Effect of dietary interventions in mild cognitive impairment: a systematic review

Br J Nutr. 2018 Dec;120(12):1388-1405. doi: 10.1017/S0007114518002945. Epub 2018 Nov 9.

Abstract

Diet has been investigated in relation to its ability to promote cognitive function. However, evidence is currently limited and has rarely been systematically reviewed, particularly in a mild cognitive impairment (MCI) population. This review examined the effect of diet on cognitive outcomes in MCI patients. A total of five databases were searched to find randomised controlled trial (RCT) studies, with diet as the main focus, in MCI participants. The primary outcome was incident dementia and/or Alzheimer's disease (AD) and secondary outcomes included cognitive function across different domains using validated neuropsychological tests. Sixteen studies met the inclusion criteria. There was a high degree of heterogeneity relating to the nature of the dietary intervention and cognitive outcomes measured, thus making study comparisons difficult. Supplementation with vitamin E (one study, n 516), ginkgo biloba (one study, n 482) or Fortasyn Connect (one study, n 311) had no significant effect on progression from MCI to dementia and/or AD. For cognitive function, the findings showed some improvements in performance, particularly in memory, with the most consistent results shown by B vitamins, including folic acid (one study, n 266), folic acid alone (one study, n 180), DHA and EPA (two studies, n 36 and n 86), DHA (one study, n 240) and flavonol supplementation (one study, n 90). The findings indicate that dietary factors may have a potential benefit for cognitive function in MCI patients. Further well-designed trials are needed, with standardised and robust measures of cognition to investigate the influence of diet on cognitive status.

Keywords: AD Alzheimer’s disease; GI glycaemic index; HF high flavonol; HR hazard ratio; LF low flavonol; MCI mild cognitive impairment; MMSE Mini Mental State Examination; RCT randomised controlled trial; Diet; Interventions; Lifestyle; Mild cognitive impairment; Systematic reviews.

Publication types

  • Systematic Review

MeSH terms

  • Alzheimer Disease / diagnosis*
  • Attention
  • Biomarkers / metabolism
  • Cognition
  • Cognitive Dysfunction / diet therapy*
  • Dementia / diagnosis*
  • Diet*
  • Dietary Supplements
  • Disease Progression
  • Docosahexaenoic Acids / therapeutic use
  • Eicosapentaenoic Acid / therapeutic use
  • Executive Function
  • Folic Acid / therapeutic use
  • Ginkgo biloba
  • Humans
  • Language
  • Neuropsychological Tests
  • Phospholipids / therapeutic use
  • Randomized Controlled Trials as Topic
  • Vitamin E / therapeutic use

Substances

  • Biomarkers
  • Fortasyn Connect
  • Phospholipids
  • Vitamin E
  • Docosahexaenoic Acids
  • Folic Acid
  • Eicosapentaenoic Acid