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Effect of long-term nutraceutical and dietary supplement use on cognition in the elderly: a 10-year systematic review of randomised controlled trials.
Br J Nutr. 2018 02; 119(3):280-298.BJ

Abstract

Nutraceuticals have generated interest as a way to mitigate the cognitive decline in older adults. The aim of this systematic review was to determine the evidence for these claims from the scientific literature in randomised, double-blinded, controlled trials (duration: ≥1 year; participants: n≥100; age(mean): ≥65 years). Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we searched four electronic databases (PubMed, Scopus, CINAHL and Web of Science) and identified twenty-five studies published between the 15·June·2006 and 14·June·2016. Interventions included B-vitamins, n-3 fatty acids, antioxidant vitamins and herbs. Of the B-vitamin studies, four found benefits to cognition with supplementation. The first of these B-vitamin studies, in individuals with mild cognitive impairment (n 266; duration=2 years), included benefit to executive function (P=0·015) and improvements in the Mini-Mental State Examination (MMSE) among participants with baseline homocysteine above 11·3 µmol/l (P<0·001). In the same sample, the second study found cognitive benefits of B-vitamins dependent on the higher baseline plasma n-3 fatty acid status. The third B-vitamin study (n 900; duration=2 years) reported improved performance in immediate (P=0·046) and delayed recall (P=0·013), whereas the fourth study (n 856; duration=2 years) reported slower rate of cognitive decline in the MMSE (P=0·05). One study investigating DHA treatment (n 402; duration=1·5 years) revealed the slower rate of cognitive change in apoE e4 non-carriers (P=0·03). As only five included studies revealed notable benefits, presently based on the specific compounds explored here, there is not compelling evidence to support the use nutraceuticals to improve cognition in the elderly. Future long-term trials of nutraceuticals should investigate interactions with lifestyle, blood biomarkers and genetic risk factors.

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Authors+Show Affiliations

1Faculty Health,University of Canberra,Kirinari Street,Bruce,Canberra,ACT 2617,Australia.

Georgousopoulou EN

1Faculty Health,University of Canberra,Kirinari Street,Bruce,Canberra,ACT 2617,Australia.

1Faculty Health,University of Canberra,Kirinari Street,Bruce,Canberra,ACT 2617,Australia.

1Faculty Health,University of Canberra,Kirinari Street,Bruce,Canberra,ACT 2617,Australia.

Panagiotakos DB

1Faculty Health,University of Canberra,Kirinari Street,Bruce,Canberra,ACT 2617,Australia.

1Faculty Health,University of Canberra,Kirinari Street,Bruce,Canberra,ACT 2617,Australia.

2Collaborative Research in Bioactives and Biomarkers (CRIBB) Group,Kirinari Street,Bruce,Canberra,ACT 2617,Australia.

1Faculty Health,University of Canberra,Kirinari Street,Bruce,Canberra,ACT 2617,Australia.

1Faculty Health,University of Canberra,Kirinari Street,Bruce,Canberra,ACT 2617,Australia.

MeSH

AgedAged, 80 and overAntioxidantsCognitionDietary SupplementsDouble-Blind MethodFatty Acids, Omega-3FemaleHumansMalePlant PreparationsRandomized Controlled Trials as TopicVitamin B ComplexVitamins

Pub Type(s)

Journal Article

Research Support, Non-U.S. Gov't

Systematic Review

Language

eng

PubMed ID

29310724

Citation

D'Cunha, Nathan M., et al. "Effect of Long-term Nutraceutical and Dietary Supplement Use On Cognition in the Elderly: a 10-year Systematic Review of Randomised Controlled Trials." The British Journal of Nutrition, vol. 119, no. 3, 2018, pp. 280-298.

D'Cunha NM, Georgousopoulou EN, Dadigamuwage L, et al. Effect of long-term nutraceutical and dietary supplement use on cognition in the elderly: a 10-year systematic review of randomised controlled trials. Br J Nutr. 2018;119(3):280-298.

