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Lin C, Lee SH, Huang CM, Wu YW, Chang YX, Liu HL, Ng SH, Cheng YC, Chiu CC, Wu SC. Cognitive protection and brain entropy changes from omega-3 polyunsaturated fatty acids supplement in late-life depression: A 52-week randomized controlled trial. J Affect Disord 2024; 351:15-23. [PMID: 38281596 DOI: 10.1016/j.jad.2024.01.205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Revised: 01/19/2024] [Accepted: 01/22/2024] [Indexed: 01/30/2024]
Abstract
BACKGROUND Late-life depression (LLD) is associated with risk of dementia, yet intervention of LLD provides an opportunity to attenuate subsequent cognitive decline. Omega-3 polyunsaturated fatty acids (PUFAs) supplement is a potential intervention due to their beneficial effect in depressive symptoms and cognitive function. To explore the underlying neural mechanism, we used resting-state functional MRI (rs-fMRI) before and after omega-3 PUFAs supplement in older adults with LLD. METHODS A 52-week double-blind randomized controlled trial was conducted. We used multi-scale sample entropy to analyze rs-fMRI data. Comprehensive cognitive tests and inflammatory markers were collected to correlate with brain entropy changes. RESULTS A total of 20 patients completed the trial with 11 under omega-3 PUFAs and nine under placebo. While no significant global cognitive improvement was observed, a marginal enhancement in processing speed was noted in the omega-3 PUFAs group. Importantly, participants receiving omega-3 PUFAs exhibited decreased brain entropy in left posterior cingulate gyrus (PCG), multiple visual areas, the orbital part of the right middle frontal gyrus, and the left Rolandic operculum. The brain entropy changes of the PCG in the omega-3 PUFAs group correlated with improvement of language function and attenuation of interleukin-6 levels. LIMITATIONS Sample size is small with only marginal clinical effect. CONCLUSION These findings suggest that omega-3 PUFAs supplement may mitigate cognitive decline in LLD through anti-inflammatory mechanisms and modulation of brain entropy. Larger clinical trials are warranted to validate the potential therapeutic implications of omega-3 PUFAs for deterring cognitive decline in patients with late-life depression.
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Affiliation(s)
- Chemin Lin
- Department of Psychiatry, Keelung Chang Gung Memorial Hospital, Keelung City, Taiwan; College of Medicine, Chang Gung University, Taoyuan County, Taiwan.; Community Medicine Research Center, Chang Gung Memorial Hospital, Keelung, Keelung, Taiwan
| | - Shwu-Hua Lee
- College of Medicine, Chang Gung University, Taoyuan County, Taiwan.; Department of Psychiatry, Linkou Chang Gung Memorial Hospital, Taoyuan County, Taiwan
| | - Chih-Mao Huang
- Department of Biological Science and Technology, National Yang Ming Chiao Tung University, Hsinchu, Taiwan
| | - Yu-Wen Wu
- Department of Engineering and System Science, National Tsing Hua University, Hsinchu, Taiwan
| | - You-Xun Chang
- Department of Engineering and System Science, National Tsing Hua University, Hsinchu, Taiwan
| | - Ho-Ling Liu
- Department of Imaging Physics, University of Texas MD Anderson Cancer Center, Houston, TX, United States of America
| | - Shu-Hang Ng
- Department of Head and Neck Oncology Group, Linkou Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan; Department of Diagnostic Radiology, Linkou Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan
| | - Ying-Chih Cheng
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan; Department of Psychiatry, China Medical University Hsinchu Hospital, China Medical University, Hsinchu, Taiwan; Research Center of Big Data and Meta-analysis, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
| | - Chih-Chiang Chiu
- Department of Psychiatry, Taipei City Psychiatric Center, Taipei City Hospital, Taipei, Taiwan; Department of Psychiatry, Taipei Medical University, Taipei, Taiwan.
| | - Shun-Chi Wu
- Department of Biological Science and Technology, National Yang Ming Chiao Tung University, Hsinchu, Taiwan.
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Song J. Amygdala activity and amygdala-hippocampus connectivity: Metabolic diseases, dementia, and neuropsychiatric issues. Biomed Pharmacother 2023; 162:114647. [PMID: 37011482 DOI: 10.1016/j.biopha.2023.114647] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Revised: 03/30/2023] [Accepted: 03/31/2023] [Indexed: 04/04/2023] Open
Abstract
With rapid aging of the population worldwide, the number of people with dementia is dramatically increasing. Some studies have emphasized that metabolic syndrome, which includes obesity and diabetes, leads to increased risks of dementia and cognitive decline. Factors such as insulin resistance, hyperglycemia, high blood pressure, dyslipidemia, and central obesity in metabolic syndrome are associated with synaptic failure, neuroinflammation, and imbalanced neurotransmitter levels, leading to the progression of dementia. Due to the positive correlation between diabetes and dementia, some studies have called it "type 3 diabetes". Recently, the number of patients with cognitive decline due to metabolic imbalances has considerably increased. In addition, recent studies have reported that neuropsychiatric issues such as anxiety, depressive behavior, and impaired attention are common factors in patients with metabolic disease and those with dementia. In the central nervous system (CNS), the amygdala is a central region that regulates emotional memory, mood disorders, anxiety, attention, and cognitive function. The connectivity of the amygdala with other brain regions, such as the hippocampus, and the activity of the amygdala contribute to diverse neuropathological and neuropsychiatric issues. Thus, this review summarizes the significant consequences of the critical roles of amygdala connectivity in both metabolic syndromes and dementia. Further studies on amygdala function in metabolic imbalance-related dementia are needed to treat neuropsychiatric problems in patients with this type of dementia.
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Affiliation(s)
- Juhyun Song
- Department of Anatomy, Chonnam National University Medical School, Hwasun 58128, Jeollanam-do, Republic of Korea.
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Yamagata K. Docosahexaenoic acid inhibits ischemic stroke to reduce vascular dementia and Alzheimer’s disease. Prostaglandins Other Lipid Mediat 2023; 167:106733. [PMID: 37028469 DOI: 10.1016/j.prostaglandins.2023.106733] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Revised: 02/17/2023] [Accepted: 04/04/2023] [Indexed: 04/08/2023]
Abstract
Stroke and dementia are global leading causes of neurological disability and death. The pathology of these diseases is interrelated and they share common, modifiable risk factors. It is suggested that docosahexaenoic acid (DHA) prevents neurological and vascular disorders induced by ischemic stroke and also prevent dementia. The purpose of this study was to review the potential preventative role of DHA against ischemic stroke-induced vascular dementia and Alzheimer's disease. In this review, I analyzed studies on stroke-induced dementia from the PubMed, ScienceDirect, and Web of Science databases as well as studies on the effects of DHA on stroke-induced dementia. As per the results of interventional studies, DHA intake can potentially ameliorate dementia and cognitive function. In particular, DHA derived from foods such as fish oil enters the blood and then migrates to the brain by binding to fatty acid binding protein 5 that is present in cerebral vascular endothelial cells. At this point, the esterified form of DHA produced by lysophosphatidylcholine is preferentially absorbed into the brain instead of free DHA. DHA accumulates in nerve cell membrane and is involved in the prevention of dementia. The antioxidative and anti-inflammatory properties of DHA and DHA metabolites as well as their ability to decrease amyloid beta (Aβ) 42 production were implicated in the improvement of cognitive function. The antioxidant effect of DHA, the inhibition of neuronal cell death by Aβ peptide, improvement in learning ability, and enhancement of synaptic plasticity may contribute to the prevention of dementia induced by ischemic stroke.
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Ogawa T, Sawane K, Ookoshi K, Kawashima R. Supplementation with Flaxseed Oil Rich in Alpha-Linolenic Acid Improves Verbal Fluency in Healthy Older Adults. Nutrients 2023; 15:nu15061499. [PMID: 36986229 PMCID: PMC10056498 DOI: 10.3390/nu15061499] [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: 02/19/2023] [Revised: 03/14/2023] [Accepted: 03/15/2023] [Indexed: 03/30/2023] Open
Abstract
The effects of docosahexaenoic acid supplements on cognitive function have long been demonstrated, but the effects of alpha-linolenic acid, a precursor of docosahexaenoic acid, have not been fully tested. The search for functional foods that delay cognitive decline in the older adults is considered a very important area from a preventive perspective. The aim of this study was to conduct an exploratory evaluation of alpha-linolenic acid on various cognitive functions in healthy older subjects. Sixty healthy older adults aged 65 to 80 years, living in Miyagi prefecture, without cognitive impairment or depression, were included in the randomized, double-blinded, placebo-controlled clinical trial. Study subjects were randomly divided into two groups and received either 3.7 g/day of flaxseed oil containing 2.2 g of alpha-linolenic acid, or an isocaloric placebo (corn oil) containing 0.04 g of alpha-linolenic acid for 12 weeks. The primary endpoints were six cognitive functions closely related to everyday life: attention and concentration, executive function, perceptual reasoning, working memory, processing speed and memory function. After 12 weeks of intake, changes in verbal fluency scores on the frontal assessment battery at bedside, a neuropsychological test assessing executive function, in which participants are asked to answer as many words as possible in Japanese, were significantly greater in the intervention group (0.30 ± 0.53) than in the control group (0.03 ± 0.49, p < 0.05). All other cognitive test scores were not significantly different between the groups. In conclusion, daily consumption of flaxseed oil containing 2.2 g alpha-linolenic acid improved cognitive function, specifically verbal fluency, despite the age-related decline, in healthy individuals with no cognitive abnormalities. Further validation studies focusing on the effects of alpha-linolenic acid on verbal fluency and executive function in older adults are needed, as verbal fluency is a predictor of Alzheimer's disease development, important for cognitive health.
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Affiliation(s)
- Toshimi Ogawa
- Department of Advanced Brain Science, Institute of Development, Aging and Cancer, Tohoku University, Sendai 980-8575, Japan
- Smart Aging Research Center, Tohoku University, Sendai 980-8575, Japan
| | - Kento Sawane
- Innovation Center, Central Research Laboratory, NIPPN Corporation, Atsugi 243-0041, Japan
| | - Kouta Ookoshi
- Innovation Center, Central Research Laboratory, NIPPN Corporation, Atsugi 243-0041, Japan
| | - Ryuta Kawashima
- Department of Advanced Brain Science, Institute of Development, Aging and Cancer, Tohoku University, Sendai 980-8575, Japan
- Smart Aging Research Center, Tohoku University, Sendai 980-8575, Japan
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Andriambelo B, Stiffel M, Roke K, Plourde M. New perspectives on randomized controlled trials with omega-3 fatty acid supplements and cognition: A scoping review. Ageing Res Rev 2023; 85:101835. [PMID: 36603691 DOI: 10.1016/j.arr.2022.101835] [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: 09/21/2022] [Revised: 12/05/2022] [Accepted: 12/21/2022] [Indexed: 01/03/2023]
Abstract
Long chain polyunsaturated omega-3 fatty acids (n-3 FA), such as eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), are known to be important components in a healthy diet and contribute to healthy functioning of the heart and the brain, among other organs. Although there are epidemiological studies on the strong relationship between fish or n-3 FA consumption and lower risk of cognitive decline, results from randomized controlled trials (RCTs) are less consistent. Here, we performed a scoping review on RCTs with n-3 FA supplementation where cognition was evaluated. Seventy-eight RCTs published before April 2022 were included in this review. Among these RCTs, 43.6% reported a positive cognitive outcome after the consumption of n-3 FA compared to the placebo. However, there was a large diversity of populations studied (age ranges and health status), wide range of doses of EPA + DHA supplemented (79 mg/day - 5200 mg/day) and a multitude of tests evaluating cognition, mainly diagnostic tests, that were used to assess cognitive scores and overall cognitive status. RCTs were thereafter categorized into non-cognitively impaired middle-aged adults (n = 24), non-cognitively impaired older adults (n = 24), adults with subjective memory complaints (n = 14), adults with mild cognitive impairments (MCI, n = 9) and people with diagnosed dementia or other cognitive changes (n = 7). Among these categories, 66.7% of RCTs conducted with MCI adults reported a positive cognitive outcome when supplemented with n-3 FA vs. the placebo. Therefore, this scoping review provides rationale and questions to a) strengthen the design of future RCTs with n-3 FA for cognitive outcomes, and b) generate more informative data to support clinicians in their practice in assessing cognition before and after a nutritional intervention.
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Affiliation(s)
- B Andriambelo
- Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, QC, Canada, Centre de Recherche sur le Vieillissement, CIUSSS de l'Estrie-CHUS, Sherbrooke, QC, Canada; Institut de la nutrition et des aliments fonctionnels, Université Laval, QC, Canada
| | - M Stiffel
- Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, QC, Canada, Centre de Recherche sur le Vieillissement, CIUSSS de l'Estrie-CHUS, Sherbrooke, QC, Canada; Institut de la nutrition et des aliments fonctionnels, Université Laval, QC, Canada
| | - K Roke
- GOED- Global Organization for EPA and DHA Omega-3, Salt Lake City, UT, United States
| | - M Plourde
- Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, QC, Canada, Centre de Recherche sur le Vieillissement, CIUSSS de l'Estrie-CHUS, Sherbrooke, QC, Canada; Institut de la nutrition et des aliments fonctionnels, Université Laval, QC, Canada.
