BACKGROUND: Increased consumption of n-3 (omega-3) long-chain polyunsaturated fatty acids (LC PUFAs), especially eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), may maintain cognitive function in later life. OBJECTIVE: We tested the hypothesis that n-3 LC PUFA supplementation would benefit cognitive function in cognitively healthy older people. DESIGN: At total of 867 cognitively healthy adults, aged 70-79 y, from 20 general practices in England and Wales were randomly assigned into a double-blind controlled trial of daily capsules providing 200 mg EPA plus 500 mg DHA or olive oil for 24 mo. Treatment-allocation codes were obtained from a central computerized randomization service. Trained research nurses administered a battery of cognitive tests, including the primary outcome, the California Verbal Learning Test (CVLT), at baseline and 24 mo. Intention-to-treat analysis of covariance, with adjustment for baseline cognitive scores, age, sex, and age at leaving full-time education, included 748 (86%) individuals who completed the study. RESULTS: The mean age of participants was 75 y; 55% of the participants were men.

Findings of observational study warrant further research in controlled clinical trial to clarify the role of these and other possible factors contributing to AD risk >> NEW YORK – Both being more physically active and adhering to a Mediterranean-type diet appears to be associated with reduced Alzheimer's risk, according to a new report in the August 12, 2009 issue of the Journal of the American Medical Association (JAMA). While previous studies have only investigated the association between either physical activity or diet and Alzheimer's disease risk separately, this new research explored their combined association. "Often times people who exercise also follow a healthy diet and vice versa.

We systematically reviewed the published literature on the effects of omega-3 fatty acids on measures of cognitive function in normal aging, incidence and treatment of dementia. Computerized databases were searched for published literature to identify potentially relevant studies with the intent to conduct a meta-analysis. We screened 5,865 titles, reviewed 497 studies of which 49 underwent a detailed review, and found 5 studies that pertained to our objectives. We included controlled clinical trials and observational studies, including prospective cohort, case-control, and case series designs; we excluded case reports. We had no language restrictions. We abstracted data on the effects of omega-3 fatty acids and on study design, relevant outcomes, study population, source, type, amount, and duration of omega-3 fatty acid consumption, and parameters of methodological quality. A single cohort study has assessed the effects of omega-3 fatty acids on cognitive function with normal aging and found no association for fish or total omega-3 consumption.

Long-chain omega-3 fatty acids could have neuroprotective properties against dementia, which is becoming a major global public health issue. We conducted a systematic review of the literature to establish the association between eating fish (a source of long-chain omega-3 fatty acids) or taking long-chain omega-3 fatty acid supplements and the risk of cognitive decline or Alzheimer disease (AD). We identified eleven observational studies and four clinical trials. All three observational studies that used cognitive decline as an outcome reported significant benefits, whereas only four of eight observational studies that used incidence of AD or dementia as an outcome reported positive findings. None of four small clinical trials provided convincing evidence for the use of this approach in the prevention or treatment of any form of dementia. In summary, the existing data favor a role for long-chain omega-3 fatty acids in slowing cognitive decline in elderly individuals without dementia, but not for the prevention or treatment of dementia (including AD).

Resveratrol, a red wine polyphenol, is known to protect against cardiovascular diseases and cancers, as well as to promote antiaging effects in numerous organisms. It also modulates pathomechanisms of debilitating neurological disorders, such as strokes, ischemia, and Huntington's disease. The role of resveratrol in Alzheimer's disease is still unclear, although some recent studies on red wine bioactive compounds suggest that resveratrol modulates multiple mechanisms of Alzheimer's disease pathology. Emerging literature indicates that mechanisms of aging and Alzheimer's disease are intricately linked and that these mechanisms can be modulated by both calorie restriction regimens and calorie restriction mimetics, the prime mediator of which is the SIRT1 protein, a human homologue of yeast silent information regulator (Sir)-2, and a member of NAD+-dependent histone deacetylases. Calorie restriction regimens and calorie restriction-mimetics trigger sirtuins in a wide variety of organisms, ranging from bacteria to mouse.

This study was carried out in 16 university hospital departments of neurology, geriatrics or psychiatry in ten cities with 686 outpatients suffering from AD. This population is representative of the AD population seen by clinicians in daily practice. Patients were evaluated by a geriatrician every six months for up to two years, and their degree of cognitive impairment was measured using the Mini Mental State Examination (MMSE). At the same time, a "one-leg balance" (OLB) test was given, where a participant was asked to stand on one leg for as long as possible. The OLB test was reported as abnormal when the participant was unable to stand on one leg for 5 seconds or more.

