Plasma nutrient status of patients with Alzheimer's disease: Systematic review and meta-analysis
Sofia Lopes da Silva,Bruno Vellas,Saskia Elemans,José A. Luchsinger,Patrick Joseph Gerardus Hendrikus Kamphuis,Kristine Yaffe,John W.C. Sijben,Martine Groenendijk,Theo Stijnen +8 more
TLDR
The first systematic review and meta‐analysis that compares plasma levels of micronutrients and fatty acids in AD patients to those in cognitively intact elderly controls is provided.Abstract:
Background Alzheimer disease (AD) patients are at risk of nutritional insufficiencies because of physiological and psychological factors. Nutritional compounds are postulated to play a role in the pathophysiological processes that are affected in AD. We here provide the first systematic review and meta-analysis that compares plasma levels of micronutrients and fatty acids in AD patients to those in cognitively intact elderly controls. A secondary objective was to explore the presence of different plasma nutrient levels between AD and control populations that did not differ in measures of protein/energy nourishment. Methods We screened literature published after 1990 in the Cochrane Central Register of Controlled Trials, Medline, and Embase electronic databases using Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines for AD patients, controls, micronutrient, vitamins, and fatty acids, resulting in 3397 publications, of which 80 met all inclusion criteria. Status of protein/energy malnutrition was assessed by body mass index, mini nutritional assessment score, or plasma albumin. Meta-analysis, with correction for differences in mean age between AD patients and controls, was performed when more than five publications were retrieved for a specific nutrient. Results We identified five or more studies for folate, vitamin A, vitamin B12, vitamin C, vitamin D, vitamin E, copper, iron, and zinc but fewer than five studies for vitamins B1 and B6, long-chain omega-3 fatty acids, calcium, magnesium, manganese, and selenium (the results of the individual publications are discussed). Meta-analysis showed significantly lower plasma levels of folate and vitamin A, vitamin B12, vitamin C, and vitamin E ( P P = .050) and vitamin D ( P = .075) were found in AD patients. No significant differences were observed for plasma levels of copper and iron. A meta-analysis that was limited to studies reporting no differences in protein/energy malnourishment between AD and control populations yielded similar significantly lower plasma levels of folate and vitamin B12, vitamin C, and vitamin E in AD. Conclusions The lower plasma nutrient levels indicate that patients with AD have impaired systemic availability of several nutrients. This difference appears to be unrelated to the classic malnourishment that is well known to be common in AD, suggesting that compromised micronutrient status may precede protein and energy malnutrition. Contributing factors might be AD-related alterations in feeding behavior and intake, nutrient absorption, alterations in metabolism, and increased utilization of nutrients for AD pathology-related processes. Given the potential role of nutrients in the pathophysiological processes of AD, the utility of nutrition may currently be underappreciated and offer potential in AD management.read more
Citations
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B Vitamins and the Brain: Mechanisms, Dose and Efficacy—A Review
TL;DR: Evidence from human research clearly shows that a significant proportion of the populations of developed countries suffer from deficiencies or insufficiencies in one or more of this group of vitamins, and that, in the absence of an optimal diet, administration of the entire B-vitamin group, rather than a small sub-set, at doses greatly in excess of the current governmental recommendations, would be a rational approach for preserving brain health.
Journal ArticleDOI
ESPEN guidelines on nutrition in dementia
Dorothee Volkert,Michael Chourdakis,Gerd Faxén-Irving,Thomas Frühwald,Francesco Landi,Merja H. Suominen,Maurits Vandewoude,Rainer Wirth,Stéphane M. Schneider +8 more
TL;DR: Nutritional care and support should be an integral part of dementia management in all stages of the disease, and the decision for or against nutritional interventions should be made on an individual basis after carefully balancing expected benefit and potential burden.
Journal ArticleDOI
Ageing, age-related diseases and oxidative stress: What to do next?
TL;DR: It is proposed that oxidized vitamin E metabolites may be used to accurately monitor individual functional antioxidant level, which might serve as promising key solutions for future elucidating the impact of oxidative stress on ageing and age-related diseases.
Journal ArticleDOI
Happily (n)ever after: Aging in the context of oxidative stress, proteostasis loss and cellular senescence.
Annika Höhn,Daniela Weber,Tobias Jung,Christiane Ott,Martín Hugo,Bastian Kochlik,Richard Kehm,Jeannette König,Tilman Grune,José Pedro Castro +9 more
TL;DR: This review will cover cellular senescence features related to the protein pool such as morphological and molecular hallmarks, how oxidative stress promotes protein modifications, how senescent cells cope with them by proteostasis mechanisms, including antioxidant enzymes and proteolytic systems.
Journal ArticleDOI
Protein phosphatase 2A dysfunction in Alzheimer's disease
Jean-Marie Sontag,Estelle Sontag +1 more
TL;DR: It remains unclear what are the primary events that underlie “PP2A” dysfunction in AD, but deregulation of PP2A enzymes definitely affects key players in the pathogenic process, and there is growing interest in developing PP 2A-centric therapies for AD.
References
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Preferred reporting items for systematic reviews and meta-analyses: the PRISMA Statement.
TL;DR: The QUOROM Statement (QUality Of Reporting Of Meta-analyses) as mentioned in this paper was developed to address the suboptimal reporting of systematic reviews and meta-analysis of randomized controlled trials.
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Preferred reporting items for systematic reviews and meta-analyses: The PRISMA statement
TL;DR: A structured summary is provided including, as applicable, background, objectives, data sources, study eligibility criteria, participants, interventions, study appraisal and synthesis methods, results, limitations, conclusions and implications of key findings.
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