Benefits of use, and tolerance of, medium-chain triglyceride medical food in the management of Japanese patients with Alzheimer’s disease: a prospective, open-label pilot study

Abstract

ObjectivesThis is the first clinical trial of this type in Japan, designed to analyze two important aspects of Alzheimer’s disease (AD) management using medium-chain triglycerides. Axona was administered for 3 months (40 g of powder containing 20 g of caprylic triglycerides). We used an indurating, four-step dose-titration method (from 10 to 40 g per day) for 7 days before the trial, and examined the tolerance and adverse effects of this intervention. We also investigated its effect on cognitive function in mild-to-moderate AD patients.Patients and methodsThis was a clinical intervention in 22 Japanese patients with sporadic AD at a mild-to-moderate stage (ten females, 12 males), mean age (± standard deviation) 63.9 (±8.5) years, Mini-Mental State Examination (MMSE) score, 10–25, seven patients were ApoE4-positive. During Axona administration, we examined changes in cognitive function by obtaining MMSE and AD assessment-scale scores. Intolerance and serum ketone concentrations were also examined.ResultsThe tolerance of Axona was good, without severe gastrointestinal adverse effects. Axona did not improve cognitive function in our sample of AD patients, even in those patients without the ApoE4 allele. However, some ApoE4-negative patients with baseline MMSE score ≥14 showed improvement in their cognitive functions.ConclusionThe modified dose-titration method, starting with a low dose of Axona, decreased gastrointestinal adverse effects in Japanese patients. Axona might be effective for some relatively mildly affected patients with AD (with cognitive function MMSE score of ≥14 and lacking the ApoE4 allele).

Medium-Chain Triglycerides in Combination with Leucine and Vitamin D Benefit Cognition in Frail Elderly Adults: A Randomized Controlled Trial

“…However, because the total score of the ADAS-cog is 70 points (11), the improvement in the ADAS-cog score in both studies was very small. A recently conducted intervention study showed that addition of 20 g of caprylic triglycerides for 3 mo did not improve cognitive function (MMSE and ADAS-cog score) in 22 Japanese AD patients, even in those patients without the ApoE4 allele (12). Considering the marked increase in the scores of the NM scale and the significant increase in MMSE points in our study, better effects on cognitive function might be observed with a smaller dose of MCTs (6 g).…”

Ketogenic diet and its impact on mental processes of working population

“…However, with patients without ApoE4 allele one of the nutritional options to improve mild cognitive impairments is adding medium chain triglycerides to the diet (Page et al, 2009, Farias et al, 2014, Sharma et al, 2014, Fernando et al, 2015, Hertz et al, 2015, Ohnuma et al, 2016.…”

Medium‐chain triglycerides given in the early stage of mild‐to‐moderate Alzheimer's disease enhance memory function

“…2 We previously reported that only patients without Apolipoprotein E4 (ApoE4) and a Mini-Mental State Examination (MMSE) score >14 could show cognitive improvement after administration of Axona. 3 This time, by re-analyzing our previous data, we investigated which aspect of cognitive function was the most improved by MCT/ketones. 3 Twenty-two previously enrolled Japanese patients with mild-to-moderate sporadic AD were re-analyzed.…”

“…3 This time, by re-analyzing our previous data, we investigated which aspect of cognitive function was the most improved by MCT/ketones. 3 Twenty-two previously enrolled Japanese patients with mild-to-moderate sporadic AD were re-analyzed. 3 The patients took 40-g Axona per day for 90 days.…”

“…3 Twenty-two previously enrolled Japanese patients with mild-to-moderate sporadic AD were re-analyzed. 3 The patients took 40-g Axona per day for 90 days. Participants completed the MMSE and the Japanese version of the Alzheimer's Disease Assessment Scalecognitive component-Japanese version( ADAS J-cog.)…”