Effects of the multidomain intervention with nutritional supplements on cognition and gut microbiome in early symptomatic Alzheimer's disease: a randomized controlled trial

Eun Hye Lee; Geon Ha Kim; Hee Kyung Park; Hae Jin Kang; Yoo Kyoung Park; Hye Ah Lee; Chang Hyung Hong; So Young Moon; Woorim Kang; Hyun-Seok Oh; Hai-Jeon Yoon; Seong Hye Choi; Jee Hyang Jeong

doi:10.3389/fnagi.2023.1266955

Effects of the multidomain intervention with nutritional supplements on cognition and gut microbiome in early symptomatic Alzheimer's disease: a randomized controlled trial

Front Aging Neurosci. 2023 Nov 2:15:1266955. doi: 10.3389/fnagi.2023.1266955. eCollection 2023.

Authors

Eun Hye Lee^{1

2}, Geon Ha Kim^{1

3}, Hee Kyung Park⁴, Hae Jin Kang⁵, Yoo Kyoung Park⁵, Hye Ah Lee⁶, Chang Hyung Hong⁷, So Young Moon⁸, Woorim Kang⁹, Hyun-Seok Oh⁹, Hai-Jeon Yoon¹⁰, Seong Hye Choi¹¹, Jee Hyang Jeong^{1

2}

Affiliations

¹ Department of Neurology, Ewha Womans University School of Medicine, Seoul, Republic of Korea.
² Department of Neurology, Ewha Womans University Seoul Hospital, Seoul, Republic of Korea.
³ Department of Neurology, Ewha Womans University Mokdong Hospital, Seoul, Republic of Korea.
⁴ Division of Psychiatry, Department of Mental Health Care of Older People, University College London, London, United Kingdom.
⁵ Department of Medical Nutrition (AgeTech-Service Convergence Major), Kyung Hee University, Yongin, Republic of Korea.
⁶ Clinical Trial Center, Ewha Womans University Mokdong Hospital, Seoul, Republic of Korea.
⁷ Department of Psychiatry, Ajou University School of Medicine, Suwon, Republic of Korea.
⁸ Department of Neurology, Ajou University School of Medicine, Suwon, Republic of Korea.
⁹ CJ Bioscience Inc., Seoul, Republic of Korea.
¹⁰ Department of Nuclear Medicine, Ewha Womans University School of Medicine, Seoul, Republic of Korea.
¹¹ Department of Neurology, Inha University College of Medicine, Incheon, Republic of Korea.

Abstract

Background: The SoUth Korean study to PrEvent cognitive impaiRment and protect BRAIN health through lifestyle intervention in at-risk elderly people (SUPERBRAIN) is a part of the World-Wide Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (WW-FINGERS) network. This study aimed to demonstrate the effects of the SUPERBRAIN-based multidomain intervention with nutritional supplements in amyloid positive emission tomography (PET) proven early symptomatic Alzheimer's disease patients.

Methods: Forty-six participants who were diagnosed with mild cognitive impairment or mild dementia and were positive in the amyloid PET study randomized into three groups: group A, the multidomain intervention with nutritional supplements; group B, nutritional supplements only; and a control group. The primary outcome was a change in the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) total scale index score after an 8-week intervention. Secondary outcomes, including gut microbiome data, were also analyzed.

Results: The RBANS total scale index score improved significantly in group A compared with group B (p < 0.032) and compared with the control group (p < 0.001). After intervention, beta diversity of the gut microbiome between group A and the control group increased, and patients in group A were more enriched with Bifidobacterium.

Conclusion: SUPERBRAIN-based multidomain intervention with nutritional supplements improves cognition and gut microbiota in patients with early symptomatic Alzheimer's disease who were amyloid-positive by PET.

Keywords: Alzheimer’s disease; dementia; gut microbiome; mild cognitive impairment; multidomain intervention; nutritional supplements; prevention.

Grants and funding

The author(s) declare financial support was received for the research, authorship, and/or publication of this article. This study was supported by grants from Daesang Life Science Corporation, the National Research Council of Science & Technology (NST) Aging Convergence Research Center (CRC22011-600), the Korea Health Technology R&D Project through the Korea Health Industry Development Institute (KHIDI) and Korea Dementia Research Center (KDRC), funded by the Ministry of Health & Welfare and Ministry of Science and ICT, Republic of Korea (HU20C0271 and HU21C0016), and the Original Technology Research Program for Brain Science through the National Research Foundation of Korea (NRF) (NRF-2018M3C7A1057137 and NRF-2020M3E5D2A01084721) and the Institute of Information & communications Technology Planning & Evaluation (IITP) (No. 2022-0-00448) funded by the Ministry of Science and ICT, Republic of Korea. These funding sources were not involved in the study design; in the collection, analysis, and interpretation of data; in the writing of the manuscript; and in the decision to submit the article for publication.