Dataset Information

A ketogenic drink improves cognition in mild cognitive impairment: Results of a 6-month RCT.

ABSTRACT:

Introduction

Counteracting impaired brain glucose metabolism with ketones may improve cognition in mild cognitive impairment (MCI).

Methods

Cognition, plasma ketone response, and metabolic profile were assessed before and 6 months after supplementation with a ketogenic drink containing medium chain triglyceride (ketogenic medium chain triglyceride [kMCT]; 15 g twice/day; n = 39) or placebo (n = 44).

Results

Free and cued recall (Trial 1; P = .047), verbal fluency (categories; P = .024), Boston Naming Test (total correct answers; P = .033), and the Trail-Making Test (total errors; P = .017) improved significantly in the kMCT group compared to placebo (analysis of covariance; pre-intervention score, sex, age, education, and apolipoprotein E4 as covariates). Some cognitive outcomes also correlated positively with plasma ketones. Plasma metabolic profile and ketone response were unchanged.

Conclusions

This kMCT drink improved cognitive outcomes in MCI, at least in part by increasing blood ketone level. These data support further assessment of MCI progression to Alzheimer's disease.

SUBMITTER: Fortier M

PROVIDER: S-EPMC8048678 | biostudies-literature | 2021 Mar

REPOSITORIES: biostudies-literature

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Publications

A ketogenic drink improves cognition in mild cognitive impairment: Results of a 6-month RCT.

Fortier Mélanie M Castellano Christian-Alexandre CA St-Pierre Valérie V Myette-Côté Étienne É Langlois Francis F Roy Maggie M Morin Marie-Christine MC Bocti Christian C Fulop Tamas T Godin Jean-Philippe JP Delannoy Carla C Cuenoud Bernard B Cunnane Stephen C SC

Alzheimer's & dementia : the journal of the Alzheimer's Association 20201026 3

<h4>Introduction</h4>Counteracting impaired brain glucose metabolism with ketones may improve cognition in mild cognitive impairment (MCI).<h4>Methods</h4>Cognition, plasma ketone response, and metabolic profile were assessed before and 6 months after supplementation with a ketogenic drink containing medium chain triglyceride (ketogenic medium chain triglyceride [kMCT]; 15 g twice/day; n = 39) or placebo (n = 44).<h4>Results</h4>Free and cued recall (Trial 1; P = .047), verbal fluency (categorie ...[more]

PMID: 33103819

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Project description:BackgroundMild cognitive impairment frequently represents a predementia stage of Alzheimer's disease. Although obstructive sleep apnea is increasingly recognized as a common comorbidity of mild cognitive impairment, most apnea research has focused on middle-aged adults with moderate-to-severe obstructive sleep apnea. Mild obstructive sleep apnea, defined as 5-14 apneas or hypopneas per hour slept, is common in older adults. Little is known about the effect on cognition of adherence to continuous positive airway pressure (CPAP) treatment of obstructive sleep apnea in older adults with mild obstructive sleep apnea and mild cognitive impairment.ObjectiveThe objective of this study was to explore the effect of CPAP adherence on cognition in older adults with mild obstructive sleep apnea and mild cognitive impairment.MethodsWe conducted a secondary analysis of data from Memories 1, a 1-year quasiexperimental clinical trial on the effect of CPAP adherence in older adults with mild cognitive impairment and obstructive sleep apnea. Those with mild obstructive sleep apnea were divided into two groups based on their CPAP adherence over 1 year: (a) CPAP adherent group (mild cognitive impairment + CPAP) with an average CPAP use of ?4 hours per night and (b) CPAP nonadherent group (mild cognitive impairment - CPAP) with an average CPAP use of <4 hours per night. Individuals currently using CPAP were not eligible. A CPAP adherence intervention was provided for all participants, and an attention control intervention was provided for participants who chose to discontinue CPAP use during the 1-year follow-up. Descriptive baseline analyses, paired t tests for within-group changes, and general linear and logistic regression models for between-group changes were conducted.ResultsThose in the mild cognitive impairment + CPAP group compared to the mild cognitive impairment - CPAP group demonstrated a significant improvement in psychomotor/cognitive processing speed, measured by the Digit Symbol Coding Test. Eight participants improved on the Clinical Dementia Rating Scale, whereas six worsened or were unchanged. Twelve participants rated themselves as improved on the Alzheimer's Disease Cooperative Study-Clinical Global Impression of Change Scale, whereas three reported their status as worsened or unchanged. The mild cognitive impairment + CPAP group had greater than an eightfold increased odds of improving on the Clinical Dementia Rating and greater than a ninefold increased odds of improving on the Alzheimer's Disease Cooperative Study-Clinical Global Impression of Change Scale, compared to the mild cognitive impairment - CPAP group.DiscussionCPAP adherence may be a promising intervention for slowing cognitive decline in older adults with mild obstructive sleep apnea and mild cognitive impairment. A larger, adequately powered study is needed.

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Project description:Exercise intervention studies in mild cognitive impairment (MCI), a prodromal stage of Alzheimer's disease (AD), have demonstrated inconsistent yet promising results. Addressing the limitations of previous studies, this trial investigated the effects of a 12-month structured exercise program on the progression of MCI. The NeuroExercise study is a multicenter randomized controlled trial across three European countries (Ireland, Netherlands, Germany). Hundred and eighty-three individuals with amnestic MCI were included and were randomized to a 12-month exercise intervention (3 units of 45 min) of either aerobic exercise (AE; n = 60), stretching and toning exercise (ST; n = 65) or to a non-exercise control group (CG; n = 58). The primary outcome, cognitive performance, was determined by an extensive neuropsychological test battery. For the primary complete case (CC) analyses, between-group differences were analyzed with analysis of covariance under two conditions: (1) the exercise group (EG = combined AE and ST groups) compared to the CG and (2) AE compared to ST. Primary analysis of the full cohort (n = 166, 71.5 years; 51.8% females) revealed no between-group differences in composite cognitive score [mean difference (95% CI)], 0.12 [(-0.03, 0.27), p = 0.13] or in any cognitive domain or quality of life. VO2 peak was significantly higher in the EG compared to the CG after 12 months [-1.76 (-3.39, -0.10), p = 0.04]. Comparing the two intervention groups revealed a higher VO2peak level in the aerobic exercise compared to the stretching and toning group, but no differences for the other outcomes. A 12-month exercise intervention did not change cognitive performance in individuals with amnestic MCI in comparison to a non-exercise CG. An intervention effect on physical fitness was found, which may be an important moderator for long term disease progression and warrants long-term follow-up investigations. Clinical Trial Registration: https://clinicaltrials.gov/ct2/show/NCT02913053, identifier: NCT02913053.

Dataset Information

A ketogenic drink improves cognition in mild cognitive impairment: Results of a 6-month RCT.

Introduction

Methods

Results

Conclusions

Publications

A ketogenic drink improves cognition in mild cognitive impairment: Results of a 6-month RCT.

Similar Datasets

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