A prospective cohort, noncomparative, multicenter trial was conducted to explore the potential of a phytotherapeutic compound, available as a dietary supplement and containing extracts of Bacopa monnieri and Haematococcus pluvialis (astaxanthin) plus phosphatidylserine and vitamin E, in improving cognition in subjects diagnosed with mild cognitive impairment. Enrolled subjects (n=104) were aged 71.2±9.9 years and had a mini-mental state examination score of 26.0±2.0 (mean ± standard deviation). They underwent the Alzheimer’s Disease Assessment Scale-cognitive subscale (ADAS-cog) test and the clock drawing test at baseline and upon completion of a 60-day period of dietary supplementation with one tablet daily of the tested compound. In 102 assessable subjects, total ADAS-cog scores improved from 13.7±5.8 at baseline to 9.7±4.9 on day 60, and the clock drawing test scores improved from 8.5±2.3 to 9.1±1.9. Both changes were statistically significant (P<0.001). Memory tasks were the individual components of ADAS-cog showing the largest improvements. In a multivariate analysis, larger improvements in total ADAS-cog score were associated with less compromised baseline mini-mental state examination scores. Perceived efficacy was rated as excellent or good by 62% of study subjects. The tested compound was well tolerated; one nonserious adverse event was reported in the overall study population, and perceived tolerability was rated excellent or good by 99% of the subjects. In conclusion, dietary supplementation with the tested compound shows potential for counteracting cognitive impairment in subjects with mild cognitive impairment and warrants further investigation in adequately controlled, longer-term studies.

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Delirium, or acute confusional disorder, is a frequent occurrence in older people admitted for an acute pathological condition and it complicates hospitalization, worsening the prognosis. The clinical picture of delirium is characterized by an acute onset and a fluctuating course, inattention, disorganized thinking, altered level of consciousness (see CAM: Confusion Assessment Method for the diagnosis of delirium) and the presentation can take two main forms, either hyperactive or hypoactive, which sometimes coexist. The onset of an acute confusional state, especially in patients with a previous normal cognitive status, represents a condition that raises a lot of distress for their families or caregivers. In order to properly face delirium it is essential first to recognize it as a disease, but this behavior does not always occur in our wards.