Abstract
BackgroundOne of the major challenges associated with our ageing population is the increasing incidence of age-associated cognitive decline, which has significant implications for an individual's ability to lead a productive and fulfilling life. In pure economic terms the costs of ageing reflects decreased productivity and engagement with the workforce. The maintenance of brain health underpinning intact cognition is a key factor to maintaining a positive, engaged, and productive lifestyle. In light of this, the role of diet, including supplementation with nutritional and even pharmacological interventions capable of ameliorating the neurocognitive changes that occur with age constitute vital areas of research.MethodsIn order to reduce cognitive ageing, the ARC longevity intervention (ARCLI) was developed to examine the effects of two promising natural pharmacologically active supplements on cognitive performance. ARCLI is a randomized, placebo-controlled, double-blind, 3-arm clinical trial in which 465 participants will be randomized to receive an extract of Bacopa monnieri (CDRI08 300 mg/day), Pycnogenol (150 mg/day), or placebo daily for 12 months. Participants will be tested at baseline and then at 3, 6 and 12 months post-randomization on a wide battery of cognitive, neuropsychological and mood measures, cardiovascular (brachial and aortic systolic and diastolic blood pressures as well as arterial stiffness), biochemical (assays to measure inflammation, oxidative stress and safety) as well as genetic assessments (telomere length and several Single Nucleotide Polymorphisms). The primary aim is to investigate the effects of these supplements on cognitive performance. The secondary aims are to explore the time-course of cognitive enhancement as well as potential cardiovascular and biochemical mechanisms underpinning cognitive enhancement over the 12 months of administration.ARCLI will represent one of the largest and most comprehensive experimental clinical trials in which supplements are administered to elderly participants. Results from ARCLI may help develop novel preventative health practices and nutritional/pharmacological targets in the elderly for cognitive and brain health.Trial registrationAustralia and New Zealand Clinical Trials Register (ANZCTR): ACTRN12611000487910
Highlights
One of the major challenges associated with our ageing population is the increasing incidence of age-associated cognitive decline, which has significant implications for an individual’s ability to lead a productive and fulfilling life
Aims and study hypotheses Extending upon preliminary findings [42,44,45], the primary aim of the current study is to examine the individual chronic 12 month effects of Bacopa (300 mg daily), and Pycnogenol (150 mg daily) on cognitive performance in a healthy elderly population
By examining the interrelationship between inflammation, oxidative stress, cardiovascular health and cognitive perfromance, the current study aims to identify modifiable risk factors for cognitive decline that can be targeted by supplementation
Summary
In order to reduce cognitive ageing, the ARC longevity intervention (ARCLI) was developed to examine the effects of two promising natural pharmacologically active supplements on cognitive performance. Anti-oxidant supplementation results in improved cognition and behaviour in aged animals and concurrent decreases in oxidative insult to neural structures [15] Human research in this area is largely limited to epidemiological studies. Bacopa appears to have multiple modes of action in the brain all of which may be useful in ameliorating cognitive decline in the elderly These include: (i) direct pro-cholinergic action; (ii) anti-oxidant (flavonoid) activity; (iii) metal chelation; (iv) anti-inflammatory effects; (v) improved blood circulation; (vi) adaptogenic activity; and (vii) removal of b-amyloid deposits. In contrast to anti-oxidants such as Vitamin C and E, and specific anti-oxidants such as Pycnogenol, the polypharmacological actions of Bacopa potentially act on several pathological changes in elderly brains in concert This potential is supported by a limited number of clinical trials into the neurocognitive effects of Pycnogenol and, to a greater extent, Bacopa. In both cases effects are evident at three months of daily administration, but not earlier
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