D'Cunha, N. M., Georgousopoulou, E. N., Dadigamuwage, L., Kellett, J., Panagiotakos, D. B., Thomas, J., McKune, A. J., Mellor, D. D., & Naumovski, N. (2018). Effect of long-term nutraceutical and dietary supplement use on cognition in the elderly: a 10-year systematic review of randomised controlled trials. The British Journal of Nutrition, 119(3), 280-298. https://doi.org/10.1017/S0007114517003452

D'Cunha NM, et al. Effect of Long-term Nutraceutical and Dietary Supplement Use On Cognition in the Elderly: a 10-year Systematic Review of Randomised Controlled Trials. Br J Nutr. 2018;119(3):280-298. PubMed PMID: 29310724.

* Article titles in AMA citation format should be in sentence-case

TY - JOUR T1 - Effect of long-term nutraceutical and dietary supplement use on cognition in the elderly: a 10-year systematic review of randomised controlled trials. AU - D'Cunha,Nathan M, AU - Georgousopoulou,Ekavi N, AU - Dadigamuwage,Lakshika, AU - Kellett,Jane, AU - Panagiotakos,Demosthenes B, AU - Thomas,Jackson, AU - McKune,Andrew J, AU - Mellor,Duane D, AU - Naumovski,Nenad, Y1 - 2018/01/09/ PY - 2018/1/10/pubmed PY - 2019/2/8/medline PY - 2018/1/10/entrez KW - AD Alzheimer’s disease KW - ADAS-cog cognitive subscale of Alzheimer’s Disease Assessment Scale KW - APOE4 apoE e4 KW - CDR Clinical Dementia Rating Scale KW - CSF cerebrospinal fluid KW - FADS fatty acid desaturase KW - Hcy homocysteine KW - MCI mild cognitive impairment KW - MMSE Mini-Mental State Examination KW - QoL quality of life KW - RCT randomised controlled trial KW - TICS Telephone Interview of Cognitive Status KW - Cognition KW - Dementia KW - Dietary supplements KW - Elderly KW - Mild cognitive impairment KW - Nutraceuticals KW - Vitamins SP - 280 EP - 298 JF - The British journal of nutrition JO - Br J Nutr VL - 119 IS - 3 N2 - Nutraceuticals have generated interest as a way to mitigate the cognitive decline in older adults. The aim of this systematic review was to determine the evidence for these claims from the scientific literature in randomised, double-blinded, controlled trials (duration: ≥1 year; participants: n≥100; age(mean): ≥65 years). Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we searched four electronic databases (PubMed, Scopus, CINAHL and Web of Science) and identified twenty-five studies published between the 15·June·2006 and 14·June·2016. Interventions included B-vitamins, n-3 fatty acids, antioxidant vitamins and herbs. Of the B-vitamin studies, four found benefits to cognition with supplementation. The first of these B-vitamin studies, in individuals with mild cognitive impairment (n 266; duration=2 years), included benefit to executive function (P=0·015) and improvements in the Mini-Mental State Examination (MMSE) among participants with baseline homocysteine above 11·3 µmol/l (P<0·001). In the same sample, the second study found cognitive benefits of B-vitamins dependent on the higher baseline plasma n-3 fatty acid status. The third B-vitamin study (n 900; duration=2 years) reported improved performance in immediate (P=0·046) and delayed recall (P=0·013), whereas the fourth study (n 856; duration=2 years) reported slower rate of cognitive decline in the MMSE (P=0·05). One study investigating DHA treatment (n 402; duration=1·5 years) revealed the slower rate of cognitive change in apoE e4 non-carriers (P=0·03). As only five included studies revealed notable benefits, presently based on the specific compounds explored here, there is not compelling evidence to support the use nutraceuticals to improve cognition in the elderly. Future long-term trials of nutraceuticals should investigate interactions with lifestyle, blood biomarkers and genetic risk factors. SN - 1475-2662 UR - https://www.unboundmedicine.com/medline/citation/29310724/Effect_of_long_term_nutraceutical_and_dietary_supplement_use_on_cognition_in_the_elderly:_a_10_year_systematic_review_of_randomised_controlled_trials_ DB - PRIME DP - Unbound Medicine ER -