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Eat for better cognition in older adults at risk for Alzheimer's disease. Nutrition 2023; 109:111969. [PMID: 36801704 DOI: 10.1016/j.nut.2022.111969] [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: 07/27/2022] [Revised: 11/10/2022] [Accepted: 12/31/2022] [Indexed: 01/13/2023]
Abstract
Alzheimer's disease is a worldwide public health problem. However, the treatment method and treatment effects are limited. The stages of preclinical Alzheimer's disease are thought to be a better intervention period. Thus, in this review, food is given focus and the intervention stage put forward. We summarized the role of diet, nutrient supplementation, and microbioecologics in cognitive decline and found that interventions such as modified Mediterranean-ketogenic diet, nuts, vitamin B, and Bifidobacterium breve A1 are beneficial to cognition protection. Eating, rather than just taking medicine, is suggested to be an effective treatment method for older adults at risk for Alzheimer's disease.
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Behl T, Kaur I, Sehgal A, Singh S, Albarrati A, Albratty M, Najmi A, Meraya AM, Bungau S. The road to precision medicine: Eliminating the "One Size Fits All" approach in Alzheimer's disease. Biomed Pharmacother 2022; 153:113337. [PMID: 35780617 DOI: 10.1016/j.biopha.2022.113337] [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: 05/03/2022] [Revised: 06/18/2022] [Accepted: 06/24/2022] [Indexed: 11/29/2022] Open
Abstract
The expeditious advancement of Alzheimer's Disease (AD) is a threat to the global healthcare system, that is further supplemented by therapeutic failure. The prevalence of this disorder has been expected to quadrupole by 2050, thereby exerting a tremendous economic pressure on medical sector, worldwide. Thus, there is a dire need of a change in conventional approaches and adopt a novel methodology of disease prevention, treatment and diagnosis. Precision medicine offers a personalized approach to disease management, It is dependent upon genetic, environmental and lifestyle factors associated with the individual, aiding to develop tailored therapeutics. Precision Medicine Initiatives are launched, worldwide, to facilitate the integration of personalized models and clinical medicine. The review aims to provide a comprehensive understanding of the neuroinflammatory processes causing AD, giving a brief overview of the disease interventions. This is further followed by the role of precision medicine in AD, constituting the genetic perspectives, operation of personalized form of medicine and optimization of clinical trials with the 3 R's, showcasing an in-depth understanding of this novel approach in varying aspects of the healthcare industry, to provide an opportunity to the global AD researchers to elucidate suitable therapeutic regimens in clinically and pathologically complex diseases, like AD.
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Affiliation(s)
- Tapan Behl
- Chitkara College of Pharmacy, Chitkara University, Rajpura, Punjab, India.
| | - Ishnoor Kaur
- Chitkara College of Pharmacy, Chitkara University, Rajpura, Punjab, India
| | - Aayush Sehgal
- Chitkara College of Pharmacy, Chitkara University, Rajpura, Punjab, India
| | - Sukhbir Singh
- Chitkara College of Pharmacy, Chitkara University, Rajpura, Punjab, India
| | - Ali Albarrati
- Rehabilitation Health Sciences College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Mohammed Albratty
- Department of Pharmaceutical Chemistry, College of Pharmacy, Jazan University, Jazan, Saudi Arabia
| | - Asim Najmi
- Department of Pharmaceutical Chemistry and Pharmacognosy, College of Pharmacy, Jazan University, Jazan, Saudi Arabia
| | - Abdulkarim M Meraya
- Pharmacy Practice Research Unit, Department of Clinical Pharmacy, College of Pharmacy, Jazan University, Jazan, Saudi Arabia
| | - Simona Bungau
- Department of Pharmacy, Faculty of Medicine and Pharmacy, University of Oradea, Oradea, Romania; Doctoral School of Biomedical Sciences, University of Oradea, Oradea, Romania.
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8
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Businaro R, Vauzour D, Sarris J, Münch G, Gyengesi E, Brogelli L, Zuzarte P. Therapeutic Opportunities for Food Supplements in Neurodegenerative Disease and Depression. Front Nutr 2021; 8:669846. [PMID: 34055858 PMCID: PMC8160227 DOI: 10.3389/fnut.2021.669846] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Accepted: 04/19/2021] [Indexed: 12/16/2022] Open
Abstract
Emerging evidence is showing nutrition as a crucial factor in the high prevalence and incidence of neurodegenerative mental disorders. Preventive interventions on neuroinflammation seem to be able to interfere with neurodegeneration. Supplementation of essential nutrients, such as long-chain-polyunsaturated fatty acids, vitamin E and mineral elements, may minimize inflammation, enhancing antioxidative defense, and lowering the risk and incidence of age-related diseases, such as cardiovascular diseases and neurodegenerative diseases. This manuscript reviews the current evidence on the role of neuroinflammation in the pathophysiology of neurodegenerative and mental disorders, and preventive strategies for food supplementation in these neuropsychiatric diseases. Dietary supplementation-based strategies have been demonstrated to be effective in subjects with mild cognitive impairment, while weaker results have been obtained in patients with advance neurodegenerative disease. Adjunctive supplementation has also been demonstrated to improve depression, this being of marked benefit considering the comorbidity between cognitive impairment/dementia and depression. Further research is needed to improve the prescriptive precision of supplementation in patients, and to better understand potential interactions with clinical and pharmacokinetic factors.
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Affiliation(s)
- Rita Businaro
- Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Rome, Italy
| | - David Vauzour
- Faculty of Medicine and Health Sciences, Norwich Medical School, University of East Anglia, Norwich, United Kingdom
| | - Jerome Sarris
- NICM Health Research Institute, Western Sydney University, Westmead, NSW, Australia.,Professorial Unit, The Melbourne Clinic, Department of Psychiatry, Melbourne University, Melbourne, VIC, Australia
| | - Gerald Münch
- Pharmacology Unit, School of Medicine, Western Sydney University, Campbelltown, NSW, Australia
| | - Erika Gyengesi
- Pharmacology Unit, School of Medicine, Western Sydney University, Campbelltown, NSW, Australia
| | | | - Pedro Zuzarte
- Psychiatric Clinic, Faculty of Medicine, University of Lisbon, Lisbon, Portugal.,Neuropsychiatry Research Department, GNR Clinical Center, Lisbon, Portugal
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Effects of Combined Physical Activity and Cognitive Training on Cognitive Function in Older Adults with Subjective Cognitive Decline: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2021. [DOI: 10.1155/2021/8882961] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Background. Subjective cognitive decline (SCD) is recognized as the earliest prodromal stage of Alzheimer’s disease (AD). Emerging studies explored the effects of combined physical activity and cognitive training interventions on cognitive ability, psychological well-being, and emotion of older adults with SCD, but the results are now still controversial. Objective. This study systematically evaluated the enhancement effects of the combined physical-cognitive interventions on memory self-efficacy, objective cognitive function, psychological well-being, and emotion of older adults with SCD. Methods. Data sources PubMed, EMBASE, Web of Science, China National Knowledge Infrastructure (CNKI), Wanfang degree and conference papers database, Chinese Science and Technology Periodical (VIP) databases from their inception to 28 February 2020, the Cochrane Central Register of Controlled Trials (Cochrane Library, 2020, Issue 3), and the reference lists of all retrieved articles were searched. Data analysis and bias risk evaluation were conducted in 2020. Two reviewers (SG and YY) independently evaluated the risk of bias of the included studies using the RoB 2 tool. Results. Eleven RCTs involving 1713 participants with SCD (age 68.0 ± 6.1) were included for review and meta-analysis. The interventions in the included studies were physical activity combined with cognitive training. Multiple-modality exercise with mind-motor training, supervised strategy-based memory training sequentially after stationary cycling, Dejian Mind-Body intervention, and physical activity and cognitive stimulation were also practiced. Conclusions. Compared to the active or nonactive control groups, the combined interventions are effective in improving objective cognitive function in SCD which may show the potential value of combined physical-cognitive interventions in improving objective cognitive ability and preventing the conversion of SCD to MCI or AD and no adverse effects. However, owing to the limitations of the included studies, these findings should be interpreted cautiously.
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The effects of lutein and zeaxanthin on resting state functional connectivity in older Caucasian adults: a randomized controlled trial. Brain Imaging Behav 2021; 14:668-681. [PMID: 30680611 DOI: 10.1007/s11682-018-00034-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
The carotenoids lutein (L) and zeaxanthin (Z) accumulate in retinal regions of the eye and have long been shown to benefit visual health. A growing literature suggests cognitive benefits as well, particularly in older adults. The present randomized controlled trial sought to investigate the effects of L and Z on brain function using resting state functional magnetic resonance imaging (fMRI). It was hypothesized that L and Z supplementation would (1) improve intra-network integrity of default mode network (DMN) and (2) reduce inter-network connectivity between DMN and other resting state networks. 48 community-dwelling older adults (mean age = 72 years) were randomly assigned to receive a daily L (10 mg) and Z (2 mg) supplement or a placebo for 1 year. Resting state fMRI data were acquired at baseline and post-intervention. A dictionary learning and sparse coding computational framework, based on machine learning principles, was used to investigate intervention-related changes in functional connectivity. DMN integrity was evaluated by calculating spatial overlap rate with a well-established DMN template provided in the neuroscience literature. Inter-network connectivity was evaluated via time series correlations between DMN and nine other resting state networks. Contrary to expectation, results indicated that L and Z significantly increased rather than decreased inter-network connectivity (Cohen's d = 0.89). A significant intra-network effect on DMN integrity was not observed. Rather than restoring what has been described in the available literature as a "youth-like" pattern of intrinsic brain activity, L and Z may facilitate the aging brain's capacity for compensation by enhancing integration between networks that tend to be functionally segregated earlier in the lifespan.
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Brainard JS, Jimoh OF, Deane KH, Biswas P, Donaldson D, Maas K, Abdelhamid AS, Hooper L, Ajabnoor S, Alabdulghafoor F, Alkhudairy L, Bridges C, Hanson S, Martin N, O'Brien A, Rees K, Song F, Thorpe G, Wang X, Winstanley L. Omega-3, Omega-6, and Polyunsaturated Fat for Cognition: Systematic Review and Meta-analysis of Randomized Trials. J Am Med Dir Assoc 2020; 21:1439-1450.e21. [DOI: 10.1016/j.jamda.2020.02.022] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Revised: 01/24/2020] [Accepted: 02/25/2020] [Indexed: 02/02/2023]
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Leckie RL, Lehman DE, Gianaros PJ, Erickson KI, Sereika SM, Kuan DCH, Manuck SB, Ryan CM, Yao JK, Muldoon MF. The effects of omega-3 fatty acids on neuropsychological functioning and brain morphology in mid-life adults: a randomized clinical trial. Psychol Med 2020; 50:2425-2434. [PMID: 31581959 PMCID: PMC8109262 DOI: 10.1017/s0033291719002617] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND The diet of most adults is low in fish and, therefore, provides limited quantities of the long-chain, omega-3 fatty acids (LCn-3FAs), eicosapentaenoic and docosahexaenoic acids (EPA, DHA). Since these compounds serve important roles in the brain, we sought to determine if healthy adults with low-LCn-3FA consumption would exhibit improvements in neuropsychological performance and parallel changes in brain morphology following repletion through fish oil supplementation. METHODS In a randomized, controlled trial, 271 mid-life adults (30-54 years of age, 118 men, 153 women) consuming ⩽300 mg/day of LCn-3FAs received 18 weeks of supplementation with fish oil capsules (1400 mg/day of EPA and DHA) or matching placebo. All participants completed a neuropsychological test battery examining four cognitive domains: psychomotor speed, executive function, learning/episodic memory, and fluid intelligence. A subset of 122 underwent neuroimaging before and after supplementation to measure whole-brain and subcortical tissue volumes. RESULTS Capsule adherence was over 95%, participant blinding was verified, and red blood cell EPA and DHA levels increased as expected. Supplementation did not affect performance in any of the four cognitive domains. Exploratory analyses revealed that, compared to placebo, fish oil supplementation improved executive function in participants with low-baseline DHA levels. No changes were observed in any indicator of brain morphology. CONCLUSIONS In healthy mid-life adults reporting low-dietary intake, supplementation with LCn-3FAs in moderate dose for moderate duration did not affect neuropsychological performance or brain morphology. Whether salutary effects occur in individuals with particularly low-DHA exposure requires further study.
