Can the course of early Alzheimer’s disease be delayed by consuming a special mixture of nutrients? This question was investigated in the European study called ‘LipiDiDiet’ led by Prof. Tobias Hartmann. 

The scientists recruited Alzheimer’s patients, who were in the early stages of the disease, to test the effectiveness of a specific nutritional drink called ‘Souvenaid’. Souvenaid was developed as a medical dietary food for the treatment of early-stage Alzheimer’s disease and is marketed by Nutricia (Danone Group). It contains a defined nutrient combination of long-chain omega-3 fatty acids, phospholipids, choline, B vitamins (B6, B12 and folic acid), vitamins C and E, selenium and uridine monophosphate. 

In this randomized double-blind study, the 311 participants were divided into two groups. The treatment group received the drink daily for breakfast. The control group was given daily  the same amount of a placebo drink, but with identical taste, consistency, color and calorie content. Neither patients, physicians nor researchers knew who was given the placebo or the multinutrient drink. 

The primary study endpoint was the slowing of cognitive decline. It was measured by a neuropsychological test battery, i.e., a combination of standardized cognitive testing procedures which measures not only the change in cognitive performance but also the ability to perform certain executive functions, such as planning, strategy and working memory. Furthermore, clinical aspects were also investigated using imaging techniques. Thus, structural brain changes could be directly recorded and assessed. 

Initial interim results after 24 months indicated some efficacy of the sip feed, but the differences in cognitive deterioration between the two patient groups were not significant. 

In September 2020, results after 36 months of treatment were published. They revealed significant differences between the two groups: Patients in the intervention group were measured to have 22 percent less brain atrophy, meaning that the brain mass of the treated Alzheimer’s patients had shrunk significantly less than that of the control group. Thus, the degenerative change process in the brain could be significantly slowed down by the nutrient preparation. In particular, the deterioration in the memory region of the brain (hippocampus), was 33 percent less in the treated patients than in the control group. It was also observed in regard to cognitive brain performance: it deteriorated 60 percent less, i.e. significantly less, in the treated subjects than in the no-treated patients.

Thus, the results of this study made it clear that such nutritional supplementation is not an effective concept in the short term. The effects seem to consolidate only with longer-term treatment, which was more than clearly shown by the comparison after 3 years with the interim results after 2 years. The researchers further found that the positive effects of the sip feed increased over the course of the treatment period and were not only focused on the memory region, but also extended to other cognitive areas. For example, the subjects were better able to cope with everyday challenges, such as paying bills, remembering routes, etc., than the control group.

This means that long-term intake of this specific multinutrient combination partially protects brain structures and reduces cognitive and functional decline in early Alzheimer’s disease. Thus, these nutrients appear to play a central role in reducing the neurodegenerative process in AD, suggesting a special nutritional need in AD. 

However, since it can be assumed that the disease begins decades before the first symptoms appear, but this cannot yet be measured with current methods, the timing to start therapy would also be crucial: the earlier, the better. Thus, not only the long-term duration of treatment would be important, but also the early start of treatment in the course of the disease. 

Despite intensive research, there is unfortunately still no medication that could cure Alzheimer’s disease. The currently available drugs can temporarily improve the symptoms, but let the patients fall back into the initial situation after some time. A sustained 3-year benefit of treatment, such as that achieved in this study with a defined nutrient mixture, has not yet been reported in incipient AD. With this in mind, the slower progression of the disease would already be a great success and is certainly a good start. 

These findings emphasize once again that AD is a generalized metabolic disorder in which monocausal therapies alone cannot lead to success, but multifactorial strategies must be used. And the international FINGER study (Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability) has already impressively demonstrated that multimodal prevention approaches can also pass clinical testing effectively. The ‘Souvenaid’ study is certainly a good start, as a sustained positive effect in terms of cognition, function and brain atrophy in an intervention for incipient Alzheimer’s disease has not yet been reported. Future studies could further clarify whether the efficacy of nutrient supplementation can be further enhanced if started at an even earlier stage, over a period longer than 3 years, as part of a multimodal intervention (e.g. FINGER trial) or in combination with pharmaceutical therapies.

