Current Neurology and Neuroscience Reports

, Volume 7, Issue 5, pp 366–372 | Cite as

Diet and Alzheimer’s disease

  • José A. LuchsingerEmail author
  • James M. Noble
  • Nikolaos Scarmeas


Alzheimer’s disease (AD) is increasing in prevalence. There are no known preventive or curative measures. There is evidence that oxidative stress, homocysteinerelated vitamins, fats, and alcohol have a role in the pathogenesis of AD. Some epidemiologic studies suggest that higher dietary intake of antioxidants, vitamins B6, B12, and folate, unsaturated fatty acids, and fish are related to a lower risk of AD, but reports are inconsistent. Modest to moderate alcohol intake, particularly wine, may be related to a lower risk of AD. The Mediterranean diet may also be related to lower AD risk. However, randomized clinical trials of supplements of vitamins E, B12, B6, and folate have shown no cognitive benefit, and randomized trials for other nutrients or diets in AD are not available. The existing evidence does not support the recommendation of specific supplements, foods, or diets for the prevention of AD.


Homocysteine Mild Cognitive Impairment Alzheimer Disease Mediterranean Diet Glycemic Load 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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References and Recommended Reading

  1. 1.
    Luchsinger JA, Mayeux R: Dietary factors and Alzheimer’s disease. Lancet Neurol 2004, 3:579–587.PubMedCrossRefGoogle Scholar
  2. 2.
    Cummings JL: Alzheimer’s disease. N Engl J Med 2004, 351:56–67.PubMedCrossRefGoogle Scholar
  3. 3.
    Brookmeyer R, Gray S, Kawas C: Projections of Alzheimer’s disease in the United States and the public health impact of delaying disease onset. Am J Public Health 1998, 88:1337–1342.PubMedCrossRefGoogle Scholar
  4. 4.
    Selkoe DJ: Alzheimer’s disease: genotypes, phenotypes, and treatments. Science 1997, 275:630–631.PubMedCrossRefGoogle Scholar
  5. 5.
    Berglund L: The APOE gene and diets: food (and drink) for thought. Am J Clin Nutr 2001, 73:669–670.PubMedGoogle Scholar
  6. 6.
    Luchsinger J, Mayeux R: Cardiovascular risk factors and Alzheimer’s disease. Curr Atheroscler Rep 2004, 6:261–266.PubMedCrossRefGoogle Scholar
  7. 7.
    Selkoe DJ: The origins of Alzheimer disease: a is for amyloid. JAMA 2000, 283:1615–1617.PubMedCrossRefGoogle Scholar
  8. 8.
    Pitchumoni SS, Doraiswamy PM: Current status of antioxidant therapy for Alzheimer’s Disease. J Am Geriatr Soc 1998, 46:1566–1572.PubMedGoogle Scholar
  9. 9.
    Neuropathology Group: Pathological correlates of late-onset dementia in a multicentre, community-based population in England and Wales: Neuropathology Group of the Medical Research Council Cognitive Function and Ageing Study (MRC CFAS). Lancet 2001, 357:169–175.CrossRefGoogle Scholar
  10. 10.
    Masaki KH, Losonczy KG, Izmirlian G, et al.: Association of vitamin E and C supplement use with cognitive function and dementia in elderly men. Neurology 2000, 54:1265–1272.PubMedGoogle Scholar
  11. 11.
    Zandi PP, Anthony JC, Khachaturian AS, et al.: Reduced risk of Alzheimer disease in users of antioxidant vitamin supplements: The Cache County Study. Arch Neurol 2004, 61:82–88.PubMedCrossRefGoogle Scholar
