Nutritional treatments for Alzheimer's disease: A narrative review

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BACKGROUND: Knowledge is limited about ways to treat, manage and slow the progression of Alzheimer's Disease (AD). It is suspected that there are potential nutrition-related components that may contribute to the pathology of AD. This includes nutrient deficiencies and/or dietary factors that may lead to comorbidities, increasing the risk for development. Thus, many nutrient-specific, dietary and medical food treatments are continually being researched. Some studies even combine both nutrient and dietary interventions to treat AD. The purpose of this review is to explore and discuss the efficacy of several macro- and micronutrients, antioxidants, dietary therapies and combined components to treat or slow the progression of AD while providing valuable insight into the role that nutrition may play in the treatment of this disease. METHODS: Using PubMed, Google Scholar, EBSCOhost and Science Direct, databases were searched using pertinent keywords. A total of 33 research articles were included, primarily consisting randomized, double-blind, placebo-controlled clinical human research trials with the addition of few animal studies. Full-text studies in detail were obtained, assessed with data extracted and summarized. RESULTS: Overall, it was determined that folate in conjunction with Donepezil, may improve cognitive function and inflammatory markers. Omega-3 fatty acids (FA) with ɑ-lipoic acid may reduce cognitive and functional decline rates. Adequate B-vitamin status is needed to obtain the benefits of omega-3 FAs. Vitamin D supplementation and medical food Souvenaid may be considered for cognitive benefits in patients with AD. Medium-chain triglyceride (MCT) supplementation is not yet supported. Antioxidant treatment is not recommended as it may accelerate cognitive decline. DASH, Mediterranean Diet, MIND and ketogenic diet therapy may be considered as dietary treatments in AD patients. Nutrient supplementation requires more research to determine appropriate dosages. CONCLUSION: Alzheimer's disease remains a major health concern to the aging public. The anti-inflammatory properties, antioxidative and neuroprotective effects of several nutrition-related treatments have been shown to be beneficial in combating the progression of this disease. Patient individualization must be considered prior to treating. It is recommended that future studies determine appropriate dosage amounts to minimize adverse effects.