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Affiliation(s)
- Regina L. Leckie
- University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - David E. Lehman
- University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Peter J. Gianaros
- Psychology Department, University of Pittsburgh, Pittsburgh, PA, USA
| | - Kirk I. Erickson
- Psychology Department, University of Pittsburgh, Pittsburgh, PA, USA
| | | | - Dora C. H. Kuan
- Psychology Department, University of Pittsburgh, Pittsburgh, PA, USA
| | - Stephen B. Manuck
- Psychology Department, University of Pittsburgh, Pittsburgh, PA, USA
| | | | - Jeffrey K. Yao
- University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
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Sheng C, Yang K, Wang X, Li H, Li T, Lin L, Liu Y, Yang Q, Wang X, Wang X, Sun Y, Han Y. Advances in Non-Pharmacological Interventions for Subjective Cognitive Decline: A Systematic Review and Meta-Analysis. J Alzheimers Dis 2020; 77:903-920. [PMID: 32741806 DOI: 10.3233/jad-191295] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background: Subjective cognitive decline (SCD) is considered the earliest symptomatic manifestation of preclinical Alzheimer’s disease (AD). Currently, given the lack of effective and curable pharmacological treatments for AD, non-pharmacological interventions (NPIs) for individuals with SCD may provide a valuable opportunity for the secondary prevention of AD. Objective: This systematic review and meta-analysis, conducted in accordance with the PRISMA guidelines, aimed to investigate the benefits of current NPIs in the population with SCD. Methods: The online electronic databases, including MEDLINE, Cochrane Central Register of Controlled Trials, EMBASE, PsycInfo, and CINAHL, were searched to identify randomized controlled trials of NPIs for SCD. Intervention strategies were psychological and health-related education interventions, mind-body therapy, lifestyle modification, cognitive training, and multidomain interventions. Outcomes included subjective memory, objective memory, global cognitive function, psychological well-being, and mood. Study quality was determined using the criteria of the Cochrane collaboration’s tool. The Hedges’ g of change was analyzed. Results: Eighteen studies were included in this review and meta-analysis. Overall, psychological and health-related education interventions exhibited a medium effect on objective memory function (Hedges’ g = 0.53, p = 0.01). Cognitive training led to a small effect on objective memory, which was marginal statistically (Hedges’ g = 0.19, p = 0.05). In addition, cognitive training also significantly improved subjective memory performance (Hedges’ g = 0.49, p = 0.0003) and psychological well-being (Hedges’ g = 0.27, p = 0.03). Conclusion: Overall, the psychological intervention and cognitive training may be beneficial to cognitive function and psychological well-being. NPIs may be effectively implemented in older adults with SCD.
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Affiliation(s)
- Can Sheng
- Department of Neurology, Xuanwu Hospital of Capital Medical University, Beijing, China
- Department of Neurology, the First Hospital of Tsinghua University, Beijing, China
| | - Kun Yang
- Evidence-Based Medicine Center, Xuanwu Hospital of Capital Medical University, Beijing, China
| | - Xiaoni Wang
- Department of Neurology, Xuanwu Hospital of Capital Medical University, Beijing, China
| | - Hongyan Li
- Department of Neurology, Civil Aviation General Hospital, Beijing, China
| | - Taoran Li
- Department of Neurology, Xuanwu Hospital of Capital Medical University, Beijing, China
| | - Li Lin
- Department of Neurology, Xuanwu Hospital of Capital Medical University, Beijing, China
| | - Yi Liu
- Department of Neurology, Xuanwu Hospital of Capital Medical University, Beijing, China
| | - Qin Yang
- Department of Neurology, Xuanwu Hospital of Capital Medical University, Beijing, China
| | - Xiaoqi Wang
- Department of Neurology, Xuanwu Hospital of Capital Medical University, Beijing, China
| | - Xue Wang
- Department of Library, Xuanwu Hospital of Capital Medical University, Beijing, China
| | - Yu Sun
- Department of Neurology, Xuanwu Hospital of Capital Medical University, Beijing, China
| | - Ying Han
- Department of Neurology, Xuanwu Hospital of Capital Medical University, Beijing, China
- Center of Alzheimer’s Disease, Beijing Institute for Brain Disorders, Beijing, China
- National Clinical Research Center for Geriatric Disorders, Beijing, China
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14
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Dietary Sources of Omega-3 Fatty Acids Versus Omega-3 Fatty Acid Supplementation Effects on Cognition and Inflammation. Curr Nutr Rep 2020; 9:264-277. [DOI: 10.1007/s13668-020-00329-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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15
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Abstract
PURPOSE OF REVIEW This review summarises the most recent evidence regarding the effects of diet in preventing and reducing age-related cognitive decline and neurodegenerative diseases. RECENT FINDINGS Recent evidence indicates that nutraceuticals and whole diet approaches may protect against the development of age-related cognitive decline and pathological neurodegeneration. The neuroprotective effects are diverse depending on the nutrient employed and may involve a reduction of neuroinflammation, an activation of the endogenous antioxidant defence system and a modulation of the gut microbiota structure and function. SUMMARY This review summarises the existing evidence in favour of diet as a viable alternative approach to directly impact cognitive decline and neurodegenerative diseases. The single nutrient (polyphenols, B vitamins, long-chain polyunsaturated fatty acids) versus whole diet approach (Mediterranean diet, Dietary Approaches to Stop Hypertension, MIND, Nordic, ketogenic) is presented and discussed. Potential mechanisms of action underlying the beneficial effects of these diets are also described. Implementation of large-scale preventive interventions based on dietary patterns identified as being beneficial to brain health should be a research and public health priority, ideally in conjunction with other health-promoting lifestyle factors.
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16
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Mascherek A, Werkle N, Göritz AS, Kühn S, Moritz S. Lifestyle Variables Do Not Predict Subjective Memory Performance Over and Above Depression and Anxiety. Front Psychol 2020; 11:484. [PMID: 32265791 PMCID: PMC7096346 DOI: 10.3389/fpsyg.2020.00484] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2019] [Accepted: 03/02/2020] [Indexed: 11/24/2022] Open
Abstract
The diagnostic value of subjective cognitive complaints for cognitive functioning in a clinical setting remains unresolved today. However, consensus exists on the relation between subjective cognitive complaints (SCC) and mood variables such as anxiety and depression. Hence, SCC have also been discussed as potential proxies of psychopathology rather than representing cognitive functioning. In order to shed more light on yet still unexplained variance in subjective cognitive complaints, the relation between lifestyle variables (such as nutrition habits, exercise, alcohol consumption, smoking, quality of sleep, and Body Mass Index) and subjective complaints of selective attention as well as subjective memory performance were assessed, additionally to the influence of objective memory performance, measures of anxiety, and depression. A sample of 877 (554 women) healthy, middle-aged individuals (51 years on average, age range 35–65) was assessed in the present study. In a logistic regression framework results revealed that the effect of lifestyle variables on subjective complaints of selective attention as well as subjective memory performance was rendered non-significant. Instead, subjective complaints of selective attention and subjective memory performance were significantly determined by measures of both, anxiety and depression. One unit increase in anxiety or depression led to an increase of 6 or 15% in subjective memory performance complaints, respectively. For subjective complaints of selective attention, a one unit increase in anxiety or depression led to an increase of 11 or 26%, respectively. The strong relation between SCC and measures of depression and anxiety corroborates the notion of SCC being indicative of mental health and general well-being.
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Affiliation(s)
- Anna Mascherek
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Nathalie Werkle
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Anja S Göritz
- Department of Psychology, Albert-Ludwigs-Universität Freiburg, Freiburg im Breisgau, Germany
| | - Simone Kühn
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany.,Lise Meitner Group for Environmental Neuroscience, Max Planck Institute for Human Development, Berlin, Germany
| | - Steffen Moritz
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
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17
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Jędrusek-Golińska A, Górecka D, Buchowski M, Wieczorowska-Tobis K, Gramza-Michałowska A, Szymandera-Buszka K. Recent progress in the use of functional foods for older adults: A narrative review. Compr Rev Food Sci Food Saf 2020; 19:835-856. [PMID: 33325174 DOI: 10.1111/1541-4337.12530] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2019] [Revised: 12/13/2019] [Accepted: 12/14/2019] [Indexed: 12/11/2022]
Abstract
The number and proportion of older adults are increasing globally, and it is predicted that in 2020, there will be 723 million people worldwide aged 66 and older. In recent decades, numerous studies showed that healthy eating is positively associated with better nutritional status and quality of life, and the decreased incidence of noncommunicable diseases. As older adults become health conscious, the demand for foods and beverages rich in nutrients and bioactive compounds has increased. The increased demand for healthy food stimulated a recent rapid increase in designing, producing, and marketing functional foods to prevent or correct nutrient deficiencies and to improve the nutritional status of older adults. These functional products contain and/or are enriched with dietary fiber; omega-3 polyunsaturated fatty acids; phytoestrogens; polyphenols; carotenoids such as alpha- and beta-carotene; lutein and zeaxanthin; pre-, pro-, and synbiotics; and plant sterols and stanols. A limited number of publications have thoroughly addressed the effect of functional foods on the nutritional status of older adults. The goal of this review was to review existing recent research on the role of functional foods in healthy and active aging.
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Affiliation(s)
- Anna Jędrusek-Golińska
- Department of Gastronomy Science and Functional Foods, Poznań University of Life Sciences, Poznań, Poland
| | - Danuta Górecka
- Department of Gastronomy Science and Functional Foods, Poznań University of Life Sciences, Poznań, Poland
| | - Maciej Buchowski
- Division of Gastroenterology, Hepatology, and Nutrition, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Katarzyna Wieczorowska-Tobis
- Institute of Human Nutrition and Dietetics, Poznań University of Life Sciences, Poland and Laboratory for Geriatric Medicine, Department of Palliative Care, University of Medical Science, Poznań, Poland
| | - Anna Gramza-Michałowska
- Department of Gastronomy Science and Functional Foods, Poznań University of Life Sciences, Poznań, Poland
| | - Krystyna Szymandera-Buszka
- Department of Gastronomy Science and Functional Foods, Poznań University of Life Sciences, Poznań, Poland
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18
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Alex A, Abbott KA, McEvoy M, Schofield PW, Garg ML. Long-chain omega-3 polyunsaturated fatty acids and cognitive decline in non-demented adults: a systematic review and meta-analysis. Nutr Rev 2019; 78:563-578. [DOI: 10.1093/nutrit/nuz073] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
Abstract
Context
Long-chain omega-3 polyunsaturated fatty acids (LCn-3PUFAs) are widely considered as nootropic agents that may be beneficial in reversing cognitive impairment.
Objective
The present systematic review of randomized controlled trials was conducted to determine the changes in cognitive function after intervention with LCn-3PUFA supplementation in non-demented adults, including those with mild cognitive impairment.
Data Sources
Five databases (MEDLINE, CINAHL, Scopus, EMBASE, and the Cochrane Library) were searched systematically along with reference lists of selected articles.
Study Selection
Studies were eligible for inclusion if they measured the effect of LCn-3PUFA supplementation on cognition in non-demented adults.
Data Extraction
A total of 787 records were screened, of which 25 studies were eligible for inclusion. Treatment effects were summarized as global cognitive function for primary outcome and measured using the Mini-Mental State Examination and individual cognitive domains for secondary outcome. The pooled effect sizes were estimated using Hedge’s g and random-effects modeling.
Data Analysis
Results from randomized controlled trials indicate that LCn-3PUFAs have no effect on global cognitive function (Hedge’s g = 0.02; 95% confidence interval, −0.12 to 0.154), and among the specific cognitive domains, only memory function showed a mild benefit (Hedge’s g = 0.31; P = 0.003; z = 2.945).
Conclusion
The existing literature suggests that LCn-3PUFA supplementation could provide a mild benefit in improving memory function in non-demented older adults.
Systematic Review Registration
PROSPERO registration no. CRD42017078664.
