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Aktuelle Ernährungsmedizin 2013; 38(04): 290-295
DOI: 10.1055/s-0033-1343311
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© Georg Thieme Verlag KG Stuttgart · New York

Brain Food

Bedeutung der Ernährung bei der Prävention und Behandlung von DemenzBrain FoodImpact of Nutrition on the Prevention and Treatment of Dementia
A. Uster
Departement Medizin, Kantonsspital Winterthur
,
P. E. Ballmer
Departement Medizin, Kantonsspital Winterthur
› Author Affiliations
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Publication History

Publication Date:
18 July 2013 (online)

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Zusammenfassung

Demenz zählt zu den häufigsten Erkrankungen im höheren Alter und belastet die Volkswirtschaft enorm. In der Schweiz leben zwischen 107 000 und 125 000 demenzkranke Menschen und die Zahl der Erkrankten steigt weiter. Niemand kann sich vollständig vor dieser Erkrankung schützen. Allerdings gibt es vielversprechende Hinweise, dass bestimmte Lifestylefaktoren das Risiko einer Demenzerkrankung verringern. Die Ernährung zählt zu den wichtigen, modifizierbaren Präventionsfaktoren. Beobachtungsstudien zeigen, dass gewisse Ernährungsmuster deutlich häufiger mit dem Auftreten einer Demenz einhergehen als andere. Die Supplementierung einzelner Nährstoffe erwies sich allerdings in klinischen kontrollierten randomisierten doppelblinden Studien gar nicht oder nur sehr begrenzt als wirksam. Vielversprechender bei der Prävention scheint ein ganzheitlicher und frühzeitiger Ansatz: Die mediterrane Ernährungsweise mit ihrer Kombination aller als potenziell präventiv angesehener Substanzen – Antioxidanzien, mehrfach ungesättigte Fettsäuren und Vitamine – hat sich in verschiedenen Studien als effektiv erwiesen. In einer amerikanischen Studie ergab sich ein um ein Drittel reduziertes Demenzrisiko mit dieser Ernährungsform. Übereinstimmend zeigten Studien mit einer frühzeitigen Behandlung (Patienten mit einer leichten kognitiven Beeinträchtigung) und einem ganzheitlichen Ansatz (Nährstoffcocktail) vorsichtig positive Ergebnisse.

Abstract

Dementia is one of the most common diseases in older age and has an enormous economic impact on health costs. In Switzerland, between 107,000 and 125,000 people live with dementia and the number of patients is continuously rising. The possibilities to prevent dementia are limited. However, there is promising evidence from research that certain life style factors reduce the risk of dementia. Diet is one of the major, modifiable preventive factors. Observational studies have shown that certain dietary patterns are more frequently associated with the development of dementia than others. In contrast, supplementation of individual nutrients in double-blind, randomized, controlled trials turned out to be of limited efficacy. More promising seems a holistic approach: Scientific evidence suggests that the Mediterranean diet, with its combination of all potentially preventive substances – antioxidants, polyunsaturated fatty acids and vitamins – effectively protects against dementia. Consistently, recent studies suggest a slight beneficial effect of a nutrient cocktail containing several potentially preventive nutrients in the early treatment of dementia (patients with mild cognitive impairment).

