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Authors: Nolan, John M. | Loskutova, Ekaterina | Howard, Alan N. | Moran, Rachel | Mulcahy, Riona | Stack, Jim | Bolger, Maggie | Dennison, Jessica | Akuffo, Kwadwo Owusu | Owens, Niamh | Thurnham, David I. | Beatty, Stephen

Article Type: Research Article

Abstract: Background: The macula (central retina) contains a yellow pigment, comprising the dietary carotenoids lutein (L), zeaxanthin (Z), and meso-zeaxanthin, known as macular pigment (MP). The concentrations of MP’s constituent carotenoids in retina and brain tissue correlate, and there is a biologically-plausible rationale, supported by emerging evidence, that MP’s constituent carotenoids are also important for cognitive function. Objective: To investigate if patients with Alzheimer’s disease (AD) are comparable to controls in terms of MP and visual function. Methods: 36 patients with moderate AD and 33 controls with the same age range participated. MP was measured using dual-wavelength autofluorescence (Heidelberg Spectralis® ); …cognitive function was assessed using a battery of cognition tests (including Cambridge Neuropsychological Test Automated Battery). Visual function was recorded by measuring best corrected visual acuity (BCVA) and contrast sensitivity (CS). Serum L and Z concentrations (by HPLC) and age-related macular degeneration (AMD, by retinal examination) status were also assessed. Results: In the AD group, central MP (i.e., at 0.23°) and MP volume were significantly lower than the control group (p < 0.001 for both), as were measures of BCVA, CS, and serum L and Z concentrations (p < 0.05, for all). Conclusion: AD patients were observed to exhibit significantly less MP, lower serum concentrations of L and Z, poorer vision, and a higher occurrence of AMD when compared to control subjects. A clinical trial in AD patients designed to investigate the impact of macular carotenoid supplementation with respect to MP, visual function, and cognitive function is merited. Show more

Keywords: Age-related macular degeneration, Alzheimer's disease, cognitive function, contrast sensitivity, lutein, meso-zeaxanthin, visual function, zeaxanthin

DOI: 10.3233/JAD-140507

Citation: Journal of Alzheimer's Disease, vol. 42, no. 4, pp. 1191-1202, 2014

Authors: Nolan, John M. | Loskutova, Ekaterina | Howard, Alan | Mulcahy, Riona | Moran, Rachel | Stack, Jim | Bolger, Maggie | Coen, Robert F. | Dennison, Jessica | Akuffo, Kwadwo Owusu | Owens, Niamh | Power, Rebecca | Thurnham, David | Beatty, Stephen

Article Type: Research Article

Abstract: Background: Patients with Alzheimer's disease (AD) exhibit significantly less macular pigment (MP) and poorer vision when compared to control subjects. Objective: To investigate supplementation with the macular carotenoids on MP, vision, and cognitive function in patients with AD versus controls. Methods: A randomized, double-blind clinical trial with placebo and active arms. 31 AD patients and 31 age-similar control subjects were supplemented for six months with either Macushield (10 mg meso-zeaxanthin [MZ]; 10 mg lutein [L]; 2 mg zeaxanthin [Z]) or placebo (sunflower oil). MP was measured using dual-wavelength autofluorescence (Heidelberg Spectralis® ). Serum L, Z, and MZ were quantified by …high performance liquid chromatography. Visual function was assessed by best corrected visual acuity and contrast sensitivity (CS). Cognitive function was assessed using a battery of cognition tests, including the Cambridge Neuropsychological Test Automated Battery (CANTAB)). Results: Subjects on the active supplement (for both AD and non-AD controls) exhibited statistically significant improvement in serum concentrations of L, Z, MZ, and MP (p < 0.001, for all) and also CS at (p = 0.039). Also, for subjects on the active supplement, paired samples t-tests exhibited four significant results (from five spatial frequencies tested) in the AD group, and two for the non-AD group, and all indicating improvements in CS. We found no significant changes in any of the cognitive function outcome variables measured (p > 0.05, for all). Conclusion: Supplementation with the macular carotenoids (MZ, Z, and L) benefits patients with AD, in terms of clinically meaningful improvements in visual function and in terms of MP augmentation. Show more

Keywords: Age-related macular degeneration, Alzheimer's disease, cognitive function, contrast sensitivity, lutein, meso-zeaxanthin, randomized clinical trial, visual function, zeaxanthin

DOI: 10.3233/JAD-142265

Citation: Journal of Alzheimer's Disease, vol. 44, no. 4, pp. 1157-1169, 2015