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Affiliation(s)
- Anu Alex
- Nutraceuticals Research Program, School of Biomedical Sciences and Pharmacy
| | - Kylie A Abbott
- Nutraceuticals Research Program, School of Biomedical Sciences and Pharmacy
| | - Mark McEvoy
- School of Medicine and Public Health
- Hunter Medical Research Institute, University of Newcastle, NSW, Australia
| | - Peter W Schofield
- School of Medicine and Public Health
- Neuropsychiatry Service, Hunter New England Local Health District, NSW, Australia
| | - Manohar L Garg
- Nutraceuticals Research Program, School of Biomedical Sciences and Pharmacy
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19
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Anker MS, Anker SD, Coats AJS, von Haehling S. The Journal of Cachexia, Sarcopenia and Muscle stays the front-runner in geriatrics and gerontology. J Cachexia Sarcopenia Muscle 2019; 10:1151-1164. [PMID: 31821753 PMCID: PMC6903443 DOI: 10.1002/jcsm.12518] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Affiliation(s)
- Markus S Anker
- Division of Cardiology and Metabolism, Department of Cardiology, Charité Universitätsmedizin Berlin, Berlin, Germany.,Berlin Institute of Health Center for Regenerative Therapies (BCRT), Berlin, Germany.,German Centre for Cardiovascular Research (DZHK) partner site Berlin, Berlin, Germany.,Department of Cardiology, Charité Campus Benjamin Franklin, Berlin, Germany
| | - Stefan D Anker
- Division of Cardiology and Metabolism, Department of Cardiology, Charité Universitätsmedizin Berlin, Berlin, Germany.,Berlin Institute of Health Center for Regenerative Therapies (BCRT), Berlin, Germany.,German Centre for Cardiovascular Research (DZHK) partner site Berlin, Berlin, Germany.,Department of Cardiology (CVK), Charité Universitätsmedizin Berlin, Berlin, Germany.,Charité Universitätsmedizin Berlin, Berlin, Germany
| | | | - Stephan von Haehling
- Department of Cardiology and Pneumology, Heart Center Göttingen, University of Göttingen Medical Center, Georg-August-University, Göttingen, Germany.,German Center for Cardiovascular Medicine (DZHK), partner site Göttingen, Göttingen, Germany
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20
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A Novel Anti-Inflammatory Role of Omega-3 PUFAs in Prevention and Treatment of Atherosclerosis and Vascular Cognitive Impairment and Dementia. Nutrients 2019; 11:nu11102279. [PMID: 31547601 PMCID: PMC6835717 DOI: 10.3390/nu11102279] [Citation(s) in RCA: 64] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2019] [Revised: 09/11/2019] [Accepted: 09/19/2019] [Indexed: 12/13/2022] Open
Abstract
Atherosclerosis is an inflammatory chronic disease affecting arterial vessels and leading to vascular diseases, such as stroke and myocardial infarction. The relationship between atherosclerosis and risk of neurodegeneration has been established, in particular with vascular cognitive impairment and dementia (VCID). Systemic atherosclerosis increases the risk of VCID by inducing cerebral infarction, or through systemic or local inflammatory factors that underlie both atherosclerosis and cognition. Omega-3 and omega-6 polyunsaturated fatty acids (PUFAs) are involved in inflammatory processes, but with opposite roles. Specifically, omega-3 PUFAs exert anti-inflammatory properties by competing with omega-6 PUFAs and displacing arachidonic acid in membrane phospholipids, decreasing the production of pro-inflammatory eicosanoids. Experimental studies and some clinical trials have demonstrated that omega-3 PUFA supplementation may reduce the risk of different phenotypes of atherosclerosis and cardiovascular disease. This review describes the link between atherosclerosis, VCID and inflammation, as well as how omega-3 PUFA supplementation may be useful to prevent and treat inflammatory-related diseases.
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21
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Rangel-Huerta OD, Gil A. Effect of omega-3 fatty acids on cognition: an updated systematic review of randomized clinical trials. Nutr Rev 2019; 76:1-20. [PMID: 29240924 DOI: 10.1093/nutrit/nux064] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Context The increasing number of studies on the effects of n-3 long-chain polyunsaturated fatty acids (LC-PUFAs) on health, particularly cognition, in the last 5 years reflects the growing interest in this area of research. Objective The aim for this systematic review was to evaluate the scientific evidence published in the last 5 years (2012-2017) on the effects of n-3 LC-PUFA intake on cognition, cognitive development, and cognitive decline to determine whether n-3 LC-PUFAs support cognitive development and prevent cognitive decline. Data Sources The PubMed database was searched. Study Selection The 51 articles included in this systematic review reported on healthy individuals with mild or moderate cognitive impairment and patients with Alzheimer's disease. Risk of bias was assessed using Cochrane methodology. Data Extraction The number of study participants, the type of study, the type and dose of n-3 LC-PUFAs, and the key results are reported here. Results Current evidence indicates that n-3 LC-PUFAs administered during pregnancy or breastfeeding have no effect on the skills or cognitive development of children in later stages of development. Evidence regarding the improvement of cognitive function during childhood and youth or in attention deficit/hyperactivity disorder is inconclusive. Moreover, it is still unclear if n-3 LC-PUFAs can improve cognitive development or prevent cognitive decline in young or older adults.
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Affiliation(s)
- Oscar D Rangel-Huerta
- Department of Biochemistry and Molecular Biology II, Institute of Nutrition and Food Technology, Biomedical Research Centre, University of Granada, Granada, Spain
| | - Angel Gil
- Department of Biochemistry and Molecular Biology II, Institute of Nutrition and Food Technology, Biomedical Research Centre, University of Granada, Granada, Spain.,Centro de Investigación Biomédica en Red de la Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain
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22
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Solfrizzi V, Agosti P, Lozupone M, Custodero C, Schilardi A, Valiani V, Sardone R, Dibello V, Di Lena L, Lamanna A, Stallone R, Bellomo A, Greco A, Daniele A, Seripa D, Sabbà C, Logroscino G, Panza F. Nutritional Intervention as a Preventive Approach for Cognitive-Related Outcomes in Cognitively Healthy Older Adults: A Systematic Review. J Alzheimers Dis 2019; 64:S229-S254. [PMID: 29865058 DOI: 10.3233/jad-179940] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
The link diet-cognitive function/dementia has been largely investigated in observational studies; however, there was a lack of evidence from randomized clinical trials (RCTs) on the prevention of late-life cognitive disorders though dietary intervention in cognitively healthy older adults. In the present article, we systematically reviewed RCTs published in the last four years (2014-2017) exploring nutritional intervention efficacy in preventing the onset of late-life cognitive disorders and dementia in cognitively healthy subjects aged 60 years and older using different levels of investigation (i.e., dietary pattern changes/medical food/nutraceutical supplementation/multidomain approach and dietary macro- and micronutrient approaches) as well as possible underlying mechanisms of nutritional prevention. From the 35 included RCTs, there was moderate evidence that intervention through dietary pattern changes, medical food/nutraceutical supplementation, and multidomain approach improved specific cognitive domains or cognitive-related blood biomarkers. There was high evidence that protein supplementation improved specific cognitive domains or functional status in prefrail older adults without effect on cognitive function. For fatty acid supplementation, mainly long-chain polyunsaturated fatty acids, there was emerging evidence suggesting an impact of this approach in improving specific cognitive domains, magnetic resonance imaging (MRI) findings, and/or cognitive-related biomarkers also in selected subgroups of older subjects, although some results were conflicting. There was convincing evidence of an impact of non-flavonoid polyphenol and flavonoid supplementations in improving specific cognitive domains and/or MRI findings. Finally, there was only low evidence suggesting efficacy of intervention with homocysteine-related and antioxidant vitamins in improving cognitive functions, dementia incidence, or cognitive-related biomarkers in cognitively healthy older subjects.
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Affiliation(s)
- Vincenzo Solfrizzi
- 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
| | - Pasquale Agosti
- Geriatric Medicine-Memory Unit and Rare Disease Centre, University of Bari 'Aldo Moro', Bari, Italy
| | - Madia Lozupone
- Department of Basic Medicine, Neurodegenerative Disease Unit, Neuroscience, and Sense Organs, University of Bari Aldo Moro, Bari, Italy
| | - Carlo Custodero
- Geriatric Medicine-Memory Unit and Rare Disease Centre, University of Bari 'Aldo Moro', Bari, Italy
| | - Andrea Schilardi
- Geriatric Medicine-Memory Unit and Rare Disease Centre, University of Bari 'Aldo Moro', Bari, Italy
| | - Vincenzo Valiani
- Geriatric Medicine-Memory Unit and Rare Disease Centre, University of Bari 'Aldo Moro', Bari, Italy
| | - Rodolfo Sardone
- National Institute of Gastroenterology "Saverio de Bellis", Research Hospital, Castellana Grotte Bari, Italy
| | - Vittorio Dibello
- Department of Interdisciplinary Medicine (DIM), Section of Dentistry, University of Bari Aldo, Moro, Bari, Italy
| | - Luca Di Lena
- National Institute of Gastroenterology "Saverio de Bellis", Research Hospital, Castellana Grotte Bari, Italy
| | - Angela Lamanna
- National Institute of Gastroenterology "Saverio de Bellis", Research Hospital, Castellana Grotte Bari, Italy
| | - Roberta Stallone
- Department of Basic Medicine, Neurodegenerative Disease Unit, Neuroscience, and Sense Organs, University of Bari Aldo Moro, Bari, Italy
| | - Antonello Bellomo
- Department of Clinical and Experimental Medicine, Psychiatric Unit, University of Foggia, Foggia, Italy
| | - Antonio Greco
- Department of Medical Sciences, Geriatric Unit and Laboratory of Gerontology and Geriatrics, IRCCS "Casa Sollievo della Sofferenza", San Giovanni Rotondo, Foggia, Italy
| | - Antonio Daniele
- Institute of Neurology, Catholic University of Sacred Heart, Rome, Italy
| | - Davide Seripa
- Department of Medical Sciences, Geriatric Unit and Laboratory of Gerontology and Geriatrics, IRCCS "Casa Sollievo della Sofferenza", San Giovanni Rotondo, Foggia, Italy
| | - Carlo Sabbà
- Geriatric Medicine-Memory Unit and Rare Disease Centre, University of Bari 'Aldo Moro', Bari, Italy
| | - Giancarlo Logroscino
- Department of Basic Medicine, Neurodegenerative Disease Unit, Neuroscience, and Sense Organs, University of Bari Aldo Moro, Bari, Italy.,Department of Clinical Research in Neurology, University of Bari Aldo Moro, "Pia Fondazione Cardinale G. Panico", Tricase, Lecce, Italy
| | - Francesco Panza
- Department of Basic Medicine, Neurodegenerative Disease Unit, Neuroscience, and Sense Organs, University of Bari Aldo Moro, Bari, Italy.,Department of Medical Sciences, Geriatric Unit and Laboratory of Gerontology and Geriatrics, IRCCS "Casa Sollievo della Sofferenza", San Giovanni Rotondo, Foggia, Italy.,Department of Clinical Research in Neurology, University of Bari Aldo Moro, "Pia Fondazione Cardinale G. Panico", Tricase, Lecce, Italy.,Geriatric Medicine-Memory Unit and Rare Disease Centre, University of Bari 'Aldo Moro', Bari, Italy
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23
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Chen ST, Volle D, Jalil J, Wu P, Small GW. Health-Promoting Strategies for the Aging Brain. Am J Geriatr Psychiatry 2019; 27:213-236. [PMID: 30686664 DOI: 10.1016/j.jagp.2018.12.016] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2018] [Revised: 12/11/2018] [Accepted: 12/11/2018] [Indexed: 12/31/2022]
Abstract
As the world's population ages and people live longer, the changes in the aging brain present substantial challenges to our health and society. With greater longevity come age-related diseases, many of which have direct and indirect influences on the health of the brain. Although there is some degree of predictable decline in brain functioning with aging, meaningful cognitive decline is not inevitable and is perhaps preventable. In this review, we present the case that the course of aging-related brain disease and dysfunction can be modified. We present the evidence for conditions and risk factors that may contribute to cognitive decline and dementia and for interventions that may mitigate their impact on cognitive functioning later in life, or even prevent them and their cognitive sequelae from developing. Although much work remains to be done to meet the challenges of the aging brain, strategies to promote its health have been demonstrated and offer much promise, which can only be realized if we mount a vigorous public health effort to implement these strategies.
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Affiliation(s)
- Stephen T Chen
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles; the University of California, Los Angeles, Longevity Center, Los Angeles; David Geffen School of Medicine, University of California, Los Angeles, Los Angeles.
| | - Dax Volle
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles; the University of California, Los Angeles, Longevity Center, Los Angeles; David Geffen School of Medicine, University of California, Los Angeles, Los Angeles
| | - Jason Jalil
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles; the University of California, Los Angeles, Longevity Center, Los Angeles; David Geffen School of Medicine, University of California, Los Angeles, Los Angeles
| | - Pauline Wu
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles; the University of California, Los Angeles, Longevity Center, Los Angeles; David Geffen School of Medicine, University of California, Los Angeles, Los Angeles
| | - Gary W Small
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles; the University of California, Los Angeles, Longevity Center, Los Angeles; David Geffen School of Medicine, University of California, Los Angeles, Los Angeles
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24
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Darcey VL, McQuaid GA, Fishbein DH, VanMeter JW. Dietary Long-Chain Omega-3 Fatty Acids Are Related to Impulse Control and Anterior Cingulate Function in Adolescents. Front Neurosci 2019; 12:1012. [PMID: 30686978 PMCID: PMC6333752 DOI: 10.3389/fnins.2018.01012] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2018] [Accepted: 12/17/2018] [Indexed: 11/13/2022] Open
Abstract
Impulse control, an emergent function modulated by the prefrontal cortex (PFC), helps to dampen risky behaviors during adolescence. Influences on PFC maturation during this period may contribute to variations in impulse control. Availability of omega-3 fatty acids, an essential dietary nutrient integral to neuronal structure and function, may be one such influence. This study examined whether intake of energy-adjusted long-chain omega-3 fatty acids [eicosapentaenoic acid (EPA) + docosahexaenoic acid (DHA)] was related to variation in impulse control and PFC activity during performance of an inhibitory task in adolescents (n = 87; 51.7% female, mean age 13.3 ± 1.1 years) enrolled in a longitudinal neuroimaging study. Intake of DHA + EPA was assessed using a food frequency questionnaire and adjusted for total energy intake. Inhibitory control was assessed using caregiver rating scale (BRIEF Inhibit subscale) and task performance (false alarm rate) on a Go/No-Go task performed during functional MRI. Reported intake of long-chain omega-3 was positively associated with caregiver ratings of adolescent ability to control impulses (p = 0.017) and there was a trend for an association between intake and task-based impulse control (p = 0.072). Furthermore, a regression of BOLD response within PFC during successful impulse control (Correct No-Go versus Incorrect No-Go) with energy-adjusted DHA + EPA intake revealed that adolescents reporting lower intakes display greater activation in the dorsal anterior cingulate, potentially suggestive of a possible lag in cortical development. The present results suggest that dietary omega-3 fatty acids are related to development of both impulse control and function of the dorsal anterior cingulate gyrus in normative adolescent development. Insufficiency of dietary omega-3 fatty acids during this developmental period may be a factor which hinders development of behavioral control.