Conclusion: 

The results of the aforementioned studies impressively underline that the multifactorial catalog of measures proposed by Knowledge stops Dementia – and especially a conscious diet that protects the brain – is the royal road in dementia prevention. It offers us a multitude of prevention strategies with which we can reduce our individual risk of Alzheimer’s disease by consistently minimizing avoidable risk factors and by adhering to a healthy lifestyle that includes not only nutrition but also other factors such as exercise, quality of sleep, social contacts, and so on. At the project ‘Knowledge stops Dementia’ you will find a lot more exciting and helpful information on this, so that you can maintain your mental health for as long as possible!

References:

  1. Soininen H et al. (2017) 36-month LipiDiDiet multinutrient clinical trial in prodromal Alzheimer’s disease . Alzheimer’s and Dementia: 1-12 
  2. Soininen H et al. (2020) 24-month intervention with a specific mulitnutrient in people with predromal Alzheimer´s disease (LipiDiDiet): a randomised, double-blind, controlled trial. Lancet Neurol 16: 965–975 
  3. Ngandu T et al. (2015) A 2 year multidomain intervention of diet, exercise, cognitive training, and vascular risk monitoring versus control to prevent cognitive decline in at-risk elderly people (FINGER): a randomised controlled trial. Lancet 365: 2255–2263 
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Knowledge stops Dementia will continue to thrive in the coming year. 480 individual donors, with an average donation of more than 25 euros, decided to support our work. We thank you from the bottom of our hearts!

From a financial point of view, this means that the Knowledge stops Dementia team can continue to work scientifically, journalistically and organizationally free of economic pressure in 2021. From an idealistic point of view, we are especially impressed by the large number of private individual donations. This shows us that we reach and move many people. Knowledge stops Dementia is crowd financed in the best sense of the word and we are proud of that!

However, we are not resting on this success. There is still a lot to be done regarding a disease that affects 35 million people worldwide. By the way, because dementia is a global problem, we present all our content on this page in English as well. The individual menu items on our project page are already filled with comprehensive knowledge about dementia and Alzheimer’s disease.

In addition to further publications that are already in progress, the expansion of our network is at the top of our project plan for the coming year. Thanks to your help and with your support, we want to become an unmistakable voice that draws attention to the relevance of lifestyle factors in the treatment and prevention of dementia with evidence-based evidence.

What exactly can you expect from us next year?

  • The therapist and partner database is now beginning to take shape. We want to help ensure that those affected by dementia receive the best possible advice. We are bringing together therapists who treat according to the latest research and patients.
  • In the course of the coming year, a handbook will be published, which summarizes the essential facts about dementia and lifestyle issues, scientifically proven and at the same time formulated in a way that can be understood by the general public It is intended to provide you with assistance in prevention and therapy.
  • In our newsfeed on our website you will find news every three weeks, which our scientific editorial team researches and prepares for you.
  • A project brochure will soon be available for download and in printed form on request. You are welcome to help with the distribution and thus make Knowledge stops Dementia even better known.
  • Of course we will continue to answer the numerous questions that reach us personally and help where we can.

In addition, there will be countless hours of all that work that usually remain invisible. Until information makes it into our publications, extensive research, discussions, debates and votes in the team are necessary. Of course, we always review the latest studies and research results on the topic of dementia and are committed to an extremely high quality standard.

As already implemented by our partner project Life-SMS (Lifestyle Strategies for Multiple Sclerosis), we would like to collect and publish detailed reports of the experiences of those affected in the future. You can also help us here: Increase the awareness of Knowledge stops Dementia in your family, among friends, relatives and work colleagues – talk about us!

As a special thank you, all our donors in November received in advance and exclusively the fact sheet: Dementia and Intestinal Health, which the Academy of Human Medicine developed to support our project. We are very happy that, thanks to your great support, we can now make this publication available for free download to all interested parties.

