Rationale for a combination of selected micronutrients to improve cognition and prevent or slow down age-related cognitive impairment

Abstract

This chapter deals with the question as to whether micronutrients contribute to the maintenance of cognitive function during the aging process. The onset of mild cognitive impairment (MCI) and at least the development of dementia are insidious, and occur years before the loss of cognition becomes apparent. Besides a couple of factors, including genetics and lifestyle, nutrition is claimed as an important factor which interacts with basic pathologies of cognitive decline. In particular, micronutrients (vitamins, trace elements and minerals) can mitigate the risk of cognitive decline, especially in elderly people at risk of deficiencies. Based on epidemiological findings and existing scientific evidence, two major groups of micronutrients will be discussed: homocysteine-lowering vitamins and antioxidants. Cognitive decline, with its early clinical diagnosis mild cognitive impairment (MCI), becomes evident in the age group > 60 years. The quality of diet determines survival and health status in free-living elderly people within a European population. High plasma levels of β-carotene (as a marker for vegetable intake) and α-tocopherol (as a marker for edible plant oils) are especially associated with lower mortality in the elderly (Buijsse et al. 2005). Epidemiological studies demonstrate that with increasing age, the prevalence of nutritional deficiencies increases, in particular deficiencies of antioxidants (β-carotene, vitamins C, E and selenium and zinc) and B-vitamins (folic acid, B6, B12). Deficiencies of micronutrients however, may contribute to, or even promote, cognitive impairment. Consequently it is suggested that a straightforward strategy to improve micronutrient status may improve cognition or delay the onset of MCI and Alzheimer dementia (AD).