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Affiliation(s)
- Valerie L Darcey
- The Interdisciplinary Program in Neuroscience, Georgetown University, Washington, DC, United States.,Center for Functional and Molecular Imaging, Georgetown University Medical Center, Washington, DC, United States
| | - Goldie A McQuaid
- Center for Functional and Molecular Imaging, Georgetown University Medical Center, Washington, DC, United States
| | - Diana H Fishbein
- Department of Human Development and Family Studies, Pennsylvania State University, University Park, PA, United States
| | - John W VanMeter
- Center for Functional and Molecular Imaging, Georgetown University Medical Center, Washington, DC, United States
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Talukdar T, Zamroziewicz MK, Zwilling CE, Barbey AK. Nutrient biomarkers shape individual differences in functional brain connectivity: Evidence from omega-3 PUFAs. Hum Brain Mapp 2018; 40:1887-1897. [PMID: 30556225 DOI: 10.1002/hbm.24498] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2018] [Revised: 12/03/2018] [Accepted: 12/06/2018] [Indexed: 12/25/2022] Open
Abstract
A wealth of neuroscience evidence demonstrates that diet and nutrition play an important role in structural brain plasticity, promoting the development of gray matter volume and maintenance of white matter integrity across the lifespan. However, the role of nutrition in shaping individual differences in the functional brain connectome remains to be well established. We therefore investigated whether nutrient biomarkers known to have beneficial effects on brain structure (i.e., the omega-3 polyunsaturated fatty acids; ω-3 PUFAs), explain individual differences in functional brain connectivity within healthy older adults (N = 96). Our findings demonstrate that ω-3 PUFAs are associated with individual differences in functional connectivity within regions that support executive function (prefrontal cortex), memory (hippocampus), and emotion (amygdala), and provide key evidence that the influence of these regions on global network connectivity reliably predict general, fluid, and crystallized intelligence. The observed findings not only elucidate the role of ω-3 PUFAs in functional brain plasticity and intelligence, but also motivate future studies to examine their impact on psychological health, aging, and disease.
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Affiliation(s)
- Tanveer Talukdar
- Decision Neuroscience Laboratory, University of Illinois, Urbana, Illinois.,Beckman Institute for Advanced Science and Technology, University of Illinois, Urbana, Illinois.,Center for Brain Plasticity, University of Illinois, Urbana, Illinois
| | - Marta K Zamroziewicz
- Decision Neuroscience Laboratory, University of Illinois, Urbana, Illinois.,Beckman Institute for Advanced Science and Technology, University of Illinois, Urbana, Illinois.,Center for Brain Plasticity, University of Illinois, Urbana, Illinois.,Medical Scholars Program, University of Illinois College of Medicine, Chicago, Illinois
| | - Christopher E Zwilling
- Decision Neuroscience Laboratory, University of Illinois, Urbana, Illinois.,Beckman Institute for Advanced Science and Technology, University of Illinois, Urbana, Illinois.,Center for Brain Plasticity, University of Illinois, Urbana, Illinois
| | - Aron K Barbey
- Decision Neuroscience Laboratory, University of Illinois, Urbana, Illinois.,Beckman Institute for Advanced Science and Technology, University of Illinois, Urbana, Illinois.,Center for Brain Plasticity, University of Illinois, Urbana, Illinois.,Carl R. Woese Institute for Genomic Biology, University of Illinois, Champaign, Illinois.,Department of Psychology, University of Illinois, Urbana, Illinois.,Department of Bioengineering, University of Illinois, Champaign, Illinois.,Division of Nutritional Sciences, University of Illinois, Champaign, Illinois.,Neuroscience Program, University of Illinois, Champaign, Illinois
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Abstract
Diet has been investigated in relation to its ability to promote cognitive function. However, evidence is currently limited and has rarely been systematically reviewed, particularly in a mild cognitive impairment (MCI) population. This review examined the effect of diet on cognitive outcomes in MCI patients. A total of five databases were searched to find randomised controlled trial (RCT) studies, with diet as the main focus, in MCI participants. The primary outcome was incident dementia and/or Alzheimer's disease (AD) and secondary outcomes included cognitive function across different domains using validated neuropsychological tests. Sixteen studies met the inclusion criteria. There was a high degree of heterogeneity relating to the nature of the dietary intervention and cognitive outcomes measured, thus making study comparisons difficult. Supplementation with vitamin E (one study, n 516), ginkgo biloba (one study, n 482) or Fortasyn Connect (one study, n 311) had no significant effect on progression from MCI to dementia and/or AD. For cognitive function, the findings showed some improvements in performance, particularly in memory, with the most consistent results shown by B vitamins, including folic acid (one study, n 266), folic acid alone (one study, n 180), DHA and EPA (two studies, n 36 and n 86), DHA (one study, n 240) and flavonol supplementation (one study, n 90). The findings indicate that dietary factors may have a potential benefit for cognitive function in MCI patients. Further well-designed trials are needed, with standardised and robust measures of cognition to investigate the influence of diet on cognitive status.
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Chianese R, Coccurello R, Viggiano A, Scafuro M, Fiore M, Coppola G, Operto FF, Fasano S, Laye S, Pierantoni R, Meccariello R. Impact of Dietary Fats on Brain Functions. Curr Neuropharmacol 2018; 16:1059-1085. [PMID: 29046155 PMCID: PMC6120115 DOI: 10.2174/1570159x15666171017102547] [Citation(s) in RCA: 79] [Impact Index Per Article: 13.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2017] [Revised: 08/24/2017] [Accepted: 10/10/2017] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Adequate dietary intake and nutritional status have important effects on brain functions and on brain health. Energy intake and specific nutrients excess or deficiency from diet differently affect cognitive processes, emotions, behaviour, neuroendocrine functions and synaptic plasticity with possible protective or detrimental effects on neuronal physiology. Lipids, in particular, play structural and functional roles in neurons. Here the importance of dietary fats and the need to understand the brain mechanisms activated by peripheral and central metabolic sensors. Thus, the manipulation of lifestyle factors such as dietary interventions may represent a successful therapeutic approach to maintain and preserve brain health along lifespan. METHODS This review aims at summarizing the impact of dietary fats on brain functions. RESULTS Starting from fat consumption, nutrient sensing and food-related reward, the impact of gut-brain communications will be discussed in brain health and disease. A specific focus will be on the impact of fats on the molecular pathways within the hypothalamus involved in the control of reproduction via the expression and the release of Gonadotropin-Releasing Hormone. Lastly, the effects of specific lipid classes such as polyunsaturated fatty acids and of the "fattest" of all diets, commonly known as "ketogenic diets", on brain functions will also be discussed. CONCLUSION Despite the knowledge of the molecular mechanisms is still a work in progress, the clinical relevance of the manipulation of dietary fats is well acknowledged and such manipulations are in fact currently in use for the treatment of brain diseases.
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Affiliation(s)
- Rosanna Chianese
- Department of Experimental Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Roberto Coccurello
- Institute of Cell Biology and Neurobiology, National Research Council (C.N.R.), Rome, Italy.,Fondazione S. Lucia (FSL) IRCCS, Roma, Italy
| | - Andrea Viggiano
- Department of Medicine, Surgery and Scuola Medica Salernitana, University of Salerno, Baronissi, SA, Italy
| | - Marika Scafuro
- Department of Experimental Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Marco Fiore
- Institute of Cell Biology and Neurobiology, National Research Council (C.N.R.), Rome, Italy.,Fondazione S. Lucia (FSL) IRCCS, Roma, Italy
| | - Giangennaro Coppola
- Department of Medicine, Surgery and Scuola Medica Salernitana, University of Salerno, Baronissi, SA, Italy.,UO Child and Adolescent Neuropsychiatry, Medical School, University of Salerno, Salerno, Italy
| | | | - Silvia Fasano
- Department of Experimental Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Sophie Laye
- INRA, Bordeaux University, Nutrition and Integrative Neurobiology, UMR, Bordeaux, France
| | - Riccardo Pierantoni
- Department of Experimental Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Rosaria Meccariello
- Department of Movement and Wellness Sciences, Parthenope University of Naples, Naples, Italy
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McNamara RK, Asch RH, Lindquist DM, Krikorian R. Role of polyunsaturated fatty acids in human brain structure and function across the lifespan: An update on neuroimaging findings. Prostaglandins Leukot Essent Fatty Acids 2018; 136:23-34. [PMID: 28529008 PMCID: PMC5680156 DOI: 10.1016/j.plefa.2017.05.001] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2016] [Revised: 04/14/2017] [Accepted: 05/08/2017] [Indexed: 01/07/2023]
Abstract
There is a substantial body of evidence from animal studies implicating polyunsaturated fatty acids (PUFA) in neuroinflammatory, neurotrophic, and neuroprotective processes in brain. However, direct evidence for a role of PUFA in human brain structure and function has been lacking. Over the last decade there has been a notable increase in neuroimaging studies that have investigated the impact of PUFA intake and/or blood levels (i.e., biostatus) on brain structure, function, and pathology in human subjects. The majority of these studies specifically evaluated associations between omega-3 PUFA intake and/or biostatus and neuroimaging outcomes using a variety of experimental designs and imaging techniques. This review provides an updated overview of these studies in an effort to identify patterns to guide and inform future research. While the weight of evidence provides general support for a beneficial effect of a habitual diet consisting of higher omega-3 PUFA intake on cortical structure and function in healthy human subjects, additional research is needed to replicate and extend these findings as well as identify response mediators and clarify mechanistic pathways. Controlled intervention trials are also needed to determine whether increasing n-3 PUFA biostatus can prevent or attenuate neuropathological brain changes observed in patients with or at risk for psychiatric disorders and dementia.
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Affiliation(s)
- Robert K McNamara
- Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati College of Medicine, Cincinnati, OH 45219, United States.
| | - Ruth H Asch
- Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati College of Medicine, Cincinnati, OH 45219, United States
| | - Diana M Lindquist
- Imaging Research Center, Department of Radiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH 45267, United States
| | - Robert Krikorian
- Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati College of Medicine, Cincinnati, OH 45219, United States
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Derbyshire E. Brain Health across the Lifespan: A Systematic Review on the Role of Omega-3 Fatty Acid Supplements. Nutrients 2018; 10:E1094. [PMID: 30111738 PMCID: PMC6116096 DOI: 10.3390/nu10081094] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2018] [Revised: 08/06/2018] [Accepted: 08/08/2018] [Indexed: 02/07/2023] Open
Abstract
The brain is the most significant and complex organ of the human body. Increasingly, we are becoming aware that certain nutrients may help to safeguard brain health. An expanse of research has investigated the effects of omega fatty acids in relation to brain health but effects across the lifespan have not been widely evaluated. The present systematic review collated evidence from 25 randomized controlled trials (n = 3633) published since 2013. Compared with control groups, omega-3 supplementation generally correlated with improvements in blood biomarkers. Subsequently, these appear to benefit those with lower baseline fatty acid levels, who are breastfeeding or who have neuropsychiatric conditions. Whilst multiple studies indicate that omega fatty acids can protect against neurodegeneration in older adults, more work is needed in the years preceding the diagnosis of such medical conditions. Bearing in mind the scale of ageing populations and rising healthcare costs linked to poor brain health, omega supplementation could be a useful strategy for helping to augment dietary intakes and support brain health across the lifespan. Ongoing research is now needed using harmonious methodologies, supplement dosages, ratios and intervention periods to help formulate congruent conclusions.
