Dementia & Alzheimer’s disease
Dementia describes a group of symptoms associated with a decline in memory, reasoning or other thinking skills. Many different types of dementia exist, and many conditions cause it. Mixed dementia is a condition in which brain changes of more than one type of dementia occur simultaneously. Alzheimer's disease is the most common cause of dementia, accounting for 60-80% of dementia cases. Dementia is not a normal part of aging. It is caused by damage to brain cells that affects their ability to communicate, which can affect thinking, behavior and feelings.
More than 25 million people in the world today are affected by dementia, most suffering from Alzheimer's disease. The number of people living with dementia in the European Union (EU27) is estimated to be 7,853,705 and in European countries represented by AE members, 9,780,678. Women continue to be disproportionately affected by dementia with 6,650,228 women and 3,130,449 men living with dementia in Europe. The numbers of people with dementia in Europe will almost double by 2050 increasing to 14,298,671 in the European Union and 18,846,286 in the wider European region. In both developed and developing nations, Alzheimer's disease has had tremendous impact on the affected individuals, caregivers, and society. .
Dementia is a term used to describe a group of symptoms affecting memory, thinking and social abilities severely enough to interfere with your daily life. It isn't a specific disease, but several diseases can cause dementia. Though dementia generally involves memory loss, memory loss has different causes. Having memory loss alone doesn't mean you have dementia, although it's often one of the early signs of the condition. Alzheimer's disease is the most common cause of a progressive dementia in older adults, but there are a number of other causes of dementia. Depending on the cause, some dementia symptoms might be reversible.
Alzheimer's disease is a progressive neurologic disorder that causes the brain to shrink (atrophy) and brain cells to die. Alzheimer's disease is the most common cause of dementia — a continuous decline in thinking, behavioral and social skills that affects a person's ability to function independently. Medications may temporarily improve or slow progression of symptoms. These treatments can sometimes help people with Alzheimer's disease maximize function and maintain independence for a time.
Inositol
Q10
A-lipoic acid
N-Acetyl-Cysteine
L-Carnitine
L-Arginine
Inositol
Inositols are sugar-like compounds that are widely distributed in nature and are a part of membrane molecules, participating as second messengers in several cell-signaling processes. This work presents a critical review of inositol actions on insulin signaling, oxidative stress, and endothelial dysfunction, and its potential for either preventing or delaying cognitive impairment in aging and neurodegenerative diseases. The biomedical uses of inositols may represent a paradigm in the industrial approach perspective, which has generated growing interest for two decades, accompanied by clinical trials for Alzheimer’s disease.
Biomedicines. 2020 Sep; 8(9): 295. Published online 2020 Aug 20. doi: 10.3390/biomedicines8090295
A double-blind controlled crossover trial of 6 gm of inositol daily vs glucose for one month each was carried out in 11 Alzheimer patients. Overall CAMCOG scores showed a trend for greater improvement with inositol. Language and orientation improved significantly more on inositol than on placebo. There were no serious side effects.
https://doi.org/10.1016/0278-5846(96)00043-7
Q10
Patients with dementia suffered from coenzyme Q10 deficiency, and the degree of deficiency was related to the level of amyloid-β and antioxidant capacity. Since adequate level of coenzyme Q10 may delay the progression of dementia, monitoring coenzyme Q10 status in patients with dementia is necessary.
Front. Aging Neurosci., 25 July 2022 Sec. Alzheimer's Disease and Related Dementias https://doi.org/10.3389/fnagi.2022.910289
CoQ10 supplementation can improve learning and memory deficits induced by diabetes in older subjects. In addition, CoQ10 at higher doses can improve cognitive performance in older healthy subjects.
Neuropsychobiology 2018/2019;77:92–100
A-lipoic acid
In this report, we have extended the analysis to 43 patients over an observation period of up to 48 months. In patients with mild dementia (ADAScog < 15), the disease progressed extremely slowly (ADAScog: +1.2 points/year, MMSE: -0.6 points/year), in patients with moderate dementia at approximately twice the rate. However, the progression appears dramatically lower than data reported for untreated patients or patients on choline-esterase inhibitors in the second year of long-term studies. Despite the fact that this study was not double-blinded, placebo-controlled and randomized, our data suggest that treatment with alpha-lipoic acid might be a successful 'neuroprotective' therapy option for AD.
J Neural Transm Suppl. 2007;(72):189-93. doi: 10.1007/978-3-211-73574-9_24.Studies performed in animal models of memory loss associated with aging and Alzheimer’s Disease have shown that α-Lipoic Acid improves memory in a variety of behavioral paradigms. Furthermore, molecular mechanisms underlying α-Lipoic Acid effects have also been investigated. Accordingly, α-Lipoic Acid shows antioxidant, antiapoptotic, anti-inflammatory, glioprotective, metal chelating properties in both in vivo and in vitro studies. In addition, it has been shown that α-Lipoic Acid reverses age-associated loss of neurotransmitters and their receptors.