  12. 12.
    Engelhart MJ, Geerlings MI, Ruitenberg A, et al.: Dietary intake of antioxidants and risk of Alzheimer disease [see comment]. JAMA 2002, 287:3223–3229.PubMedCrossRefGoogle Scholar
  13. 13.
    Morris MC, Evans DA, Bienias JL, et al.: Dietary intake of antioxidant nutrients and the risk of incident Alzheimer disease in a biracial community study. JAMA 2002, 287:3230–3237.PubMedCrossRefGoogle Scholar
  14. 14.
    Luchsinger JA, Tang MX, Shea S, Mayeux R: Antioxidant vitamin intake and risk of Alzheimer disease. Arch Neurol 2003, 60:203–208.PubMedCrossRefGoogle Scholar
  15. 15.
    Sano M, Ernesto C, Thomas RG, et al.: A controlled trial of selegiline, alpha-tocopherol, or both as treatment for Alzheimer’s disease. The Alzheimer’s Disease Cooperative Study. N Engl J Med 1997, 336:1216–1222.PubMedCrossRefGoogle Scholar
  16. 16.
    Petersen RC: Mild cognitive impairment as a diagnostic entity. J Intern Med 2004, 256:183–194.PubMedCrossRefGoogle Scholar
  17. 17.
    Petersen RC, Thomas RG, Grundman M, et al.: Vitamin E and donepezil for the treatment of mild cognitive impairment. N Engl J Med 2005, 352:2379–2388.PubMedCrossRefGoogle Scholar
  18. 18.
    Miller ER 3rd, Pastor-Barriuso R, Dalal D, et al.: Metaanalysis: high-dosage vitamin E supplementation may increase all-cause mortality. Ann Intern Med 2005, 142:37–46.PubMedGoogle Scholar
  19. 19.
    Seshadri S, Beiser A, Selhub J, et al.: Plasma homocysteine as a risk factor for dementia and Alzheimer’s disease. N Engl J Med 2002, 346:476–483.PubMedCrossRefGoogle Scholar
  20. 20.
    Selhub J, Jacques PF, Wilson PW, et al.: Vitamin status and intake as primary determinants of homocysteinemia in an elderly population. JAMA 1993, 270:2693–2698.PubMedCrossRefGoogle Scholar
  21. 21.
    Seshadri S, Wolf PA: Homocysteine and the brain: vascular risk factor or neurotoxin? Lancet Neurol 2003, 2:11.PubMedCrossRefGoogle Scholar
  22. 22.
    Snowdon DA, Tully CL, Smith CD, et al.: Serum folate and the severity of atrophy of the neocortex in Alzheimer disease: findings from the Nun study. Am J Clin Nutr 2000, 71:993–998.PubMedGoogle Scholar
  23. 23.
    Luchsinger JA, Tang MX, Shea S, et al.: Plasma homocysteine levels and risk of Alzheimer disease. Neurology 2004, 62:1972–1976.PubMedGoogle Scholar
  24. 24.
    Haan MN, Miller JW, Aiello AE, et al.: Homocysteine, B vitamins, and the incidence of dementia and cognitive impairment: results from the Sacramento Area Latino Study on Aging. Am J Clin Nutr 2007, 85:511–517.PubMedGoogle Scholar
  25. 25.
    Wang HX, Wahlin A, Basun H, et al.: Vitamin B(12) and folate in relation to the development of Alzheimer’s disease. Neurology 2001, 56:1188–1194.PubMedGoogle Scholar
  26. 26.
    Crystal HA, Ortof E, Frishman WH, et al.: Serum vitamin B12 levels and incidence of dementia in a healthy elderly population: a report from the Bronx Longitudinal Aging Study. J Am Geriatr Soc 1994, 42:933–936.PubMedGoogle Scholar
  27. 27.
    Morris MC, Evans DA, Schneider JA, et al.: Dietary folate and vitamins B-12 and B-6 not associated with incident Alzheimer’s disease. J Alzheimers Dis 2006, 9:435–443.PubMedGoogle Scholar
