Souvenaid in the management of mild cognitive impairment: an expert consensus opinion

Abstract

Background Mild cognitive impairment (MCI) among an aging global population is a growing challenge for healthcare providers and payers. In many cases, MCI is an ominous portent for dementia. Early and accurate diagnosis of MCI provides a window of opportunity to improve the outcomes using a personalized care plan including lifestyle modifications to reduce the impact of modifiable risk factors (for example, blood pressure control and increased physical activity), cognitive training, dietary advice, and nutritional support. Souvenaid is a once-daily drink containing a mixture of precursors and cofactors (long-chain omega-3 fatty acids, uridine, choline, B vitamins, vitamin C, vitamin E, and selenium), which was developed to support the formation and function of neuronal membranes and synapses. Healthcare providers, patients, and carers require expert advice about the use of Souvenaid. Methods An international panel of experts was convened to review the evidence and to make recommendations about the diagnosis and management of MCI, identification of candidates for Souvenaid, and use of Souvenaid in real-world practice. This article provides a summary of the expert opinions and makes recommendations for clinical practice and future research. Summary of opinion Early diagnosis of MCI requires the use of suitable neuropsychological tests combined with a careful clinical history. A multimodal approach is recommended; dietary and nutritional interventions should be considered alongside individualized lifestyle modifications. Although single-agent nutritional supplements have failed to produce cognitive benefits for patients with MCI, a broader nutritional approach warrants consideration. Evidence from randomized controlled trials suggests that Souvenaid should be considered as an option for some patients with early Alzheimer’s disease (AD), including those with MCI due to AD (prodromal AD). Conclusion Early and accurate diagnosis of MCI provides a window of opportunity to improve the outcomes using a multimodal management approach including lifestyle risk factor modification and consideration of the multinutrient Souvenaid. Electronic supplementary material The online version of this article (10.1186/s13195-019-0528-6) contains supplementary material, which is available to authorized users.

36‐month LipiDiDiet multinutrient clinical trial in prodromal Alzheimer's disease

“…Effect size, expressed as Cohen's d value, for established clinically relevant AD treatment is modest (up to or slightly exceeding a value of 0.30) 34 and a similar effect size (0.25-0.31) was observed for all outcome measures with significant betweengroup differences in this trial. Our results thus support the current expert opinion on Fortasyn Connect 17 and extend it by highlighting that the potential benefit might be further increased by early and longterm intervention.…”

“…[14][15][16] Recently, a further expert consensus opinion stated that Fortasyn Connect is not recommended for patients with moderate or advanced AD dementia, but should be considered as an option for patients with mild AD dementia or MCI due to AD pathology (prodromal AD), based on the available clinical trials results including LipiDiDiet. 17 The European LipiDiDiet research consortium conducts preclinical research and clinical trials to better understand the impact of nutrition at different stages of AD. Here we studied the prodromal stage of AD as defined using the International Working Group-1 criteria.…”

Quantitative Assessment of Resting-State for Mild Cognitive Impairment Detection: A Functional Near-Infrared Spectroscopy and Deep Learning Approach

“…None of the available pharmacologic or non-pharmacologic therapies are able to slow or stop the destruction of neurons caused by AD symptoms [2]. Mild cognitive impairment (MCI) is a transitional state between healthy aging and AD [4]. Researchers believe that treatment in the early stages (i.e., MCI) of the AD continuum may be effective for preventing the progression of AD and sustaining brain function [2].…”

Nutritional Interventions for Early Dementia

“…That is, on the possibility of preventing or delaying the progression of dementia through nutritional interventions. In this regard, an international panel of experts recently convened that Souvenaid (a multinutrient product targeting synaptic dysfunction containing long-chain omega-3 fatty acids, uridine, choline, B vitamins, vitamin C, vitamin E, and selenium) should be considered as a therapeutic option in patients with prodromal AD or mild AD dementia (42). This advice was based on the results of randomized controlled trials of Souvenaid providing some evidence of efficacy in participants with early AD, but not among those at the advanced stages of the disease (43)(44)(45).…”