International Journal of School and Cognitive Psychology
Open Access

Abstract

Efficacy of Adjunctive Extra Virgin Coconut Oil Use in Moderate to Severe Alzheimer’s Disease

Gandotra S, Kour J and Van der Waag A

Background: Ketogenic compounds derived from medium chain triglyceride (MCT) oils have been claimed to have beneficial health effects in the Alzheimer?s disease (AD] mainly attributed to its medium chain triglycerides. AD is known to have been characterized by early and region specific decline in cerebral glucose metabolism. It is hypothesized that Alzheimer brain tends to preferentially utilize ketones generated from medium chain triglycerides in light of decreased glucose metabolism to improve cognition. Extra virgin coconut oil with predominance of MCT content was used in subjects with moderate to severe AD to examine its efficacy in improving cognitive performance. Methods: Daily oral administration of extra virgin coconut oil (20 gm) was evaluated in 31 subjects with predominantly moderate to severe AD diagnosed as per DSM IV TR criteria for AD in a 6 week trial using quasi experimental non randomized pre-post intervention design. Subjects were on a normal diet and continued taking approved AD medications. Primary cognitive end points were mean change from baseline in the AD Assessment Scale-Cognitive subscale [ADAS-Cog], and Clinicians Interview based Impression of Change Plus Caregivers input [CIBIC-Plus]. Active oil administration continued for 4 weeks from baseline with successive ratings on measures of cognitive change at 2, 4 and 6 weeks respectively. Results: There was a significant difference between the ADAS-Cog scores from baseline over repeated ratings at 2, 4 and 6 weeks (Mauchly?s Chi Square ?2 = 61.1, ?=0.4, F =14, p=0.00, ?2=0.31). Post hoc comparisons of ADAS-Cog scores from baseline at 4 and 6 weeks were similar [At 4 weeks, Mean difference=4.1, P=0.00, C.I= (1.4-6.7); at 6 weeks, Mean difference=4.1, p=0.00, C.I= (1.0-7.2). The response rate of CIBIC-Plus defined as improved or no change was significantly improved over successive ratings from 2 weeks to 6 weeks (Cochran?s Q=22.5, df=2, P=.00). No statistically significant difference could be noted for the total cholesterol, Triglycerides and LDL fractions over the study trial except for the HDL fraction over repeated measures at 4 and 6 weeks over baseline (Mauchly?s Chi Square ?2 (df=2)=6.5, ?=0.8, F (df 1.6, 49.9)=6.4, p=0.005, ?2=0.17). Conclusions: Addition of adjunctive coconut oil is likely to have beneficial effects in cognitive performance for those suffering from moderate to severe AD and the effects were sustained for at least 2 weeks after the oil administration stopped. No deleterious effects on the overall lipid profile could be elicited.