New Perspectives on Alzheimer’s Disease and Nutrition

Article type: Meeting Report

Authors: Gustafson, Deborah R.^{a; b} | Clare Morris, Martha^c | Scarmeas, Nikolaos^{d; e} | Shah, Raj C.^f | Sijben, John^g | Yaffe, Kristine^{h; *} | Zhu, Xiongweiⁱ

Affiliations: [a] Department of Neurology, State University of New York - Downstate Medical Center, Brooklyn, New York, NY, USA | [b] Section for Psychiatry and Neurochemistry, Neuropsychiatric Epidemiology Unit, Sahlgrenska Academy at University of Gothenburg, Institute for Neuroscience and Physiology, NeuroPsychiatric Epidemiology Unit, Wallinsgatan, Gothenburg, Sweden | [c] Section on Nutrition and Nutritional Epidemiology, Department of Internal Medicine, Rush University Medical Center, Chicago, IL, USA | [d] Taub Institute for Research in Alzheimer’s Disease and the Aging Brain, the Gertrude H. Sergievsky Center, Department of Neurology, Columbia University, New York, NY, USA | [e] Department of Social Medicine, Psychiatry and Neurology, National and Kapodistrian, University of Athens, Athens, Greece | [f] Department of Family Medicine and Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, IL, USA | [g] Nutricia Research, Nutricia Advanced Medical Nutrition, Utrecht, Netherlands | [h] Department of Psychiatry and Department of Neurology, University of California San Francisco; and San Francisco VA Medical Center, San Francisco, CA, USA | [i] Department of Pathology, Case Western Reserve University, Cleveland, OH, USA

Correspondence: [*] Correspondence to: Kristine Yaffe, MD, Roy and Marie Scola Endowed Chair in Psychiatry, Vice Chair for Clinical & Translational Research, Professor, Department of Psychiatry, Neurology, and Epidemiology and Biostatistics, University of California, San Francisco, Chief, Geriatric Psychiatry, San Francisco VAMC, 4150 Clement St, San Francisco, CA 94121, USA. Tel.: +1 415 221 4810 x3985; Fax: +1 415 750 6641; kristine.yaffe@ucsf.edu

Abstract: Accumulating evidence shows nutritional factors influence the risk of developing Alzheimer’s disease (AD) and its rate of clinical progression. Dietary and lifestyle guidelines to help adults reduce their risk have been developed. However, the clinical dementia picture remains complex, and further evidence is required to demonstrate that modifying nutritional status can protect the brain and prevent, delay, or reduce pathophysiological consequences of AD. Moreover, there is a pressing need for further research because of the global epidemic of overweight and obesity combined with longer life expectancy of the general population and generally observed decreases in body weight with aging and AD. A new research approach is needed, incorporating more sophisticated models to account for complex scenarios influencing the relationship between nutritional status and AD. Systematic research should identify and address evidence gaps. Integrating longitudinal epidemiological data with biomarkers of disease, including brain imaging technology, and randomized controlled interventions may provide greater insights into progressive and subtle neurological changes associated with dietary factors in individuals at risk for or living with AD. In addition, greater understanding of mechanisms involved in nutritional influences on AD risk and progression, such as oxidative stress and loss of neuronal membrane integrity, will better inform possible interventional strategies. There is consensus among the authors that nutritional deficits, and even states of excess, are associated with AD, but more work is needed to determine cause and effect. Appropriately designed diets or nutritional interventions may play a role, but additional research is needed on their clinical–cognitive effectiveness.

Keywords: Alzheimer’s disease, cognition disorders, diet therapy, neuronal membrane, nutrition

DOI: 10.3233/JAD-150084

Journal: Journal of Alzheimer's Disease, vol. 46, no. 4, pp. 1111-1127, 2015