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Abstract
OBJECTIVES This review provides a broad overview of the effectiveness of interventions for subjective cognitive decline (SCD) in improving psychological well-being, metacognition and objective cognitive performance. METHODS Databases including PubMed, Web of Science and Cochrane Systematic Reviews were searched up to August 2017 to identify randomised controlled trials evaluating interventions for SCD. Interventions were categorised as psychological, cognitive, lifestyle or pharmacological. Outcomes of interest included psychological well-being, metacognitive ability and objective cognitive performance. To assess the risk of bias, three authors independently rated study validity using criteria based on the Critical Appraisal Skills Programme. Random-effects meta-analyses were undertaken where three or more studies investigated similar interventions and reported comparable outcomes. RESULTS Twenty studies met inclusion criteria and 16 had sufficient data for inclusion in the meta-analyses. Of these, only seven were rated as being high quality. Group psychological interventions significantly improved psychological well-being (g=0.40, 95% CI 0.03 to 0.76; p=0.03) but the improvement they conferred on metacognitive ability was not statistically significant (g=0.26, 95% CI -0.22 to 0.73; p=0.28). Overall, cognitive training interventions led to a small, statistically significant improvement in objective cognitive performance (g=0.13, 95% CI 0.01 to 0.25; p=0.03). However, the pooled effect sizes of studies using active control groups (g=0.02, 95% CI -0.19 to 0.22; p=0.85) or reporting global cognitive measures (g=0.06, 95% CI -0.19 to 0.31; p=0.66) were non-significant. CONCLUSIONS There is a lack of high-quality research in this field. Group psychological interventions improve psychological well-being and may also improve metacognition. A large, high-quality study is indicated to investigate this further. There is no evidence to suggest that cognitive interventions improve global cognitive performance and the clinical utility of small improvements in specific cognitive domains is questionable. There is a lack of research considering lifestyle interventions and poor quality evidence for pharmacological interventions. PROSPERO REGISTRATION NUMBER CRD42017079391.
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Affiliation(s)
- Rohan Bhome
- Division of Psychiatry, University College London, London, UK
| | - Alex J Berry
- Camden and Islington NHS Foundation Trust, London, UK
| | | | - Robert J Howard
- Division of Psychiatry, University College London, London, UK
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31
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Berkowitz CL, Mosconi L, Scheyer O, Rahman A, Hristov H, Isaacson RS. Precision Medicine for Alzheimer's Disease Prevention. Healthcare (Basel) 2018; 6:healthcare6030082. [PMID: 30011822 PMCID: PMC6164450 DOI: 10.3390/healthcare6030082] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2018] [Revised: 07/08/2018] [Accepted: 07/10/2018] [Indexed: 12/12/2022] Open
Abstract
Precision medicine is an approach to medical treatment and prevention that takes into account individual variability in genes, environment, and lifestyle and allows for personalization that is based on factors that may affect the response to treatment. Several genetic and epigenetic risk factors have been shown to increase susceptibility to late-onset Alzheimer's disease (AD). As such, it may be beneficial to integrate genetic risk factors into the AD prevention approach, which in the past has primarily been focused on universal risk-reduction strategies for the general population rather than individualized interventions in a targeted fashion. This review discusses examples of a "one-size-fits-all" versus clinical precision medicine AD prevention strategy, in which the precision medicine approach considers two genes that can be commercially sequenced for polymorphisms associated with AD, apolipoprotein E (APOE), and methylenetetrahydrofolate reductase (MTHFR). Comparing these two distinct approaches provides support for a clinical precision medicine prevention strategy, which may ultimately lead to more favorable patient outcomes as the interventions are targeted to address individualized risks.
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Affiliation(s)
- Cara L Berkowitz
- Department of Neurology, Weill Cornell Medicine, New York, NY 10021, USA.
| | - Lisa Mosconi
- Department of Neurology, Weill Cornell Medicine, New York, NY 10021, USA.
| | - Olivia Scheyer
- Department of Neurology, Weill Cornell Medicine, New York, NY 10021, USA.
| | - Aneela Rahman
- Department of Neurology, Weill Cornell Medicine, New York, NY 10021, USA.
| | - Hollie Hristov
- Department of Neurology, Weill Cornell Medicine, New York, NY 10021, USA.
| | - Richard S Isaacson
- Department of Neurology, Weill Cornell Medicine, New York, NY 10021, USA.
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Effects of n-3 polyunsaturated fatty acid supplementation on cognitive functions, electrocortical activity and neurogenesis in a non-human primate, the grey mouse lemur (Microcebus murinus). Behav Brain Res 2018; 347:394-407. [DOI: 10.1016/j.bbr.2018.02.029] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2017] [Revised: 02/21/2018] [Accepted: 02/21/2018] [Indexed: 12/13/2022]
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Haley AP, Oleson S, Pasha E, Birdsill A, Kaur S, Thompson J, Tanaka H. Phenotypic heterogeneity of obesity-related brain vulnerability: one-size interventions will not fit all. Ann N Y Acad Sci 2018; 1428:89-102. [PMID: 29741211 DOI: 10.1111/nyas.13673] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2017] [Revised: 02/10/2018] [Accepted: 02/17/2018] [Indexed: 01/07/2023]
Abstract
Intact memory and problem solving are key to functional independence and quality of life in older age. Considering the unprecedented demographic shift toward a greater number of older adults than children in the United States in the next few decades, it is critically important for older adults to maintain work productivity and functional independence for as long as possible. Implementing early interventions focused on modifiable risk factors for cognitive decline at midlife is a strategy with the highest chance of success at present, bearing in mind the current lack of dementia cures. We present a selective, narrative review of evidence linking nutrition, body composition, vascular health, and brain function in midlife to highlight the phenotypic heterogeneity of obesity-related brain vulnerability and to endorse the development of individually tailored lifestyle modification plans for primary prevention of cognitive decline.
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Affiliation(s)
- Andreana P Haley
- Department of Psychology, The University of Texas at Austin, Austin, Texas.,Imaging Research Center, The University of Texas at Austin, Austin, Texas
| | - Stephanie Oleson
- Department of Psychology, The University of Texas at Austin, Austin, Texas
| | - Evan Pasha
- Department of Kinesiology and Health Education, The University of Texas at Austin, Austin, Texas
| | - Alex Birdsill
- Department of Psychology, The University of Texas at Austin, Austin, Texas
| | - Sonya Kaur
- Department of Psychology, The University of Texas at Austin, Austin, Texas
| | - Janelle Thompson
- Department of Psychology, The University of Texas at Austin, Austin, Texas
| | - Hirofumi Tanaka
- Department of Kinesiology and Health Education, The University of Texas at Austin, Austin, Texas
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34
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Baleztena J, Ruiz-Canela M, Sayon-Orea C, Pardo M, Añorbe T, Gost JI, Gomez C, Ilarregui B, Bes-Rastrollo M. Association between cognitive function and supplementation with omega-3 PUFAs and other nutrients in ≥ 75 years old patients: A randomized multicenter study. PLoS One 2018; 13:e0193568. [PMID: 29579102 PMCID: PMC5868762 DOI: 10.1371/journal.pone.0193568] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2017] [Accepted: 02/10/2018] [Indexed: 02/06/2023] Open
Abstract
A few studies have assessed the association between omega-3 polyunsaturated fatty acids (n-3 PUFA) and cognitive impairment (CI) in very old adults. The aim of this study was to evaluate the effect of a multinutrient supplementation rich in n-3 PUFA on the cognitive function in an institutionalized ≥75-year-old population without CI or with mild cognitive impairment (MCI). A multicenter placebo-controlled double-blind randomized trial was conducted between 2012 and 2013. Cognitive function was assessed at baseline and after one year using 4 neuropsychological tests. Nutritional status was assessed using Mini Nutritional Assessment (MNA). Interaction between Mini-Mental State Examination (MMSE) score and nutritional status were analyzed using linear regression models. A total of 99 participants were randomized to receive placebo or pills rich in n-3 PUFA. After 1-year follow-up, both groups decreased their MMSE score (-1.18, SD:0. 53 and -0.82, SD:0. 63, p = 0.67 for the control and the intervention group respectively). The memory subscale of the MMSE showed an improvement (+0.26, SD:0.18) in the intervention group against a worsening in the control group (-0.11, SD: 0.14; p = 0.09 for differences between groups). Patients at intervention group with normal nutritional status (MNA ≥24) showed an improvement in the MMSE (+1.03, p = 0.025 for differences between 1-y and baseline measurements) against a worsening in the group with malnutrition (MNA<24) (-0.4, p = 0.886 for differences between 1-y and baseline; p of interaction p = 0.05). Supplementation with n-3 PUFA did not show an improvement in the global cognitive function in institutionalized elderly people without CI or with MCI. They only suggest an apparent improvement in memory loss if previously they were well nourished.
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Affiliation(s)
- Joaquin Baleztena
- Centro Residencial Clínica Universidad de Navarra, Pamplona, Spain
- * E-mail: (MBR); (JB)
| | - Miguel Ruiz-Canela
- Department of Preventive Medicine and Public Health, University of Navarra, Pamplona, Spain
- Navarra’s Health Research Institute (IDISNA), Pamplona, Spain
- Biomedical Research Center Network on Obesity and Nutrition (CIBERobn) Physiopathology of Obesity and Nutrition, Institute of Health Carlos III, Madrid, Spain
| | - Carmen Sayon-Orea
- Department of Preventive Medicine and Public Health, University of Navarra, Pamplona, Spain
- Department of Preventive Medicine, Complejo Hospitalario de Navarra, Pamplona, Spain
| | | | | | | | | | | | - Maira Bes-Rastrollo
- Department of Preventive Medicine and Public Health, University of Navarra, Pamplona, Spain
- Navarra’s Health Research Institute (IDISNA), Pamplona, Spain
- Biomedical Research Center Network on Obesity and Nutrition (CIBERobn) Physiopathology of Obesity and Nutrition, Institute of Health Carlos III, Madrid, Spain
- * E-mail: (MBR); (JB)
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Marin R, Diaz M. Estrogen Interactions With Lipid Rafts Related to Neuroprotection. Impact of Brain Ageing and Menopause. Front Neurosci 2018; 12:128. [PMID: 29559883 PMCID: PMC5845729 DOI: 10.3389/fnins.2018.00128] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2017] [Accepted: 02/16/2018] [Indexed: 12/22/2022] Open
Abstract
Estrogens (E2) exert a plethora of neuroprotective actions against aged-associated brain diseases, including Alzheimer's disease (AD). Part of these actions takes place through binding to estrogen receptors (ER) embedded in signalosomes, where numerous signaling proteins are clustered. Signalosomes are preferentially located in lipid rafts which are dynamic membrane microstructures characterized by a peculiar lipid composition enriched in gangliosides, saturated fatty acids, cholesterol, and sphingolipids. Rapid E2 interactions with ER-related signalosomes appear to trigger intracellular signaling ultimately leading to the activation of molecular mechanisms against AD. We have previously observed that the reduction of E2 blood levels occurring during menopause induced disruption of ER-signalosomes at frontal cortical brain areas. These molecular changes may reduce neuronal protection activities, as similar ER signalosome derangements were observed in AD brains. The molecular impairments may be associated with changes in the lipid composition of lipid rafts observed in neurons during menopause and AD. These evidences indicate that the changes in lipid raft structure during aging may be at the basis of alterations in the activity of ER and other neuroprotective proteins integrated in these membrane microstructures. Moreover, E2 is a homeostatic modulator of lipid rafts. Recent work has pointed to this relevant aspect of E2 activity to preserve brain integrity, through mechanisms affecting lipid uptake and local biosynthesis in the brain. Some evidences have demonstrated that estrogens and the docosahexaenoic acid (DHA) exert synergistic effects to stabilize brain lipid matrix. DHA is essential to enhance molecular fluidity at the plasma membrane, promoting functional macromolecular interactions in signaling platforms. In support of this, DHA detriment in neuronal lipid rafts has been associated with the most common age-associated neuropathologies, namely AD and Parkinson disease. Altogether, these findings indicate that E2 may participate in brain preservation through a dual membrane-related mechanism. On the one hand, E2 interacting with ER related signalosomes may protect against neurotoxic insults. On the other hand, E2 may exert lipostatic actions to preserve lipid balance in neuronal membrane microdomains. The different aspects of the emerging multifunctional role of estrogens in membrane-related signalosomes will be discussed in this review.
