Micronutrients supplementation and nutritional status in cognitively impaired elderly persons: a two-month open label pilot study.
BACKGROUND
Malnutrition is a widespread problem in elderly people and is associated with cognitive decline. However, interventional studies have produced ambiguous results. For this reason, we wanted to determine the effect of micronutrient supplementation on blood and tissue levels and on general nutritional status in persons with mild or moderate cognitive impairment.


METHODS
We performed a 2-month, open-label trial, administering a daily micronutrient supplement to 42 memory clinic patients with mild cognitive deficits. Blood levels of antioxidants, zinc, and B vitamins were determined before and after supplementation. In addition, we assessed metabolic markers for B vitamins and intracellular (buccal mucosa cell [BMC]) antioxidant levels. Nutritional status was assessed by using the Mini Nutritional Assessment (MNA).


RESULTS
Blood levels of B vitamins, folic acid, lutein, β-carotene, α-carotene, and α-tocopherol increased significantly. Decreases in homocysteine levels and the thiamine pyrophosphate effect and an increase in holotranscobalamin were observed. We found no increase in intracellular antioxidant levels of BMC. The MNA score in subjects at risk for malnutrition increased significantly, mainly owing to better perception of nutritional and overall health status.


CONCLUSIONS
Micronutrient supplementation improved serum micronutrient status, with improved metabolic markers for B vitamins but not for intracellular antioxidant status, and was associated with improved self-perception of general health status. Our data underline the necessity of determining micronutrient status and support the use of additional assessments for general health and quality of life in nutritional supplementation trials.
Department of Neurology, Ulm University, Oberer Eselsberg 45, 89081 Ulm, Germany. Christine.arnim@uni-ulm.de.
Christine A F
CA
von Arnim
Stephanie
S
Dismar
Cornelia S
CS
Ott-Renzer
Nathalie
N
Noeth
Albert C
AC
Ludolph
Hans K
HK
Biesalski
D000368:Aged; D000369:Aged, 80 and over; D000975:Antioxidants / Q000378:metabolism; D002338:Carotenoids / Q000097:blood; D003072:Cognition Disorders / Q000188:drug therapy*; D019587:Dietary Supplements; D005260:Female; D005492:Folic Acid / Q000097:blood; D006801:Humans; D014975:Lutein / Q000097:blood; D008297:Male; D018977:Micronutrients / Q000008:administration & dosage* / Q000097:blood*; D008875:Middle Aged; D009061:Mouth Mucosa / Q000166:cytology / Q000187:drug effects; D015596:Nutrition Assessment; D009752:Nutritional Status; D010865:Pilot Projects; D014803:Vitamin B Complex / Q000097:blood; D024502:alpha-Tocopherol / Q000097:blood; D019207:beta Carotene / Q000097:blood
D000975:Antioxidants; D018977:Micronutrients; D019207:beta Carotene; D014803:Vitamin B Complex; D002338:Carotenoids; C041635:alpha-carotene; D005492:Folic Acid; D024502:alpha-Tocopherol; D014975:Lutein