Schlüsselwörter

Demenz - Alzheimererkrankung - Omega-3-Fettsäuren - B-Vitamine - Antioxidanzien

Keywords

dementia - Alzheimer’s disease - omega-3 fatty acids - B-vitamins - antioxidants
 

  • Literatur

  • 1 Staehelin HB. Epidemiologie der Demenzerkrankung. Schweiz Med Forum 2004; 4: 247-250
    PubMedGoogle Scholar
  • 2 Von Armin CA. Chancen und Grenzen der Ernährung bei Demenz. Schweiz Zeitschr Ernährung (SZE) 2012; 2: 13-16
    PubMedGoogle Scholar
  • 3 Kivipelto M, Solomon A. Alzheimer’s disease – the ways of prevention. J Nutr Health Aging 2008; 12: 89-94
    CrossrefPubMedGoogle Scholar
  • 4 Barak Y, Aizenberg D. Is dementia preventable? Focus on Alzheimer’s disease. Expert Rev Neurother 2010; 10: 1689-1698
    CrossrefPubMedGoogle Scholar
  • 5 Bundesamt für Gesundheit BAG. Demenz – gesundheits- und sozialpolitische Herausforderung. Tagungsband; August 2011
    Google Scholar
  • 6 Mohajeri MH, Leuba G. Prevention of age-associated dementia. Brain Res Bull 2009; 80: 315-325
    CrossrefPubMedGoogle Scholar
  • 7 Schaefer EJ, Bongard V, Beiser AS et al. Plasma phosphatidylcholine docosahexaenoic acid content and risk of dementia and Alzheimer disease: the Framingham Heart Study. Arch Neurol 2006; 63: 1545-1550
    CrossrefPubMedGoogle Scholar
  • 8 Fotuhi M, Mohassel P, Yaffe K. Fish consumption, long-chain omega-3 fatty acids and risk of cognitive decline or Alzheimer disease: a complex association. Nat Clin Pract Neurol 2009; 5: 140-152
    PubMedGoogle Scholar
  • 9 Quinn JF, Raman R, Thomas RG et al. Docosahexaenoic acid supplementation and cognitive decline in Alzheimer disease: a randomized trial. JAMA 2010; 304: 1903-1911
    CrossrefPubMedGoogle Scholar
  • 10 Van de Rest O, Geleijnse JM, Kok FJ et al. Effect of fish oil on cognitive performance in older subjects: a randomized, controlled trial. Neurology 2008; 71: 430-438
    CrossrefPubMedGoogle Scholar
  • 11 Dangour AD, Allen E, Elbourne D et al. Effect of 2-y n-3 long chain polyunsaturated fatty acid supplementation on cognitive function in older people: a randomized, double-blind, controlled trial. Am J Clin Nutr 2010; 91: 1725-1732
    CrossrefPubMedGoogle Scholar
  • 12 Yurko-Mauro K, McCarthy D, Rom D et al. Beneficial effects of docosahexaenoic acid on cognition in age-related cognitive decline. Alzheimers Dement 2010; 6: 456-464
    CrossrefPubMedGoogle Scholar
  • 13 Féart C, Barberger-Gateau P. Epidemiological studies on cognition and the omega-6/omega-3 balance. World Rev Nutr Diet 2011; 102: 92-97
    PubMedGoogle Scholar
  • 14 Press D, Alexander M. Prevention of dementia. In: Wilterding JL, ed. UpToDate. Waltham MA: UpToDate; 2012
    Google Scholar
  • 15 Dangour AD, Whitehouse PJ, Rafferty K et al. B-Vitamins and fatty acids in the prevention and treatment of Alzheimer’s disease and dementia: a systematic review. J Alzheimers Dis 2010; 22: 205-224
    PubMedGoogle Scholar
  • 16 Durga J, van Boxtel MP, Schouten EG et al. Effect of 3-year folic acid supplementation on cognitive function in older adults in the FACIT trial: a randomised, double blind, controlled trial. Lancet 2007; 369: 208-216
    CrossrefPubMedGoogle Scholar
  • 17 McMahon JA, Green TJ, Skeaff CM et al. A controlled trial of homocysteine lowering and cognitive performance. N Engl J Med 2006; 354: 2764-2772
    CrossrefPubMedGoogle Scholar
  • 18 Ford AH, Almeida OP. Effect of homocysteine lowering treatment on cognitive function: a systematic review and meta-analysis of randomized controlled trials. J Alzheimers Dis 2012; 29: 133-149
    PubMedGoogle Scholar
  • 19 Behl C. Amyloid beta-protein toxicity and oxidative stress in Alzheimer’s disease. Cell tissue Res 1997; 290: 471-480
    CrossrefPubMedGoogle Scholar
  • 20 Christen Y. Oxidative stress and Alzheimer disease. Am J Clin Nutr 2000; 71: 621-629
    PubMedGoogle Scholar
  • 21 Sung S, Yao Y, Uryu K et al. Early vitamin E supplementation in young but not aged mice reduces Abeta levels and amyloid deposition in a transgenic model of Alzheimer’s disease. FASEB J 2004; 18: 323-325
    PubMedGoogle Scholar
  • 22 Harrison FE, Hosseini AH, McDonald MP et al. Vitamin C reduces spatial learning deficits in middle-aged and very old APP/PSEN1 transgenic and wild-type mice. Pharmacol Biochem Behav 2009; 93: 443-450
    CrossrefPubMedGoogle Scholar
  • 23 Engelhart MJ, Geerlings MI, Ruitenberg A et al. Dietary intake of antioxidants and risk of Alzheimer disease. JAMA 2002; 287: 3223-3229
    CrossrefPubMedGoogle Scholar
  • 24 Morris MC, Evans DA, Bienias JL et al. Dietary intake of antioxidant nutrients and the risk of incident Alzheimer disease in a biracial community study. JAMA 2002; 287: 3230-3237
    CrossrefPubMedGoogle Scholar
  • 25 Luchsinger JA, Tang MX, Shea S et al. Antioxidant vitamin intake and risk of Alzheimer disease. Arch Neurol 2003; 60: 203-208
    CrossrefPubMedGoogle Scholar