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Affiliation(s)
- Raquel Marin
- Laboratory of Cellular Neurobiology, Department of Basic Medical Sciences, Medicine, Faculty of Health Sciences, University of La Laguna, Tenerife, Spain.,Fisiología y Biofísica de la Membrana Celular en Patologías Neurodegenerativas y Tumorales, Consejo Superior de Investigaciones Cientificas, Unidad Asociada de Investigación, Universidad de La Laguna Tenerife, Tenerife, Spain
| | - Mario Diaz
- Fisiología y Biofísica de la Membrana Celular en Patologías Neurodegenerativas y Tumorales, Consejo Superior de Investigaciones Cientificas, Unidad Asociada de Investigación, Universidad de La Laguna Tenerife, Tenerife, Spain.,Laboratory of Membrane Physiology and Biophysics, Department of Animal Biology, Edaphology and Geology, University of La Laguna, Tenerife, Spain
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Carmichael OT, Pillai S, Shankapal P, McLellan A, Kay DG, Gold BT, Keller JN. A Combination of Essential Fatty Acids, Panax Ginseng Extract, and Green Tea Catechins Modifies Brain fMRI Signals in Healthy Older Adults. J Nutr Health Aging 2018; 22:837-846. [PMID: 30080229 DOI: 10.1007/s12603-018-1028-2] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
OBJECTIVES To assess the effects of a combination of omega 3 essential fatty acids, green tea catechins, and ginsenosides on cognition and brain functioning in healthy older adults. DESIGN Double-blind, placebo-controlled, crossover design randomized controlled trial with 26-day intervention phases and a 30-day washout period. SETTING The Institute for Dementia Research and Prevention at the Pennington Biomedical Research Center. PARTICIPANTS Ten independently-living, cognitively-healthy older adults (mean age: 67.3 + 2.01 years). INTERVENTION Daily consumption of an investigational product (trade name "Cerbella TM") consisting of an emulsified liquid combination of standardized fish oil, panax ginseng extract, and green tea catechins in a flavored base of lecithin phospholipids optimized to maximize bioavailability of the active ingredients. MEASUREMENTS Before and after supplementation with the investigational product or placebo, participants completed cognitive tests including the Mini Mental State Exam (MMSE), Stroop test, Digit Symbol Substitution Test (DSST), and Immediate and Delayed Recall tests, as well as functional magnetic resonance imaging (fMRI) during a standard cognitive task switching paradigm. RESULTS Performance on the MMSE, Stroop test, and DSST increased significantly over one month of supplementation with the investigational product (one-sample t tests, p<.05) although differences between these changes and corresponding changes during supplementation with placebo were not significant (two-sample t tests, p>.05). During supplementation with the investigational product, brain activation during task performance increased significantly more than during supplementation with placebo in brain regions known to be activated by this task (anterior and posterior cingulate cortex). Functional connectivity during task execution between task regions (middle frontal gyrus and anterior cingulate cortex) increased significantly during supplementation with the investigational product, relative to placebo. Functional connectivity during rest between task regions (precentral gyrus and middle frontal gyrus) and default mode network regions (medial frontal gyrus and precuneus) decreased during supplementation with the investigational product relative to placebo, suggesting greater segregation of task and rest related brain activity. CONCLUSION One-month supplementation with a combination of omega 3 essential fatty acids, green tea catechins, and ginsenosides was associated with suggestive changes in cognitive functioning as well as modification of brain activation and brain functional connectivity in cognitively healthy older adults.
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Affiliation(s)
- O T Carmichael
- Owen Carmichael, Pennington Biomedical Research Center, 6400 Perkins Road, Baton Rouge, LA, 70808, USA,
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Abstract
OBJECTIVES The present study constitutes the first randomized controlled trial to investigate the relation of lutein (L) and zeaxanthin (Z) to brain function using functional magnetic resonance imaging (fMRI). It was hypothesized that L and Z supplementation in older adults would enhance neural efficiency (i.e., reduce activation) and cognitive performance on a verbal learning task relative to placebo. METHODS A total of 44 community-dwelling older adults (mean age=72 years) were randomly assigned to receive either placebo or L+Z supplementation (12 mg/daily) for 1 year. Neurocognitive performance was assessed at baseline and post-intervention on an fMRI-adapted task involving learning and recalling word pairs. Imaging contrasts of blood-oxygen-level-dependent (BOLD) signal were created by subtracting active control trials from learning and recall trials. A flexible factorial model was employed to investigate the expected group (placebo vs. supplement) by time (baseline vs. post-intervention) interaction in pre-specified regions-of-interest. RESULTS L and Z appeared to buffer cognitive decline on the verbal learning task (Cohen's d=.84). Significant interactions during learning were observed in left dorsolateral prefrontal cortex and anterior cingulate cortex (p < .05, family-wise-error corrected). However, these effects were in the direction of increased rather than decreased BOLD signal. Although the omnibus interaction was not significant during recall, within-group contrasts revealed significant increases in left prefrontal activation in the supplement group only. CONCLUSIONS L and Z supplementation appears to benefit neurocognitive function by enhancing cerebral perfusion, even if consumed for a discrete period of time in late life. (JINS, 2018, 24, 77-90).
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Zamroziewicz MK, Talukdar MT, Zwilling CE, Barbey AK. Nutritional status, brain network organization, and general intelligence. Neuroimage 2017; 161:241-250. [DOI: 10.1016/j.neuroimage.2017.08.043] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2017] [Revised: 08/13/2017] [Accepted: 08/14/2017] [Indexed: 11/25/2022] Open
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Antony JM, Weaver I, Rueffer M, Guthrie N, Evans M. The Essentials of a Global Index for Cognitive Function. Transl Neurosci 2017; 8:87-96. [PMID: 28924492 PMCID: PMC5597950 DOI: 10.1515/tnsci-2017-0014] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2017] [Accepted: 08/02/2017] [Indexed: 12/11/2022] Open
Abstract
Cognition is comprised of the faculties: perception, creativity, intuition, and ratiocination. Optimal levels of cognition are needed for independent functioning and balanced living. With an aging population that continues to grow, dietary supplements that tilt the balance towards maintenance of cognition are being marketed for vulnerable populations facing these challenges. Randomized clinical trials provide the causal inference necessary to define the efficacy of emerging nutraceuticals. Cognition testing, in particular, requires a battery of tests that encompass all brain regions involved in cognition so as to provide endpoints necessary for product validation. The lack of well controlled studies for comparison analyses, limited sample sizes, ambiguous dosages, and poor cognitive measures result in data that cannot be compared across studies to determine the efficacy of supplements claiming to enhance cognition. Clinical trials for the nutraceutical industry should consider the multifaceted nature of supplements, where clinical endpoints must be comprehensive while remaining feasible. Combining endpoints of cognition with physiological biomarkers of immunity and metabolism to arrive at a global index for cognitive health may be necessary for claim substantiation in order to fully justify and scientifically validate improvements in cognitive health. The issues and needs of a global index will be discussed here.
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Affiliation(s)
| | - Ian Weaver
- Department of Psychology and Neuroscience, Dalhousie University, Halifax, NS B3H 4R2, Canada
| | - Matthew Rueffer
- Robarts Clinical Trials, 100 Dundas St, London, ON N6A 5B6, Canada
| | - Najla Guthrie
- KGK Science Inc. 1440, One London Place, London, ON, N6A 5R8, Canada
| | - Malkanthi Evans
- KGK Science Inc. 1440, One London Place, London, ON, N6A 5R8, Canada
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Phillips C. Lifestyle Modulators of Neuroplasticity: How Physical Activity, Mental Engagement, and Diet Promote Cognitive Health during Aging. Neural Plast 2017; 2017:3589271. [PMID: 28695017 PMCID: PMC5485368 DOI: 10.1155/2017/3589271] [Citation(s) in RCA: 125] [Impact Index Per Article: 17.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2017] [Revised: 05/01/2017] [Accepted: 05/28/2017] [Indexed: 12/24/2022] Open
Abstract
The number of the elderly across the globe will approximate 2.1 billion by 2050. Juxtaposed against this burgeoning segment of the population is evidence that nonpathological aging is associated with an increased risk for cognitive decline in a variety of domains, changes that can cause mild disability even before the onset of dementia. Given that pharmacological treatments that mitigate dementia are still outstanding, alternative therapeutic options are being investigated increasingly. The results from translational studies have shown that modifiable lifestyle factors-including physical activity, cognitive engagement, and diet-are a key strategy for maintaining brain health during aging. Indeed, a multiplicity of studies has demonstrated relationships between lifestyle factors, brain structure and function, and cognitive function in aging adults. For example, physical activity and diet modulate common neuroplasticity substrates (neurotrophic signaling, neurogenesis, inflammation, stress response, and antioxidant defense) in the brain whereas cognitive engagement enhances brain and cognitive reserve. The aims of this review are to evaluate the relationship between modifiable lifestyle factors, neuroplasticity, and optimal brain health during aging; to identify putative mechanisms that contribute positive brain aging; and to highlight future directions for scientists and clinicians. Undoubtedly, the translation of cutting-edge knowledge derived from the field of cognitive neuroscience will advance our understanding and enhance clinical treatment interventions as we endeavor to promote brain health during aging.
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Omega-3 Supplementation and the Neural Correlates of Negative Affect and Impulsivity: A Double-Blind, Randomized, Placebo-Controlled Trial in Midlife Adults. Psychosom Med 2017; 79:549-556. [PMID: 28121722 PMCID: PMC5453831 DOI: 10.1097/psy.0000000000000453] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
OBJECTIVE In clinical trials, omega-3 fatty acid supplementation improves symptoms in psychiatric disorders involving dysregulated mood and impulse control, yet it is unclear whether in healthy adults, omega-3 fatty acid supplementation affects mood, impulse control, and the brain systems supporting these processes. Accordingly, this study tested the hypotheses that eciosapentaenoic (EPA) and docosahexaenoic (DHA) acid supplementation reduces negative affect and impulsive behaviors in healthy adults and that these changes correspond to alterations in corticolimbic and corticostriatal brain systems, which support affective and impulsive processes. METHODS Healthy volunteers (N = 272) consuming 300 mg/d or less of EPA and DHA were enrolled in a double-blind, randomized, placebo controlled clinical trial. The participants received either capsules providing 1000 mg of EPA and 400 mg of DHA versus identical appearing soybean oil capsules per day for 18 weeks. Negative affect and impulsivity were measured by questionnaire and ecological momentary assessment, as well as functional alterations in corticolimbic and corticostriatal brain systems evoked by standardized functional magnetic resonance imaging tasks. RESULTS There were no group by time interactions for any questionnaire or ecological momentary assessment measures of mood and impulsivity. Likewise, no group by time interactions were observed for functional magnetic resonance imaging responses evoked within corticolimbic and corticostriatal systems. CONCLUSIONS In healthy adults with low intake of omega-3 fatty acids, moderate-dose supplementation for 18 weeks did not alter affect or impulsive behaviors nor alter corticolimbic and corticostriatal brain functionality. TRIAL REGISTRATION Trial number NCT00663871.
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Cederholm T. Fish consumption and omega-3 fatty acid supplementation for prevention or treatment of cognitive decline, dementia or Alzheimer's disease in older adults - any news? Curr Opin Clin Nutr Metab Care 2017; 20:104-109. [PMID: 27977429 DOI: 10.1097/mco.0000000000000350] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE OF REVIEW Twenty years of research indicates that fish and n-3 fatty acids (FAs), for example docosahexaenoic acid, may attenuate cognitive decline including Alzheimer's disease in older people. This review concerns reports during 2015-2016 in humans. RECENT FINDINGS One prospective cohort study showed that seafood consumption was related to less neuritic plaques and neurofibrillary tangles in brain autopsies from elderly care residents. In a large 5-year intervention no effects on cognition could be shown either in n-3 FA supplemented or in control patients. Two meta-analyses in community-dwelling patients support preservation of cognition with higher fish intake. Older adults with memory complaints may improve cortical blood flow during memory challenges by n-3 FA supplementation. Recalculations from a report in Alzheimer's disease patients indicated a dose-response pattern between increments of serum n-3 FAs and cognitive improvement. Still, a Cochrane review (using three randomized control trials) concluded that n-3 FAs cannot provide any 6-month benefit in patients with mild/moderate Alzheimer's disease. SUMMARY The accumulated knowledge indicates that healthy populations may have preventive benefits from fish and docosahexaenoic acid intake, like older adults with memory complaints/mild cognitive impairment, and maybe subgroups of patients with mild/moderate Alzheimer's disease may also show such benefits. Still, more studies are needed.
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Affiliation(s)
- Tommy Cederholm
- Departments of Geriatric Medicine, Uppsala University Hospital and Public Health and Caring Sciences, Clinical Nutrition and Metabolism, Uppsala University, Uppsala, Sweden
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Hooper C, De Souto Barreto P, Payoux P, Salabert AS, Guyonnet S, Andrieu S, Sourdet S, Delrieu J, Vellas B. Association of Cortical β-Amyloid with Erythrocyte Membrane Monounsaturated and Saturated Fatty Acids in Older Adults at Risk of Dementia. J Nutr Health Aging 2017; 21:1170-1175. [PMID: 29188876 DOI: 10.1007/s12603-017-0975-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
OBJECTIVES We examined the relationships between erythrocyte membrane monounsaturated fatty acids (MUFAs) and saturated fatty acids (SFAs) and cortical β-amyloid (Aβ) load in older adults reporting subjective memory complaints. DESIGN This is a cross-sectional study using data from the Multidomain Alzheimer Preventive Trial (MAPT); a randomised controlled trial. SETTING French community dwellers aged 70 or over reporting subjective memory complaints, but free from a diagnosis of clinical dementia. PARTICIPANTS Participants of this study were 61 individuals from the placebo arm of the MAPT trial with data on erythrocyte membrane fatty acid levels and cortical Aβ load. MEASUREMENTS Cortical-to-cerebellar standard uptake value ratios were assessed using [18F] florbetapir positron emission tomography (PET). Fatty acids were measured in erythrocyte cell membranes using gas chromatography. Associations between erythrocyte membrane MUFAs and SFAs and cortical Aβ load were explored using adjusted multiple linear regression models and were considered significant at p ≤ 0.005 (10 comparisons) after correction for multiple testing. RESULTS We found no significant associations between fatty acids and cortical Aβ load using multiple linear regression adjusted for age, sex, education, cognition, PET-scan to clinical assessment interval, PET-scan to blood collection interval and apolipoprotein E (ApoE) status. The association closest to significance was that between erythrocyte membrane stearic acid and Aβ (B-coefficient 0.03, 95 % CI: 0.00,0.05, p = 0.05). This association, although statistically non-significant, appeared to be stronger amongst ApoE ε4 carriers (B-coefficient 0.04, 95 % CI: -0.01,0.09, p = 0.08) compared to ApoE ε4 non-carriers (B-coefficient 0.02, 95 % CI: -0.01,0.05, p = 0.18) in age and sex stratified analysis. CONCLUSION Future research in the form of large longitudinal observational study is needed to validate our findings, particularly regarding the potential association of stearic acid with cortical Aβ.
