Observational studies suggest that nutritional factors have a potential cognitive benefit. However, systematic reviews of randomised trials of dietary and nutritional supplements have reported largely null effects on cognitive outcomes and have highlighted study inconsistencies and other limitations. In this Personal View, the Nutrition for Dementia Prevention Working Group presents what we consider to be limitations in the existing nutrition clinical trials for dementia prevention. On the basis of this evidence, we propose recommendations for incorporating dietary patterns and the use of genetic, and nutrition assessment tools, biomarkers, and novel clinical trial designs to guide future trial developments. Nutrition-based research has unique challenges that could require testing both more personalised interventions in targeted risk subgroups, identified by nutritional and other biomarkers, and large-scale and pragmatic study designs for more generalisable public health interventions across diverse populations.
Bibliographical noteFunding Information:
We thank Dr Kristina McLinden (National Institute on Aging, Bethesda, MD, USA), and Brianna Liu and Thomas Urich (Department of Medicine, University of Southern California, Los Angeles, CA, USA).
This Personal View was supported by funding from both the National Institute on Aging (NIA; grant number R13AG069386) and the Alzheimer's Association. NS chairs and receives funding from the Albert Einstein College of Medicine Data Safety Monitoring Board. HNY is supported by the NIA (grant numbers: R21AG056518, R01AG055770, R01AG054434, R01AG067063, and RF1AG076124); is a principal investigator for NIA; and received honoraria from Huron Consulting firm. SJ receives funding from National Institutes of Health (NIH). SA receives funding from Nestec, and consultant fees from Roche as honororia for lectures. SC receives funding from NIH (grant number R01AG055122). MC receives funding from and is an employee of the Alzheimer's Association and has a child who attends graduate school at the University of Southern California. MS received funding from the Alzheimer's Association for help in preparing this manuscript; she also receives funding from the Lieber Institute for Brain Development Simons Foundation for Autism Research Initiative Nature, American Chemical Society, which paid for travel and meeting attendance in 2019. EM receives funding from and is an employee of the Alzheimer's Association. CT receives funding from NIA for diet and store prevention; the Alzheimer's Association for being part of the US Pointer study; UpToDate for being an author for cards on Nutritional antioxidants, and diets and supplements for lipid lowering; and Food and Nutrition Conference and Expo 2021 for providing lectures on nutrition and the brain (Women). GLB receives funding from NIH and NIA (grant number R01 AG043398) for a 3-year secondary prevention trial of omega-3 fatty acids for cerebral white matter lesions; GLB was also lead investigator on four issued patents owned by Nestle SA (international application numbers: PCT/EP2017/082148, PCT/EP2018/058701, PCT/EP2018/064813, and PCT/EP2017/065340); receives funding from a NIH/National Center on Complementary and Integrative Health training (grant number R90AT008924); was an advisor for the EU/USA Task Force on Clinical Trials in Alzheimer's Disease (unpaid) and Horizon 2020 EU-International research consortium PROPAG- AGEING (unpaid); and is co-founder, past co-chair and executive committee member of the Nutrition, Metabolism and Dementia professional interest area at the Alzheimer's Association ISTAART (unpaid). HS receives funding from the Alzheimer's Association and the NIH and is an employee of the Alzheimer's Association. LSS receives grants from Eli Lilly, Eisai, Roche/Genentech, Biogen, Novartis, Biohaven, Washington University Dominantly Inherited Alzheimer Network Trial Unit; and personal fees from Eli Lilly, Boehringer Ingelheim, Neurim, Cognition Therapeutics, Takeda, vTv Therapeutics, Roche/Genentech, Samus, Immunobrain Checkpoint, Cortexyme, AC Immune, Otsuka, GW Research, and Novo Nordisk. All other authors report no competing interests.
© 2022 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license