Conflict of evidence: carotenoids and other micronutrients in the prevention and treatment of cognitive impairment

Abstract

Cognitive impairment is a common age-related disorder which affects in the stadium and type Alzheimer's Disease (AD) a steadily growing number of patients. AD is not curable and is not being easily diagnosed in its preclinical phase. This work aims at highlighting the complex though promising rationale for the use of selected micronutrients against age-related cognitive impairment and its progression. The advances made in the last decades in both defining the etiopathogenesis of cognitive impairment and in revealing mechanisms of action underlying possible preventive effects of several vitamins and micronutrients--likely related to antioxidant activity and modulation of cellular signaling--is being accompanied by conflicting results of most clinical trials. Therefore, available data do not currently support the use of substances such as carotenoids, polyphenols, vitamin D, curcumin, vitamin E, vitamin C, or lipoic acid in AD prevention and/or treatment. This might be partly due to the fact that cognitive impairment and especially AD are extremely complex disorders. The main obstacle to the inclusion of micronutrients among anticognitive impairment drug strategies, however, is that studies conducted so far are poorly comparable and probably underestimate of the role of vascular damage in age-related cognitive impairment. A possible clinical benefit of these substances in AD is not disproved to date, thus further better designed studies are needed.