We wish you a Merry Christmas and thank you once again!

Your Knowledge stops Dementia-Team

Of course you can continue to support us financially through our permanent Betterplace site. Especially high planning security is provided by small but numerous and steady monthly contributions.

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The 2020 report of the Lancet Commission on Dementia Prevention, Intervention, and Care lists 12 modifiable risk factors that could help prevent dementia. This new report provides some important updates to the previous document, published in 2017.

The 2017 report had already recognized that acting on certain modifiable factors could help reduce a person’s risk of developing dementia. These factors are:

  • a lower level of education
  • hearing loss
  • hypertension
  • obesity
  • smoking
  • depression
  • low social contact
  • physical inactivity
  • diabetes

To the original nine factors, the new report has added 3 more:

  • head injuries
  • excessive alcohol intake
  • air pollution

Head injuries – Traumatic brain injuries are usually caused by car, motorcycle, and bicycle accidentes; military exposures; firearms; boxing, horse riding, and other recreational sports, most of them occurring during midlife. Falls are the most common cause of brain injuries later in life.

Excessive alcohol intake – Even though it has been previously shown that low doses of alcohol can prevent cardiovascular diseases, heavy drinking is associated with brain changes, cognitive impairment, and dementia – a risk known for centuries. Drinking more  than 21 units of alcohol per week (1 unit of alcohol=10 ml or 8 g pure alcohol) is  associated with a high  risk of dementia. 

Air pollution – Airborne particulate pollutants accelerate neuro- degenerative processes through cerebrovascular and cardiovascular disease, Aβ deposition, and amyloid precursor protein processing. High nitrogen dioxide (NO2) concentration, fine ambient particulate matter (PM)  from traffic exhaust and PM  from residential wood burning are associated with increased dementia incidence.

Together, the 12 modifiable risk factors account for around 40% of worldwide dementias, which consequently could theoretically be prevented or delayed. 

It is clear that the contribution of risk factors to the development of dementia begins early and continues throughout life, so it is never too early or too late to initiate any measures that will mitigate the negative effect of the 12 risk factors. Changes in any risk factor alone can prevent or delay dementia symptoms and should always be encouraged.

What can be done?

Preventive actions require both policy and individual engagement. Public health programs should be developed to increase social, cognitive and physical activities and to improve cardio-vascular health.  

Furthermore, the entire food system (including production and marketing) should be revised and changed: the goal is to stimulate the consumption of natural and nutritious foods and to reduce the consumption of sugary and ultra-processed foods.

Public health programs should be offered to the general population (with special attention to high-risk groups), including:

  • hypertension and diabetes treatment in midlife
  • prevention of head injury through traffic awareness campaigns and use of safety equipment at work and sports
  • support smoking cessation
  • reduce air pollution, promoting use of bicycles and public transport. Reduce second-hand tobacco smoke exposure.
  • encourage use of hearing aids for hearing loss and reduce hearing loss by protection of ears from excessive noise exposure
  • provide all children with primary and secondary education
  • support treatment and prevention of depression
  • limit alcohol intake.

At individual level, a healthy lifestyle including a balanced diet, regular physical activity, social and intellectual activities throughout life and prioritizing contact with nature should be sought. 

Conclusion: At this point the project “Knowledge stops Dementia” can help by keeping you up to date on what is known and new about dementia prevention and treatment! On our webpage you find an increasing amount of information covering the topics above, hopefully supporting you in the implementation of personal measures for prevention and recovering.

We are happy to support you in living a healthy life and minimising your personal risk of dementia. At the same time, we also offer support for your loved ones who are already suffering from some form of dementia. Don’t forget to register for our newsfeed! Not only you but also your children and grandchildren can only win!

Photo by Deva Darshan on Unsplash

Reference:

Livingston G, Huntley J, Sommerlad A, et al. Dementia prevention, intervention, and care: 2020 report of the Lancet Commission. Lancet. 2020;396(10248):413-446.

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