Shea Thomas B, Remington Ruth
aLaboratory for Neuroscience bDepartment of Biological Sciences, University of Massachusetts Lowell, Lowell, Massachusetts cFramingham State University, Framingham, Massachusetts, USA.
Curr Opin Psychiatry. 2015 Mar;28(2):141-7. doi: 10.1097/YCO.0000000000000138.
Evidence for the benefit of nutrition in Alzheimer's disease continues to accumulate. Many studies with individual vitamins or supplements show marginal, if any, benefit. However, new findings with combinatorial formulations demonstrate improvement in cognitive performance and behavioral difficulties that accompany Alzheimer's disease. Herein, we review some of the most recent clinical advances and summarize supportive preclinical studies.
We present novel positive effects on Alzheimer's disease derived from diet, trace elements, vitamins and supplements. We discuss the inherent difficulty in conducting nutritional studies because of the variance in participants' nutritional history, versus pharmacological interventions in which participants are naive to the intervention. We examine the evidence that epigenetics play a role in Alzheimer's disease and how nutritional intervention can modify the key epigenetic events to maintain or improve cognitive performance.
Overall consideration of the most recent collective evidence suggests that the optimal approach for Alzheimer's disease would seem to combine early, multicomponent nutritional approaches (a Mediterranean-style diet, multivitamins and key combinatorial supplements), along with lifestyle modifications such as social activity and mental and physical exercise, with ultimate addition of pharmacological agents when warranted.
营养对阿尔茨海默病有益的证据不断积累。许多针对单一维生素或补充剂的研究显示,即便有好处也很有限。然而,组合配方的新研究结果表明,阿尔茨海默病患者的认知表现和行为障碍有所改善。在此,我们回顾一些最新的临床进展,并总结支持性的临床前研究。
我们介绍了饮食、微量元素、维生素和补充剂对阿尔茨海默病产生的新的积极影响。我们讨论了开展营养研究存在的固有困难,这是由于参与者营养史存在差异,而药物干预的参与者对干预措施并不了解。我们研究了表观遗传学在阿尔茨海默病中发挥作用的证据,以及营养干预如何改变关键的表观遗传事件以维持或改善认知表现。
对最新综合证据的全面考量表明,阿尔茨海默病的最佳治疗方法似乎是将早期多成分营养方法(地中海式饮食、多种维生素和关键组合补充剂)与社交活动以及心理和体育锻炼等生活方式改变相结合,最终在必要时添加药物治疗。