of investigation (i.e., medical food/nutraceutical supplementation/multidomain approach and dietary
food/macro- and micronutrient approaches). From the reviewed RCTs, there was emerging evidence that nutritional intervention through medical food/nutraceutical supplementation (Fortasyn Connect® and another similar nutraceutical formulation) and multidomain approach improved magnetic resonance imaging findings and other cognitive-related biomarkers, but without clear effect on cognition in mild AD and MCI. Moreover, there was some evidence of a positive effect of antioxidant-rich foods (nuts) in improving specific cognitive domains and cognitive-related outcomes in MCI and mild-to-moderate dementia, but only in small samples. There was also convincing evidence for fatty acid supplementation, mainly n-3 polyunsaturated fatty acids (PUFAs), in improving specific cognitive domains and/or cognitive-related biomarkers in MCI and AD. Furthermore, antioxidant vitamin and trace element supplementations improved only cognitive-related outcomes and biomarkers, without effect on cognitive function in AD and MCI patients. Finally, high-dose B vitamin supplementation in AD and MCI patients improved cognitive outcomes but only in the subjects with a high baseline plasma n-3 PUFA, while folic acid supplementation had positive impact on specific cognitive domains.

Affiliations

P. Agosti

Geriatric Medicine-Memory Unit and Rare Disease Centre, University of Bari “Aldo Moro”, Bari, Italy

A. Schilardi

Geriatric Medicine-Memory Unit and Rare Disease Centre, University of Bari “Aldo Moro”, Bari, Italy

V. Valiani

Geriatric Medicine-Memory Unit and Rare Disease Centre, University of Bari “Aldo Moro”, Bari, Italy

A. D'Introni

Geriatric Medicine-Memory Unit and Rare Disease Centre, University of Bari “Aldo Moro”, Bari, Italy

M. Lozupone

Neurodegenerative Disease Unit, Department of Basic Medicine, Neuroscience, and Sense Organs, University of Bari “Aldo Moro”, Bari, Italy

F. Panza

Neurodegenerative Disease Unit, Department of Basic Medicine, Neuroscience, and Sense Organs, University of Bari “Aldo Moro”, Bari, Italy; Geriatric Unit & Laboratory of Gerontology and Geriatrics, Department of Medical Sciences, IRCCS “Casa Sollievo della Sofferenza”, San Giovanni Rotondo, Foggia, Italy

V. Dibello

Interdisciplinary Department of Medicine (DIM), Section of Dentistry, University of Bari “Aldo Moro”, Bari, Italy

M. La Montagna

Psychiatric Unit, Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy

F. D'Urso

Psychiatric Unit, Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy

V. Solfrizzi

Geriatric Medicine-Memory Unit and Rare Disease Centre, University of Bari “Aldo Moro”, Bari, Italy

C. Sabbà

Geriatric Medicine-Memory Unit and Rare Disease Centre, University of Bari “Aldo Moro”, Bari, Italy

Copyright

© Società Italiana di Gerontologia e Geriatria (SIGG) , 2018

How to Cite

[1]
Agosti, P., Schilardi, A., Valiani, V., D’Introni, A., Lozupone, M., Panza, F., Dibello, V., La Montagna, M., D’Urso, F., Solfrizzi, V. and Sabbà, C. 2018. Nutritional interventions in patients with Alzheimer’s disease and other late-life cognitive disorders. JOURNAL OF GERONTOLOGY AND GERIATRICS. 66, 02 Special (Jun. 2018), 100-118.
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