  28. 28.
    Morris MC, Evans DA, Bienias JL, et al.: Dietary folate and vitamin B12 intake and cognitive decline among community-dwelling older persons. Arch Neurol 2005, 62:641–645.PubMedCrossRefGoogle Scholar
  29. 29.
    Luchsinger JA, Tang MX, Miller J, et al.: Relation of higher folate intake to lower risk of Alzheimer disease in the elderly. Arch Neurol 2007, 64:86–92.PubMedCrossRefGoogle Scholar
  30. 30.
    Morris MS, Jacques PF, Rosenberg IH, Selhub J: Folate and vitamin B-12 status in relation to anemia, macrocytosis, and cognitive impairment in older Americans in the age of folic acid fortification. Am J Clin Nutr 2007, 85:193–200.PubMedGoogle Scholar
  31. 31.
    Toole JF, Malinow MR, Chambless LE, et al.: Lowering homocysteine in patients with ischemic stroke to prevent recurrent stroke, myocardial infarction, and death: The Vitamin Intervention for Stroke Prevention (VISP) Randomized Controlled Trial. JAMA 2004, 291:565–575.PubMedCrossRefGoogle Scholar
  32. 32.
    McMahon JA, Green TJ, Skeaff CM, et al.: A controlled trial of homocysteine lowering and cognitive performance. N Engl J Med 2006, 354:2764–2772.PubMedCrossRefGoogle Scholar
  33. 33.
    Kruman II, Culmsee C, Chan SL, et al.: Homocysteine elicits a DNA damage response in neurons that promotes apoptosis and hypersensitivity to excitotoxicity. J Neurosci 2000, 20:6920–6926.PubMedGoogle Scholar
  34. 34.
    Hu FB, Willett WC: Optimal diets for prevention of coronary heart disease. JAMA 2002, 288:2569–2578.PubMedCrossRefGoogle Scholar
  35. 35.
    Cohn JS: Oxidized fat in the diet, postprandial lipaemia, and cardiovascular disease. Curr Opin Lipidol 2002, 13:19–24.PubMedCrossRefGoogle Scholar
  36. 36.
    Luchsinger JA, Tang MX, Shea S, Mayeux R: Caloric intake and the risk of Alzheimer disease. Arch Neurol 2002, 59:1258–1263.PubMedCrossRefGoogle Scholar
  37. 37.
    Morris MC, Evans DA, Bienias JL, et al.: Dietary fats and the risk of incident Alzheimer disease. Arch Neurol 2003, 60:194–200.PubMedCrossRefGoogle Scholar
  38. 38.
    Morris MC, Evans DA, Bienias JL, et al.: Consumption of fish and n-3 fatty acids and risk of incident Alzheimer disease [see comment]. Arch Neurol 2003, 60:940–946.PubMedCrossRefGoogle Scholar
  39. 39.
    Engelhart MJ, Geerlings MI, Ruitenberg A, et al.: Dietary intake of antioxidants and risk of Alzheimer disease. JAMA 2002, 287:3223–3229.PubMedCrossRefGoogle Scholar
  40. 40.
    Pi-Sunyer FX: Glycemic index and disease. Am J Clin Nutr 2002, 76S:290–298.Google Scholar
  41. 41.
    Luchsinger JA, Tang MX, Shea S, Mayeux R: Hyperinsulinemia and risk of Alzheimer disease. Neurology 2004, 63:1187–1192.PubMedGoogle Scholar
  42. 42.
    Luchsinger JA, Tang MX, Mayeux R: Glycemic load and risk of Alzheimer’s disease. J Nutr Health Aging 2007, In press.Google Scholar
  43. 43.
    Mukamal KJ, Longstreth WT Jr, Mittleman MA, et al.: Alcohol consumption and subclinical findings on magnetic resonance imaging of the brain in older adults: the cardiovascular health study. Stroke 2001, 32:1939–1946.PubMedGoogle Scholar
  44. 44.
