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The Impact of Supplemental Macular Carotenoids in Alzheimer's Disease: A Randomized Clinical Trial

Article type: Research Article

Authors: Nolan, John M.a; * | Loskutova, Ekaterinaa | Howard, Alanb; c | Mulcahy, Rionad | Moran, Rachela | Stack, Jima | Bolger, Maggied | Coen, Robert F.e | Dennison, Jessicaa | Akuffo, Kwadwo Owusua | Owens, Niamha | Power, Rebeccaa | Thurnham, Davidf | Beatty, Stephena

Affiliations: [a] Macular Pigment Research Group, Department of Chemical and Life Sciences, Waterford Institute of Technology, Waterford, Ireland | [b] Howard Foundation, Cambridge, UK | [c] Downing College, University of Cambridge, Cambridge, UK | [d] University Hospital Waterford, Age-Related Care Unit, Waterford, Ireland | [e] Mercer's Institute for Successful Ageing, St. James's Hospital, Dublin, Ireland | [f] Northern Ireland, Centre for Food and Health (NICHE), University of Ulster, Coleraine, UK

Correspondence: [*] Correspondence to: Professor John Nolan, Macular Pigment Research Group, Vision Research Centre, Carriganore House, Waterford Institute of Technology, West Campus, Carriganore, Waterford, Ireland. Tel.: +353 51 834074; E-mail: [email protected].

Keywords: Age-related macular degeneration, Alzheimer's disease, cognitive function, contrast sensitivity, lutein, meso-zeaxanthin, randomized clinical trial, visual function, zeaxanthin

DOI: 10.3233/JAD-142265

Journal: Journal of Alzheimer's Disease, vol. 44, no. 4, pp. 1157-1169, 2015

Accepted 15 October 2014
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Published: 19 February 2015
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Abstract

Background:

Patients with Alzheimer's disease (AD) exhibit significantly less macular pigment (MP) and poorer vision when compared to control subjects.

Objective:

To investigate supplementation with the macular carotenoids on MP, vision, and cognitive function in patients with AD versus controls.

Methods:

A randomized, double-blind clinical trial with placebo and active arms. 31 AD patients and 31 age-similar control subjects were supplemented for six months with either Macushield (10 mg meso-zeaxanthin [MZ]; 10 mg lutein [L]; 2 mg zeaxanthin [Z]) or placebo (sunflower oil). MP was measured using dual-wavelength autofluorescence (Heidelberg Spectralis®). Serum L, Z, and MZ were quantified by high performance liquid chromatography. Visual function was assessed by best corrected visual acuity and contrast sensitivity (CS). Cognitive function was assessed using a battery of cognition tests, including the Cambridge Neuropsychological Test Automated Battery (CANTAB)).

Results:

Subjects on the active supplement (for both AD and non-AD controls) exhibited statistically significant improvement in serum concentrations of L, Z, MZ, and MP (p < 0.001, for all) and also CS at (p = 0.039). Also, for subjects on the active supplement, paired samples t-tests exhibited four significant results (from five spatial frequencies tested) in the AD group, and two for the non-AD group, and all indicating improvements in CS. We found no significant changes in any of the cognitive function outcome variables measured (p > 0.05, for all).

Conclusion:

Supplementation with the macular carotenoids (MZ, Z, and L) benefits patients with AD, in terms of clinically meaningful improvements in visual function and in terms of MP augmentation.

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