16 November 2020

Using CANTAB to examine the potential synergistic effects of a combination of omega-3 fatty acids, carotenoids and vitamin E on the cognitive health and function of patients with MCI.

Dr Rebecca Power, Postdoctoral Researcher at the Nutrition Research Centre Ireland, shared the role that CANTAB played in her latest publication: Targeted Nutritional Intervention for Patients with Mild Cognitive Impairment: The Cognitive impAiRmEnt Study (CARES) Trial 1

Can you tell us more about your research group?

The Nutrition Research Centre Ireland (NRCI) is a multi-disciplinary research group studying the role of nutrition and lifestyle for human well-being. The NRCI was established by researchers within the School of Health Sciences at the Waterford Institute of Technology, Waterford, Ireland to enable scientists to conduct research across a diverse range of human health-related disciplines including eye health, cognition, chemistry, biochemistry, clinical nutrition, biotechnology, cancer and mental health.

Since 2014, cross-sectional and interventional work at the NRCI has demonstrated the importance of good nutrition, and the benefits of targeted nutritional supplementation in optimising the neurocognitive environment. Research at the centre has intensified over the last few years to support the role of nutrition for maintaining and optimising cognitive health and function in both cognitively healthy and impaired individuals. Our recent publication highlighted the potential of targeted nutritional supplementation on cognitive performance among patients with mild cognitive impairment (MCI).

What is the rationale behind your study?

This exploratory research was undertaken for a number of reasons. Firstly, omega-3 fatty acids (the building blocks of our cells), carotenoids (plant-based pigments that give fruits and vegetables their bright colours) and vitamin E (one of four essential fat-soluble vitamins) are important parts of a healthy diet. Previous research from our centre and others have shown that each of these nutrients are important for optimising and maintaining healthy brain function, primarily due to their antioxidant and anti-inflammatory properties. Secondly, given that these key nutrients are depleted in individuals with MCI in comparison to cognitively healthy individuals, it is likely that they will benefit from targeted nutritional intervention. Finally, and importantly, no interventional studies to date have examined the potential synergistic effects of a combination of omega-3 fatty acids, carotenoids and vitamin E on the cognitive health and function of patients with MCI.

Shows the nutrients in the brain

Which methods did you use?

Individuals with clinically confirmed MCI consumed an omega-3 fatty acid (1g of fish oil (of which 430 mg docosahexaenoic acid [DHA] and 90 mg eicosapentaenoic acid [EPA]), plus carotenoid (10mg lutein, 10mg meso-zeaxanthin, 2mg zeaxanthin) plus vitamin E (15mg α-tocopherol) formulation (now commercially known as Memory Health), or placebo (sunflower oil), for 12 months. These doses were provided via two oval-sized capsules, which individuals daily. Global cognition was assessed using the Montreal Cognitive Assessment (MoCA) and the Repeatable Battery for the Assessment of Neuropsychological Status. Additional assessments of specific cognitive domains were performed using CANTAB. This included the motor screening task (MOT) to determine comprehension, the spatial working memory (SWM) task to measure executive function (working memory), the reaction time task (RTI) to assess attention and the paired associated learning (PAL) task to test episodic memory. Nutritional status was measured in blood (using gas chromatography and high performance liquid chromatography) and in tissue (using the Heidelberg Spectralis and the Pharmanex Biophotonic Scanner).

What are the key findings?

This exploratory study identified trends in improved performance in episodic memory and global cognition among individuals with clinically confirmed MCI following 12-month targeted nutritional supplementation with a combination of omega-3 fatty acids, carotenoids and vitamin E.

What are the implications of your study?

Given that there has been little clinical success with pharmacological strategies for cognitive decline and Alzheimer’s disease, shifting focus towards preventative approaches is timely and warranted. This research has shown that individuals with clinically confirmed MCI respond positively to targeted nutritional supplementation. The results of this study are highly promising and highlight the potential of nutrition as a preventative strategy for modifying or delaying MCI progression and improving cognitive outcomes.

Why did you choose CANTAB?

CANTAB is one of the most widely employed cognition batteries and it has been shown to be sensitive in assessing cognitive performance for many population groups including healthy individuals and patients with neurodegenerative disorders.

What are the next steps for your research?

Given that the findings from this exploratory work are extremely promising, further research is warranted to re-examine the potential of nutrition in improving cognitive outcomes in individuals with MCI in a sample with sufficient statistical power. Our centre is currently working to identify and secure funding to replicate this research in a larger, appropriately powered interventional trial. The identification and recruitment of individuals with MCI, as well as maintaining study participation, are common challenges encountered when conducting research in the MCI population. Therefore, engagement and buy-in from stakeholders (namely clinicians, volunteers and their family) will be vital to the success of future interventional work with this population group.

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Dr Rebecca Power

Postdoctoral Researcher at the Nutrition Research Centre Ireland

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