The dietary supplement Ginkgo biloba was found to be ineffective in reducing the development of dementia and Alzheimer's disease in older people, according to a study published in the Journal of the American Medical Association¹. Researchers led by Steven T. DeKosky, M.D., formerly of the University of Pittsburgh, vice president and dean of the School of Medicine at the University of Virginia in Charlottesville, conducted the trial known as the Ginkgo Evaluation of Memory (GEM) study at four clinical sites over the course of 8 years. GEM is the largest clinical trial ever to evaluate ginkgo's effect on the occurrence of dementia.

Resveratrol is a phytoalexin structurally related to stilbenes, which is synthesized in considerable amounts in the skin of grapes, raspberries, mulberries, pistachios and peanuts, and by at least 72 medicinal and edible plant species in response to stress conditions. It was isolated in 1940 and did not maintain much interest for around five decades until its role in treatment of cardiovascular diseases was suggested. To date, resveratrol has been identified as an agent that may be useful to treat cancer, pain, inflammation, tissue injury, and other diseases. However, currently the attention is being focused in analyzing its properties against neurodegenerative diseases and as antiaging compound. It has been reported that resveratrol shows effects in in vitro models of epilepsy, Alzheimer's disease, Parkinson's disease, Huntington's disease, amyotrophic lateral sclerosis, and nerve injury. However, evidences in vivo as well as in human beings are still lacking.

From Illinois - According to research in the journal Psychology and Aging, video games may improve cognitive function in the elderly. In a study of 40 older adults, researchers found that those assigned to play a strategy-based video game for nearly 24 hours, spread out over the course of 4 to 5 weeks, showed improved performance in task switching, working memory, visual short-term memory and reasoning, compared to those who did not play video games.

From Maryland - A panel of FDA advisers has concluded that two types of long-acting beta-2 agonist inhalers carry too high a risk for asthma-related complications. The drugs, Serevent and Foradil, when used without a corticosteroid, were found to have unacceptably high risks among all age groups. While some on the advisory panel disagreed with the ruling concerning adults, the decision was unanimous in regards to children.

Learn from Dr. Trevor Robbins, Professor of Cognitive Neuroscience at Cambridge University, U.K., about new therapies for schizophrenia, Alzheimer's Disease, and ADHD using cognitive enhancement drugs. Dr. Robbins goes into fascinating detail about how drugs such as Ritalin, atomoxetine and the new class of ampakines can actually improve patients' performance on cognitive tests. Recorded at the Staglin Music Festival for Mental Health 2008

Current treatment for Alzheimers disease offer symptomatic relief only, but this may soon be changing. Recent discoveries by Nazneen Dewji, PhD, UCSD School of Medicine, support the development of two totally new drugs that would potentially treat the cause. Join us for this exciting discussion of what the future may hold in treating Alzheimers disease. Series: Sam and Rose Stein Institute for Research on Aging (SIRA) [11/2008

Ginkgo biloba for Prevention of Dementia A Randomized Controlled 

Context

Ginkgo biloba is widely used for its potential effects on memory and cognition. To date, adequately powered clinical trials testing the effect of G biloba on dementia incidence are lacking.

Objective

To determine effectiveness of G biloba vs placebo in reducing the incidence of all-cause dementia and Alzheimer disease (AD) in elderly individuals with normal cognition and those with mild cognitive impairment (MCI).

Design, Setting, and Participants

AIM OF THE STUDY: Bacopa monnieri (Brahmi) is extensively used in traditional Indian medicine as a nerve tonic and thought to improve memory. To examine the neuroprotective effects of Brahmi extract, we tested its protection against the beta-amyloid protein (25-35) and glutamate-induced neurotoxicity in primary cortical cultured neurons. MATERIALS AND METHODS: Neuroprotective effects were determined by measuring neuronal cell viability following beta-amyloid and glutamate treatment with and without Brahmi extract. Mechanisms of neuroprotection were evaluated by monitoring cellular oxidative stress and acetylcholinesterase activity. RESULTS: Our result demonstrated that Brahmi extract protected neurons from beta-amyloid-induced cell death, but not glutamate-induced excitotoxicity. This neuroprotection was possibly due to its ability to suppress cellular acetylcholinesterase activity but not the inhibition of glutamate-mediated toxicity.

Alzheimer's disease (AD) is a progressive neurodegenerative disorder that destroys patient memory and cognition, communication ability with the social environment and the ability to carry out daily activities. Despite extensive research into the pathogenesis of AD, a neuroprotective treatment - particularly for the early stages of disease - remains unavailable for clinical use. In this review, we advance the suggestion that lipoic acid (LA) may fulfil this therapeutic need.