Supplementation With Carotenoids, Omega-3 Fatty Acids, and Vitamin E Has a Positive Effect on the Symptoms and Progression of Alzheimer’s Disease

Article type: Research Article

Authors: Nolan, John M.^{a; 1; *} | Power, Rebecca^{a; 1} | Howard, Alan N.^b | Bergin, Paula^a | Roche, Warren^a | Prado-Cabrero, Alfonso^a | Pope, George^c | Cooke, John^c | Power, Tommy^a | Mulcahy, Ríona^{a; c; d}

Affiliations: [a] Nutrition Research Centre Ireland, School of Health Sciences, South East Technological University, West Campus, Waterford, Ireland | [b] Howard Foundation, Cambridge, UK | [c] Age-Related Care Unit, Health Service Executive, University Hospital Waterford, Dunmore Road, Waterford, Ireland | [d] Royal College of Surgeons in Ireland, Saint Peter’s, Dublin, Ireland

Correspondence: [*] Correspondence to: Professor John Nolan, Nutrition Research Centre Ireland, School of Health Sciences, Carriganore House, South East Technological University, West Campus, Waterford, X91 K236, Ireland. Tel.: +353 87 271 74 74; E-mail: john.nolan@setu.ie.

Note: [1] John M. Nolan and Rebecca Power are contributed equally to this work.

Abstract: Background:Preliminary work by our center has reported behavior and functional benefits in patients with Alzheimer’s disease (AD) following targeted micronutritional supplementation. Objective:To build on the existing exploratory research and investigate the impact of these micronutrients on the natural progression of AD in a randomized controlled trial. Methods:Patients with mild-moderate AD consumed daily 1 g fish oil (of which 500 mg DHA, 150 mg EPA), 22 mg carotenoids (10 mg lutein, 10 mg meso-zeaxanthin, 2 mg zeaxanthin), and 15 mg vitamin E or placebo for 12 months in a double-blind, placebo-controlled, randomized clinical trial. Carotenoids, ω-3FAs, and vitamin E were quantified in blood. Carotenoids were also measured in skin. AD severity was measured using the mini-mental state examination and dementia severity rating scale tools. Behavior, mood, and memory were measured using an informant-based questionnaire. Results:Following 12 months of supplementation, the active group (n = 50) compared to the placebo group (n = 27), demonstrated statistically significant improvements in skin carotenoid measurements, blood carotenoids, ω-3FAs, and vitamin E concentrations (p < 0.05, for all). The active group also performed better in objective measures of AD severity (i.e., memory and mood), with a statistically significant difference reported in the clinical collateral for memory (p < 0.001). Conclusion:Exponential increases in the prevalence of AD and its relentless progressive nature is driving the need for interventions that help to ameliorate symptoms and improve quality of life in AD patients. Given the positive outcomes demonstrated in this trial, this combined micronutrient dietary supplement should be considered in the overall management of AD.

Keywords: Alzheimer’s disease, antioxidants, carotenoids, clinical collateral, disease management, disease progression, nutrition, omega-3 fatty acids, vitamin E

DOI: 10.3233/JAD-220556

Journal: Journal of Alzheimer's Disease, vol. 90, no. 1, pp. 233-249, 2022