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Affiliation(s)
- C Hooper
- Claudie Hooper, Gérontopôle, Department of Geriatrics, CHU Toulouse, Purpan University Hospital, Toulouse, France. , Tel : +33 (5) 61 77 64 25, Fax : +33 (5) 61 77 64 75
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Hooper C, De Souto Barreto P, Coley N, Cantet C, Cesari M, Andrieu S, Vellas B. Cognitive Changes with Omega-3 Polyunsaturated Fatty Acids in Non-Demented Older Adults with Low Omega-3 Index. J Nutr Health Aging 2017; 21:988-993. [PMID: 29083439 DOI: 10.1007/s12603-017-0957-5] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
OBJECTIVES To investigate the changes in specific domains of cognitive function in older adults reporting subjective memory complaints with a low omega-3 index receiving omega 3 polyunsaturated fatty acid (n-3 PUFA) supplementation or placebo. DESIGN This is a secondary exploratory analysis of the Multidomain Alzheimer Preventive Trial (MAPT) using subjects randomized to the n-3 PUFA supplementation or placebo group. SETTING French community dwellers aged 70 or over reporting subjective memory complaints, but free from clinical dementia. PARTICIPANTS A subgroup of MAPT subjects in the lowest quartile of omega-3 index distribution with baseline values ≤ 4.83 % (n = 183). INTERVENTION The n-3 PUFA supplementation group consumed a daily dose of DHA (800 mg) and EPA (a maximum amount of 225 mg) for 3 years. The placebo group received identical capsules comprising liquid paraffin oil. MEASUREMENTS Linear mixed-model repeated-measures analyses were used including baseline, 6, 12, 24 and 36-month follow-up data to assess between-group differences in the change in eight cognitive tests over 36 months. RESULTS There was less decline on the Controlled Oral Word Association Test (COWAT) in the n-3 PUFA supplementation group compared to placebo (p = 0.009; between group mean difference over 36 months, 2.3; 95% CI, 0.6,4.0). No significant differences for any of the other cognitive tests were found, including other tests of executive functioning, although, numerically all results were in favour of the n-3 PUFA supplementation. CONCLUSIONS We found some evidence that n-3 PUFAs might be beneficial for the maintenance of executive functioning in older adults at risk of dementia with low omega-3 index, but this exploratory finding requires further confirmation. A larger specifically designed randomised controlled trial could be merited.
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Affiliation(s)
- C Hooper
- Claudie Hooper, Gérontopôle, Department of Geriatrics, CHU Toulouse, Purpan University Hospital, Toulouse, France: , Tel : +33 (5) 61 77 64 25, Fax : +33 (5) 61 77 64 75
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Zamroziewicz MK, Paul EJ, Zwilling CE, Johnson EJ, Kuchan MJ, Cohen NJ, Barbey AK. Parahippocampal Cortex Mediates the Relationship between Lutein and Crystallized Intelligence in Healthy, Older Adults. Front Aging Neurosci 2016; 8:297. [PMID: 27999541 PMCID: PMC5138207 DOI: 10.3389/fnagi.2016.00297] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2016] [Accepted: 11/22/2016] [Indexed: 11/13/2022] Open
Abstract
Introduction: Although, diet has a substantial influence on the aging brain, the relationship between dietary nutrients and aspects of brain health remains unclear. This study examines the neural mechanisms that mediate the relationship between a carotenoid important for brain health across the lifespan, lutein, and crystallized intelligence in cognitively intact older adults. We hypothesized that higher serum levels of lutein are associated with better performance on a task of crystallized intelligence, and that this relationship is mediated by gray matter structure of regions within the temporal cortex. This investigation aims to contribute to a growing line of evidence, which suggests that particular nutrients may slow or prevent aspects of cognitive decline by targeting specific features of brain aging. Methods: We examined 76 cognitively intact adults between the ages of 65 and 75 to investigate the relationship between serum lutein, tests of crystallized intelligence (measured by the Wechsler Abbreviated Scale of Intelligence), and gray matter volume of regions within the temporal cortex. A three-step mediation analysis was implemented using multivariate linear regressions to control for age, sex, education, income, depression status, and body mass index. Results: The mediation analysis revealed that gray matter thickness of one region within the temporal cortex, the right parahippocampal cortex (Brodmann's Area 34), partially mediates the relationship between serum lutein and crystallized intelligence. Conclusion: These results suggest that the parahippocampal cortex acts as a mediator of the relationship between serum lutein and crystallized intelligence in cognitively intact older adults. Prior findings substantiate the individual relationships reported within the mediation, specifically the links between (i) serum lutein and temporal cortex structure, (ii) serum lutein and crystallized intelligence, and (iii) parahippocampal cortex structure and crystallized intelligence. This report demonstrates a novel structural mediation between lutein status and crystallized intelligence, and therefore provides further evidence that specific nutrients may slow or prevent features of cognitive decline by hindering particular aspects of brain aging. Future work should examine the potential mechanisms underlying this mediation, including the antioxidant, anti-inflammatory, and membrane modulating properties of lutein.
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Affiliation(s)
- Marta K Zamroziewicz
- Decision Neuroscience Laboratory, University of Illinois Urbana-ChampaignUrbana, IL, USA; Beckman Institute for Advanced Science and Technology, University of Illinois Urbana-ChampaignUrbana, IL, USA; Neuroscience Program, University of Illinois Urbana-ChampaignUrbana, IL, USA
| | - Erick J Paul
- Decision Neuroscience Laboratory, University of Illinois Urbana-ChampaignUrbana, IL, USA; Beckman Institute for Advanced Science and Technology, University of Illinois Urbana-ChampaignUrbana, IL, USA
| | - Chris E Zwilling
- Decision Neuroscience Laboratory, University of Illinois Urbana-ChampaignUrbana, IL, USA; Beckman Institute for Advanced Science and Technology, University of Illinois Urbana-ChampaignUrbana, IL, USA
| | - Elizabeth J Johnson
- Jean Mayer USDA Human Nutrition Center on Aging, Tufts University Boston, MA USA
| | - Matthew J Kuchan
- Research, Scientific and Medical Affairs, Abbott Nutrition Columbus, OH, USA
| | - Neal J Cohen
- Beckman Institute for Advanced Science and Technology, University of Illinois Urbana-ChampaignUrbana, IL, USA; Neuroscience Program, University of Illinois Urbana-ChampaignUrbana, IL, USA; Department of Psychology, University of Illinois Urbana-ChampaignUrbana, IL, USA; Carle Neuroscience Institute, Carle Foundation HospitalUrbana, IL, USA
| | - Aron K Barbey
- Decision Neuroscience Laboratory, University of Illinois Urbana-ChampaignUrbana, IL, USA; Beckman Institute for Advanced Science and Technology, University of Illinois Urbana-ChampaignUrbana, IL, USA; Neuroscience Program, University of Illinois Urbana-ChampaignUrbana, IL, USA; Department of Psychology, University of Illinois Urbana-ChampaignUrbana, IL, USA; Carle Neuroscience Institute, Carle Foundation HospitalUrbana, IL, USA; Department of Internal Medicine, University of Illinois Urbana-ChampaignUrbana, IL, USA; Department of Speech and Hearing Science, University of Illinois Urbana-ChampaignUrbana, IL, USA; Institute for Genomic Biology, University of Illinois Urbana-ChampaignChampaign, IL, USA
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Yanai H. Effects of N-3 Polyunsaturated Fatty Acids on Dementia. J Clin Med Res 2016; 9:1-9. [PMID: 27924168 PMCID: PMC5127208 DOI: 10.14740/jocmr2815w] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/11/2016] [Indexed: 12/30/2022] Open
Abstract
N-3 polyunsaturated fatty acids (PUFAs) including α-linolenic acid (ALA), eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) have anti-inflammatory effects and neuronal protective functions and may benefit prevention of dementia; however, the epidemiological evidence is very limited. Therefore, the literature about the association between n-3 PUFA and dementia was searched, by using Pubmed. In the analyses of observational studies, n-3 PUFA has been reported to be beneficially associated with dementia in 17 studies; however, the beneficial association between n-3 PUFA and dementia was denied by three studies. In the analyses of intervention studies, n-3 PUFA supplementation was beneficially associated with dementia in eight studies; however, five studies reported the negligible effect of n-3 PUFA for dementia. N-3 PUFA may improve Alzheimer’s disease by increasing clearance of amyloid-β peptide, neurotrophic and neuroprotective factors, and by anti-inflammatory effects. In conclusion, patients with mild memory and/or cognitive impairment can be treated by a long-term and higher intake of n-3 PUFA.
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Affiliation(s)
- Hidekatsu Yanai
- Department of Internal Medicine, National Center for Global Health and Medicine Kohnodai Hospital, 1-7-1 Kohnodai, Ichikawa, Chiba 272-0034, Japan.
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Shaffer J. Neuroplasticity and Clinical Practice: Building Brain Power for Health. Front Psychol 2016; 7:1118. [PMID: 27507957 PMCID: PMC4960264 DOI: 10.3389/fpsyg.2016.01118] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2016] [Accepted: 07/12/2016] [Indexed: 01/26/2023] Open
Abstract
The focus of this review is on driving neuroplasticity in a positive direction using evidence-based interventions that also have the potential to improve general health. One goal is to provide an overview of the many ways new neuroscience can inform treatment protocols to empower and motivate clients to make the lifestyle choices that could help build brain power and could increase adherence to healthy lifestyle changes that have also been associated with simultaneously enhancing vigorous longevity, health, happiness, and wellness. Another goal is to explore the use of a focus in clinical practice on helping clients appreciate this new evidence and use evolving neuroscience in establishing individualized goals, designing strategies for achieving them and increasing treatment compliance. The timing is urgent for such interventions with goals of enhancing brain health across the lifespan and improving statistics on dementia worldwide.
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Affiliation(s)
- Joyce Shaffer
- Department of Psychiatry and Behavioral Sciences, University of Washington Seattle, WA, USA
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Zamroziewicz MK, Barbey AK. Nutritional Cognitive Neuroscience: Innovations for Healthy Brain Aging. Front Neurosci 2016; 10:240. [PMID: 27375409 PMCID: PMC4893495 DOI: 10.3389/fnins.2016.00240] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2016] [Accepted: 05/17/2016] [Indexed: 11/29/2022] Open
Abstract
Nutritional cognitive neuroscience is an emerging interdisciplinary field of research that seeks to understand nutrition's impact on cognition and brain health across the life span. Research in this burgeoning field demonstrates that many aspects of nutrition—from entire diets to specific nutrients—affect brain structure and function, and therefore have profound implications for understanding the nature of healthy brain aging. The aim of this Focused Review is to examine recent advances in nutritional cognitive neuroscience, with an emphasis on methods that enable discovery of nutrient biomarkers that predict healthy brain aging. We propose an integrative framework that calls for the synthesis of research in nutritional epidemiology and cognitive neuroscience, incorporating: (i) methods for the precise characterization of nutritional health based on the analysis of nutrient biomarker patterns (NBPs), along with (ii) modern indices of brain health derived from high-resolution magnetic resonance imaging (MRI). By integrating cutting-edge techniques from nutritional epidemiology and cognitive neuroscience, nutritional cognitive neuroscience will continue to advance our understanding of the beneficial effects of nutrition on the aging brain and establish effective nutritional interventions to promote healthy brain aging.
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Affiliation(s)
- Marta K Zamroziewicz
- Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-ChampaignUrbana, IL, USA; Neuroscience Program, University of Illinois at Urbana-ChampaignChampaign, IL, USA
| | - Aron K Barbey
- Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-ChampaignUrbana, IL, USA; Neuroscience Program, University of Illinois at Urbana-ChampaignChampaign, IL, USA; Carle R. Woese Institute for Genomic Biology, University of Illinois at Urbana-ChampaignChampaign, IL, USA; Department of Bioengineering, University of Illinois at Urbana-ChampaignChampaign, IL, USA; Department of Internal Medicine, University of Illinois at Urbana-ChampaignChampaign, IL, USA; Department of Psychology, University of Illinois at Urbana-ChampaignChampaign, IL, USA; Department of Speech and Hearing Science, University of Illinois at Urbana-ChampaignChampaign, IL, USA
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