4.7 Article

36-month LipiDiDiet multinutrient clinical trial in prodromal Alzheimer's disease

Journal

ALZHEIMERS & DEMENTIA
Volume 17, Issue 1, Pages 29-40

Publisher

WILEY
DOI: 10.1002/alz.12172

Keywords

Alzheimer's disease; atrophy; cognition; dietary intervention; function; hippocampus; mild cognitive impairment; nutrition; omega 3; prodromal; randomized controlled clinical trial; therapy

Funding

  1. European Union FP7 [211696]
  2. European Research Council [804371]
  3. Academy of Finland [317465, 287490]
  4. Academy of Finland (AKA) [317465, 317465] Funding Source: Academy of Finland (AKA)
  5. European Research Council (ERC) [804371] Funding Source: European Research Council (ERC)

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The LipiDiDiet trial demonstrated that the specific multinutrient combination Fortasyn Connect has beneficial effects on cognition and disease progression in prodromal Alzheimer's disease, with greater benefits observed with long-term use.
Introduction: The LipiDiDiet trial investigates the effects of the specific multinutrient combination Fortasyn Connect on cognition and related measures in prodromal Alzheimer's disease (AD). Based on previous results we hypothesized that benefits increase with long-term intervention. Methods: In this randomized, double-blind, placebo-controlled trial, 311 people with prodromal AD were recruited using the International Working Group-1 criteria and assigned to active product (125 mL once-a-day drink) or an isocaloric, same tasting, placebo control drink. Main outcome was change in cognition (Neuropsychological Test Battery [NTB] 5-item composite). Analyses were by modified intention-to-treat, excluding (ie, censoring) data collected after the start of open-label active product and/or AD medication. Results: Of the 382 assessed for eligibility, 311 were randomized, of those 162 participants completed the 36-month study, including 81 with 36-month data eligible for efficacy analysis. Over 36 months, significant reductions in decline were observed for the NTB 5-item composite (-60%; between-group difference 0.212 [95% confidence interval: 0.044 to 0.380]; P = 0.014), Clinical Dementia Rating-Sum of Boxes (-45%; P = 0.014), memory (-76%; P = 0.008), and brain atrophy measures; small to medium Cohen's d effect size (0.25-0.31) similar to established clinically relevant AD treatment. Discussion: This multinutrient intervention slowed decline on clinical and other measures related to cognition, function, brain atrophy, and disease progression. These results indicate that intervention benefits increased with long-term use.

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