Life Sciences Volume 284, 1 November 2021, 119899α-Lipoic Acid, a low-molecular-weight dithiol with a chiral centre, is a dietary supplement thought to have potential therapeutic effects for the prevention or treatment of neurodegenerative diseases. In addition, treatment with α-Lipoic Acid is able to regulate inflammatory cell infiltration into the central nervous system and to down-regulate VCAM-1 and human monocyte adhesion to epithelial cells. In neurodegenerative disease models, treatment with α-Lipoic Acid is able to improve the function of the dopamine, serotonin and norepinephrine neurotransmitters. Scientific evidence shows that α-Lipoic Acid possesses the ability to improve memory capacity in a number of experimental neurodegenerative disease models and in age-related cognitive decline in rodents. Studies have shown that this substance is able to reduce memory loss
Progress in nutrition Vol. 22 No. 1 (2020) DOI https://doi.org/10.23751/pn.v22i1.9341
N-Acetyl-Cysteine
N-acetylcysteine (NAC) is a glutathione precursor with potent antioxidant, pro-neurogenesis and anti-inflammatory properties and a favourable safety profile. The available data suggested statistically significant cognitive improvements following NAC treatment
Neuroscience & Biobehavioral Reviews Volume 78, July 2017, Pages 44-56N-acetylcysteine, a drug also widely available as a dietary supplement, is a precursor of L-cysteine, which in turn is a component of glutathione. Because cysteine availability is a limiting factor for glutathione synthesis, treatment with N-acetylcysteine may increase glutathione levels and thereby counter oxidative stress, promote redox -regulated cell signaling, and improve immune responses. Based on the available literature, a nutraceutical formulation containing N-acetylcysteine among other compounds has shown some pro-cognitive benefits in Alzheimer's patients and older adults
J Prev Alzheimers Dis. 2017;4(3):201-206. doi: 10.14283/jpad.2017.22.
L-Carnitine
Several studies explored the effects of acetyl-L-carnitine (ALC) in dementia, suggesting a role in slowing down cognitive decline. The underlying mechanisms may include restoring of cell membranes and synaptic functioning, enhancing cholinergic activity, promoting mitochondrial energy metabolism, protecting against toxins, and exerting neurotrophic effects. The effects of ALC on the gut–liver–brain axis seem to identify the category of patients in which the new insights contribute most to the mechanisms of action of ALC,
Nutrients. 2020 May; 12(5): 1389. Published online 2020 May 12. doi: 10.3390/nu12051389In a double-blind, placebo-controlled, parallel-group, randomized clinical trial, we studied the efficacy of long-term (1-year) oral treatment with acetyl-L-carnitine in 130 patients with a clinical diagnosis of Alzheimer's disease. We employed 14 outcome measures to assess functional and cognitive impairment. After 1 year, both the treated and placebo groups worsened, but the treated group showed a slower rate of deterioration in 13 of the 14 outcome measures, reaching statistical significance for the Blessed Dementia Scale, logical intelligence, ideomotor and buccofacial apraxia, and selective attention. Adjusting for initial scores with analysis of covariance, the treated group showed better scores on all outcome measures, reaching statistical significance for the Blessed Dementia Scale, logical intelligence, verbal critical abilities, long-term verbal memory, and selective attention The analysis for patients with good treatment compliance showed a greater drug benefit than for the overall sample. Reported adverse events were relatively mild, and there was no significant difference between the treated and placebo groups either in incidence or severity.
Neurology, November 01, 1991; 41 (11) DOI: https://doi.org/10.1212/WNL.41.11.1726
L-Arginine
L-arginine has multiple direct and indirect effects on human vasculature, and might play an important role in the pathogenesis of both atherosclerosis and Alzheimer’s Disease. L-arginine and NO can have a dual role in Alzheimer’s Disease under oxidative stress. Their neuroprotective or neurotoxic roles are limited by isoforms and the concentration of ROS. L-arginine and NO, as modulators, may play a role in Alzheimer’s Disease by influencing inflammatory processes. Regulating the level and the metabolic pathway of L-arginine, and selectively producing different isoforms of NO may produce therapeutic effects. L-arginine and NO can regulate the metabolism of glucose and insulin activity that affects Alzheimer’s Disease. L-arginine is an essential amino acid, involved in diverse physiological and pathological processes, including neurotransmission, neurogenesis and neuroplasticity, cellular redox metabolism and redox stress, inflammation, and regulation of cerebral blood flow. Increasing evidence implicates L-arginine in the pathogenesis of diverse age-related diseases, including Alzheimer's disease.
Int J Clin Exp Pathol. 2009; 2(3): 211–238. Published online 2008 Oct 2.
** All data above are published as clinical trials and do not refer to EFSA claims. This means that they do not intend to be medical or therapeutical advice.