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Macular Pigment, Visual Function, and Macular Disease among Subjects with Alzheimer's Disease: An Exploratory Study

Article type: Research Article

Authors: Nolan, John M.a; * | Loskutova, Ekaterinaa | Howard, Alan N.b; c | Moran, Rachela | Mulcahy, Rionad | Stack, Jima | Bolger, Maggied | Dennison, Jessicaa | Akuffo, Kwadwo Owusua | Owens, Niamha | Thurnham, David I.e | Beatty, Stephena

Affiliations: [a] Macular Pigment Research Group, Department of Chemical and Life Sciences, Waterford Institute of Technology, Waterford, Ireland | [b] Howard Foundation Cambridge, UK | [c] Downing College, University of Cambridge, Cambridge, UK | [d] Waterford Regional Hospital, Age-Related Care Unit, Waterford, Ireland | [e] Northern Ireland, Centre for Food and Health (NICHE), University of Ulster, Coleraine, UK

Correspondence: [*] Correspondence to: John Nolan, Macular Pigment Research Group, Vision Research Centre, Carriganore House, Waterford Institute of Technology, West Campus, Carriganore, Waterford, Ireland. Tel.: +353 51 834074; E-mail: jmnolan@wit.ie.

Keywords: Age-related macular degeneration, Alzheimer's disease, cognitive function, contrast sensitivity, lutein, meso-zeaxanthin, visual function, zeaxanthin

DOI: 10.3233/JAD-140507

Journal: Journal of Alzheimer's Disease, vol. 42, no. 4, pp. 1191-1202, 2014

Accepted 2 May 2014
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Published: 10 October 2014
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Abstract

Background:

The macula (central retina) contains a yellow pigment, comprising the dietary carotenoids lutein (L), zeaxanthin (Z), and meso-zeaxanthin, known as macular pigment (MP). The concentrations of MP’s constituent carotenoids in retina and brain tissue correlate, and there is a biologically-plausible rationale, supported by emerging evidence, that MP’s constituent carotenoids are also important for cognitive function.

Objective:

To investigate if patients with Alzheimer’s disease (AD) are comparable to controls in terms of MP and visual function.

Methods:

36 patients with moderate AD and 33 controls with the same age range participated. MP was measured using dual-wavelength autofluorescence (Heidelberg Spectralis®); cognitive function was assessed using a battery of cognition tests (including Cambridge Neuropsychological Test Automated Battery). Visual function was recorded by measuring best corrected visual acuity (BCVA) and contrast sensitivity (CS). Serum L and Z concentrations (by HPLC) and age-related macular degeneration (AMD, by retinal examination) status were also assessed.

Results:

In the AD group, central MP (i.e., at 0.23°) and MP volume were significantly lower than the control group (p < 0.001 for both), as were measures of BCVA, CS, and serum L and Z concentrations (p < 0.05, for all).

Conclusion:

AD patients were observed to exhibit significantly less MP, lower serum concentrations of L and Z, poorer vision, and a higher occurrence of AMD when compared to control subjects. A clinical trial in AD patients designed to investigate the impact of macular carotenoid supplementation with respect to MP, visual function, and cognitive function is merited.

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