Medicine Poster Session
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Introduction
Presenile and senile dementia is a pathological condition which gradually destroys the patient’s memory, capacity to concentrate and reasoning power; it currently represents an authentic therapeutic challenge. Senile ageing of the brain is a multifactor process. In addition to the hereditary factor there are others that may accelerate it (environmental, psychosocial, pathological and biochemical factors). In particular, neurotransmission deficiency, a reduction in the cellular energy metabolism, a loss in fluidity of the biological membranes and damage caused by free radicals often speed up the deterioration of an elderly patient’s brain.
Phospholipids, acetylcarnitine, L- glutamine and antioxidants (vit. E, ß -carotene, selenium), taken singly, have proved to have some effect in the prevention and treatment of the clinical and biochemical symptoms correlated with dementia.
The aim of this study was to evaluate whether the administration of a supplement to the diet (Nolder® ) containing all the components listed previously, may be effective against the clinical symptoms of patients with mild and moderate dementia.
Materials and Methods
Patients and Methods
Twenty patients (7 males and 13 females with an average age of 72 years) with presenile or senile dementia (14 mild , 6 moderate, as defined by the global deterioration scale GDS) were treated for two months with two sachets / day of the supplement mentioned above (Nolder® ).
The tests used for evaluation at the beginning of the study (T0) and after two months of treatment (T60) were the Mini Mental State Examination (MMSE) and the Index of Mental Decline (IMD).
Results
The results obtained are summarized in table 1 and Figures 1 and 2.
Table 1
Total sample |
mild GDS |
"moderate" GDS |
||
Average MMSE |
T0 |
16.7 |
18.6 |
12.2 |
(higher=better) |
T60 |
19.2 |
21.9 |
12.8 |
p* |
<0.001 |
<0.001 |
0.234 |
|
Average IVC |
T0 |
26.1 |
19.7 |
40.8 |
(lower=better) |
T60 |
19.3 |
12.4 |
35.0 |
p* |
<0.001 |
<0.001 |
0.137 |
|
*paired-t-test |
Fig. 1
Fig. 2
From a preliminary analysis it can be seen how all the elderly patients presented significant improvements in their mean scores both for the MMSE, which rose from 16.7 (T0) to 19.2 (T60), and the IVC, which fell from 26.1 (T0) to 19.3 (T60). Even more interestingly, in the group of patients with mild dementia, significant improvements were observed in performance with regard to both the MMSE score ( which rose from 18.6 (T0) to 21.9 (T60) ) and the IVC (which fell from 19.7 (T0) to 12.4 (T60) ). The same improvement was not observed in the group of patients classified as suffering from moderate dementia on admission to the study ("moderate" GDS).
Discussion and Conclusion
This study documents a significant improvement in the performance of elderly patients with presenile and senile dementia, evaluated on the basis of the MMSE and IVC.
The beneficial effect of including an oral supplement in their diet based on phospholipids, acetylcarnitine, L-glutamine and antioxidants (Nolder® ) proves particularly effective in patients with mild dementia.
Despite all the limitations of a open pilot study and the limited number of cases, these results are extremely promising and suggest a need for further controlled studies.
References
1) Ames B.N. et al: Oxidants, antioxidants, and the degenerative diseases of aging. Proc. Natl. Acad. Sci. USA, 1993, vol. 90: 7915-7922.
2) Hawkes W.C. and Hornobostel L.: Effects of dietary selenium on mood in healthy men living in a metabolic research unit. Biol. Psychiatry, 1996; 39: 121-128.
3) Bonavita E.: Study of the efficacy and tolerability of L-acetylcarnitine therapy in the senile brain. Int. J. Clin. Pharmacol., Ther. And Toxicol., 1986M; vol. 24, n° 9: 511-516.
4) Onofrj M. et al: Central cholinergic effects of levoacetylcarnitine. Drugs Exptl. Clin. Res. 1983; IX (1): 161-169.
5) Reaven P.D. et al: Effect of dietary antioxidant combinations in humans. Protection of LDL by vitamin E but not by b -carotene. Arteriosclerosis and thrombosis, 1993, vol. 13, n° 4: 590-600.
6) Palmieri G. et al: Double-blind controlled trial of phosphotidylserine in patients with senile mental deterioration. Clinical Trials Journal, 1987; vol. 24, n° 1: 73-83.
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