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Johns Hopkins Memory and Alzheimer’s Treatment Center is currently recruiting adults over the age of 60 who have been diagnosed with mild memory impairment (especially those with early Alzheimer’s disease) for a research study of dietary treatments for the condition.

Alzheimer’s disease is known to be associated with insulin resistance, or abnormal glucose metabolism. Abnormalities in the brain’s use of glucose can be observed on imaging studies even before clinical symptoms have begun to appear.

And in patients who already have established dementia due to Alzheimer’s disease, there is a strong link between the severity of cognitive impairment and the decrease in glucose uptake.

When glucose is unavailable, ketone bodies, which are produced by the metabolism of fats, can act as a “backup” fuel, possibly slowing cognitive decline or even improving cognition in Alzheimer’s patients.

Two diets to be tested

The Hopkins study is a 12-week clinical trial of a high-fat, low-carbohydrate diet vs. a low-fat diet high in fruits, vegetables and grains. Both diets are considered safe for most physically healthy older adults.

All education, support and vitamin supplements are provided free of charge. Participants may stay on their existing medications. Your physician will be asked to agree to your participation.

Each patient will have a study partner who is cognitively healthy, lives with the participant, and can help him or her adhere to the diet. A research dietitian will teach participants and partners the new diet and monitor adherence with food logs, in-person assessments and urine ketone testing.

After an initial baseline visit, participants will complete four in-person assessments, during which adherence to the diet will be assessed and neurocognitive tests will be administered.

Researchers expect that the diet will be manageable and well-tolerated by those with moderate cognitive impairment and Alzheimer’s disease. They also hope to demonstrate that following such a diet will result in a greater increase (or less decline) in cognitive test scores than the comparison diet.

Those following the study diet will consume fewer than 20 mg. of carbohydrates a day, supplemented by extra dietary fats. Those in the comparison group will follow the National Institute on Aging diet for seniors, which includes selections from grains, proteins, fruits, vegetables, dairy, oils, solid fats and added sugars.

Success in small study

In a similar but smaller study conducted at the University of Kansas Alzheimer’s Disease Center, researchers fed 10 Alzheimer’s patients a diet comprised of 70 percent fat for three months.

The researchers evaluated whether the higher-fat diet resulted in better scoring on a standard Alzheimer’s assessment of cognitive functions including memory, language, orientation and praxis (the ability to put an idea or theory into practice).

Using that test, cognition in Alzheimer’s patients has been found to generally decline by five points or so per year. But the University of Kansas researchers found that the higher-fat diet partially reversed the decline, with participants improving an average of four points on the scale.

In other trials, patients with Alzheimer’s disease who did not change their diet but were taking the medication Aricept (donapezil) only improved by about two points on the scale. In the University of Kansas study, the patients’ scores didn’t decline at all, and everyone who stayed on the diet and on their medications improved to some degree.

For more information on the Hopkins study, or to volunteer, call Alison Buchholz, Ph.D., (410) 502-6352.