  • 26 Zandi PP, Anthony JC, Khachaturian AS et al. Cache County Study Group. Reduced risk of Alzheimer disease in users of antioxidant vitamin supplements: the Cache County Study. Arch Neurol 2004; 61: 82-88
    CrossrefPubMedGoogle Scholar
  • 27 Yaffe K, Clemons TE, McBee WL et al. Impact of antioxidants, zinc, and copper on cognition in the elderly: a randomized, controlled trial. Neurology 2004; 63: 1705-1707
    CrossrefPubMedGoogle Scholar
  • 28 Petersen RC, Thomas RG, Grundman M et al. Vitamin E and donepezil for the treatment of mild cognitive impairment. N Engl J Med 2005; 352: 2379-2388
    CrossrefPubMedGoogle Scholar
  • 29 Kang JH, Cook NR, Manson JE et al. Vitamin E, vitamin C, beta carotene, and cognitive function among women with or at risk of cardiovascular disease: The women’s antioxidant and cardiovascular study. Circulation 2009; 119: 2772-2780
    CrossrefPubMedGoogle Scholar
  • 30 Grodstein F, Kang JH, Glynn RJ et al. A randomized trial of beta carotene supplementation and cognitive function in men: the Physicians’ Health Study 2. Arch Intern Med 2007; 167: 2184-2190
    CrossrefPubMedGoogle Scholar
  • 31 DeKosky ST, Williamson JD, Fitzpatrick AL et al. Ginkgo biloba for prevention of dementia: a randomized controlled trial. JAMA 2008; 300: 2253-2262
    CrossrefPubMedGoogle Scholar
  • 32 Snitz BE, O’Meara ES, Carlson MC et al. Ginkgo biloba for preventing cognitive decline in older adults: a randomized trial. JAMA 2009; 302: 2663-2670
    CrossrefPubMedGoogle Scholar
  • 33 Birks J, Grimley Evans J. Ginkgo biloba for cognitive impairment and dementia. Cochrane Database Syst Rev 2009; 21 CD003120
    PubMedGoogle Scholar
  • 34 von Arnim CA, Gola U, Biesalski HK. More than the sum of its parts? Nutrition in Alzheimer’s disease. Nutrition 2010; 26: 694-700
    CrossrefPubMedGoogle Scholar
  • 35 Scarmeas N, Stern Y, Tang MX et al. Mediterranean diet and risk for Alzheimer’s disease. Ann Neurol 2006; 59: 912-921
    CrossrefPubMedGoogle Scholar
  • 36 Scarmeas N, Luchsinger JA, Mayeux R et al. Mediterranean diet and Alzheimer disease mortality. Neurology 2007; 69: 1084-1093
    CrossrefPubMedGoogle Scholar
  • 37 Barberger-Gateau P, Raffaitin C, Letenneur L et al. Dietary patterns and risk of dementia: the Three-City cohort study. Neurology 2007; 69: 1921-1930
    CrossrefPubMedGoogle Scholar
  • 38 Féart C, Samieri C, Rondeau V et al. Adherence to a Mediterranean diet, cognitive decline, and risk of dementia. JAMA 2009; 302: 638-648
    CrossrefPubMedGoogle Scholar
  • 39 Gu Y, Nieves JW, Stern Y et al. Food combination and Alzheimer disease risk: a protective diet. Arch Neurol 2010; 67: 699-706
    CrossrefPubMedGoogle Scholar
  • 40 Bowman GL, Silbert LC, Howieson D et al. Nutrient biomarker patterns, cognitive function, and MRI measures of brain aging. Neurology 2012; 78: 241-249
    CrossrefPubMedGoogle Scholar
  • 41 Scheltens P, Kamphuis PJ, Verhey FR et al. Efficacy of a medical food in mild Alzheimer’s disease: A randomized, controlled trial. Alzheimers Dement 2010; 6: 1-10
    CrossrefPubMedGoogle Scholar
  • 42 Scheltens P, Twisk JW, Blesa R et al. Efficacy of Souvenaid in Mild Alzheimer’s Disease: Results from a randomized controlled trial. J Alzheimers Dis 2012; 31: 226-236
    PubMedGoogle Scholar
  • 43 Arab L, Sabbagh MN. Are certain life style habits associated with lower Alzheimer’s disease risk?. J Alzheimers Dis 2010; 20: 785-794
    PubMedGoogle Scholar
  • 44 Patterson C, Feightner JW, Garcia A et al. Diagnosis and treatment of dementia: 1. Risk assessment and primary prevention of Alzheimer disease. CMAJ 2008; 178: 548-556
    CrossrefPubMedGoogle Scholar
  • 45 Lautenschlager NT, Cox KL, Flicker L et al. Effect of physical activity on cognitive function in older adults at risk for Alzheimer disease: a randomized trial. JAMA 2008; 300: 1027-1037
    CrossrefPubMedGoogle Scholar
  • 46 Verhaeghen P, Marcoen A, Goossens L. Improving memory performance in the aged through mnemonic training: a meta-analytic study. Psychol Aging 1992; 7: 242-251
    CrossrefPubMedGoogle Scholar
  • 47 Yaffe K, Fiocco AJ, Lindquist K et al. Predictors of maintaining cognitive function in older adults: the Health ABC study. Neurology 2009; 72: 2029-2035
    CrossrefPubMedGoogle Scholar
  • 48 Scarmeas N, Luchsinger JA, Schupf N et al. Physical activity, diet, and risk of Alzheimer disease. JAMA 2009; 6: 627-637
    PubMedGoogle Scholar
  • 49 Ritchi K, Carrière I, Ritchie CW et al. Designing prevention programmes to reduce incidence of dementia: prospective cohort study of modifiable risk factors. BMJ 2010; 341: c3885
    CrossrefPubMedGoogle Scholar
  • 50 US Department of Health and Human Services. NIH Consensus Development Conference Statement on Preventing Alzheimer’s Disease and Cognitive decline. http://consensus.nih.gov/2010/alzstatement.htm
    Google Scholar