    Sacco RL, Elkind M, Boden-Albala B, et al.: The protective effect of moderate alcohol consumption on ischemic stroke. JAMA 1999, 281:53–60.PubMedCrossRefGoogle Scholar
  45. 45.
    Heinonen IM, Lehtonen PJ, Hopia AI: Antioxidant activity of berry and fruit wines and liquors. J Agric Food Chem 1998, 46:25–31.PubMedCrossRefGoogle Scholar
  46. 46.
    Mukamal KJ, Kuller LH, Fitzpatrick AL, et al.: Prospective study of alcohol consumption and risk of dementia in older adults. JAMA 2003, 289:1405–1413.PubMedCrossRefGoogle Scholar
  47. 47.
    Ruitenberg A, van Swieten JC, Witteman JC, et al.: Alcohol consumption and risk of dementia: the Rotterdam Study. Lancet 2002, 359:281–286.PubMedCrossRefGoogle Scholar
  48. 48.
    Truelsen T, Thudium D, Grønbæk M, Copenhagen City Heart Study: Amount and type of alcohol and risk of dementia: the Copenhagen City Heart Study. Neurology 2002, 59:1313–1319.PubMedGoogle Scholar
  49. 49.
    Luchsinger JA, Tang MX, Siddiqui M, et al.: Alcohol intake and risk of dementia. J Am Geriatr Soc 2004, 52:540–546.PubMedCrossRefGoogle Scholar
  50. 50.
    Orgogozo JM, Dartigues JF, Lafont S, et al.: Wine consumption and dementia in the elderly: a prospective community study in the Bordeaux area. Rev Neurol (Paris) 1997, 153:185–192.Google Scholar
  51. 51.
    Linday J, Laurin D, Verreault R: Risk factors for Alzheimer’s disease: a prospective analysis from the Canadian Study of Health and Aging. Am J Epidemiol 2002, 156:445–453.CrossRefGoogle Scholar
  52. 52.
    Trichopoulos D, Lagiou P: Mediterranean diet and cardiovascular epidemiology. Eur J Epidemiol 2004, 19:7–8.PubMedGoogle Scholar
  53. 53.
    Trichopoulou A, Lagiou P, Kuper H, Trichopoulos D: Cancer and Mediterranean dietary traditions. Cancer Epidemiol Biomarkers Prev 2000, 9:869–873.PubMedGoogle Scholar
  54. 54.
    Trichopoulou A, Orfanos P, Norat T, et al.: Modified Mediterranean diet and survival: EPIC-elderly prospective cohort study. BMJ 2005, 330:991.PubMedCrossRefGoogle Scholar
  55. 55.
    Scarmeas N, Stern Y, Tang MX, et al.: Mediterranean diet and risk for Alzheimer’s disease. Ann Neurol 2006, 59:912–921.PubMedCrossRefGoogle Scholar
  56. 56.
    Thiébaut AC, Freedman LS, Carroll RJ, Kipnis V: Is it necessary to correct for measurement error in nutritional epidemiology? Ann Intern Med 2007, 146:65–67.PubMedGoogle Scholar
  57. 57.
    Devanand DP, Michaels-Marston KS, Liu X, et al.: Olfactory deficits in patients with mild cognitive impairment predict Alzheimer’s disease at follow-up. Am J Psychiatry 2000, 157:1399–1405.PubMedCrossRefGoogle Scholar
  58. 58.
    Shumaker SA, Legault C, Rapp SR, et al.: Estrogen plus progestin and the incidence of dementia and mild cognitive impairment in postmenopausal women: The Women’s Health Initiative Memory Study: a randomized controlled trial. JAMA 2003, 289:2651–2662.PubMedCrossRefGoogle Scholar

Copyright information

© Current Medicine Group LLC 2007

Authors and Affiliations

  • José A. Luchsinger
    • 1
    Email author
  • James M. Noble
  • Nikolaos Scarmeas
  1. 1.Taub Institute for Research of Alzheimer’s Disease and the Aging BrainColumbia UniversityNew YorkUSA

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