ReviewRole of nutraceuticals in cognition during aging and related disorders
Introduction
Aging is a complex and inevitable biological phenomenon with concomitant structural and functional changes in the brain of a living organism (Gupta et al., 2019; Srivas and Thakur, 2019). Some changes are part of the normal aging process, while others are debilitating, referred to as pathological and predisposing individuals to neurodegenerative disorders. Cognition is one of the higher order brain functions that show conspicuous alteration with advancing age and influence the quality of life (Tucker-Drob, 2019). Recent demographic survey reports that approximately 15–20% of total world population aged 65 years and above, manifests mild cognitive impairment (MCI) (Alzheimer's Association, 2019).
Cognitive abilities can be categorized into specific domains including attention, memory, executive function, language and visuospatial abilities. Executive cognitive function involves decision making, problem solving, planning and sequencing of responses and multitasking (Murman, 2015). Age-related cognitive deficits are pronounced in certain domains including episodic and working memory, executive functions and conceptual reasoning. Memory retrieval is one of the most studied cognitive domains because its impairment is a frequent complaint that older adults make during normal aging. Other cognitive domains of speech, language and procedural memory are resilient to brain aging and might even improve with increasing age (Harada et al., 2013).
There is significant heterogeneity among older adults in the rate of cognitive decline ranging from subtle to severe forms interfering with the ability to participate in normal daily activities. More importantly, epidemiological studies reveal that elderly with decline of cognitive capacity have higher risk to develop neurological ailments including Alzheimer's, Huntington's and Parkinson's disease (Tyas et al., 2007; Ravaglia et al., 2008; Campbell et al., 2013; Vlachos et al., 2020). Therefore, age-associated cognitive decline has become an increasing biomedical concern (Bishop et al., 2010; Konar et al., 2016) and development of prevention and treatment strategies of MCI as well as severe dementia is demanded (Antony et al., 2017; D’ Cunha et al., 2018; Park, 2019).
Studies on animal models and human cohorts have demonstrated the critical influence of nutritional status on cognitive abilities (Tucker, 2016; Wahl et al., 2017; Liu et al., 2020a, Liu et al., 2020b). Therefore, dietary intervention through nutraceuticals is being considered as an attractive approach to ameliorate the cognitive impairment during aging and pathological conditions (Vlachos and Scarmeas, 2019). Nutraceuticals comprise of natural food and supplements with antioxidant and/or anti-inflammatory properties and immense health benefits (Kelsey et al., 2010; Mecocci et al., 2014). The present review article focuses on the role of nutraceuticals in age-related cognitive decline and associated disorders.
Section snippets
Factors influencing brain aging and cognitive decline
Unravelling the causal factors of cognitive decline associated with normal aging would offer hope for the prevention of pathological aging and treatment of neurodegenerative disorders. Cognitive aging is governed by multiple factors including lifestyle, diet, endocrine and genetic parameters, oxidative damage, neurotoxic exposures, medical and surgical interventions for disease. These factors influence brain integrity at structural, neurochemical and gene expression level compromising
Nutrition as potential modifier of cognitive aging
The brain has a high demand for nutrients and accumulating studies reveal that nutritional imbalances dampen structural and functional integrity of brain critically impacting our cognitive capacities. Malnutrition in community-dwelling elderly population and aged patients in hospital have been associated with cognitive decline. Elderly people are at increased risk for micronutrient deficiencies due to a variety of factors including social, physical, economic, and emotional obstacles to eating.
Nutraceutical intervention in cognitive decline during aging and disorders
There is an increasing interest in the area of cognitive enhancement not only in the aged but also in the young and cognitively intact individuals. Emerging evidences suggest that nutrition is a modifiable risk factor of cognitive deficits and optimum nutritional intake is necessary to maintain cognitive health (Pelletier et al., 2015; Valls-Pedret et al., 2015) and diminish risk of neurodegenerative pathologies in later life (Otaegui-Arrazola et al., 2014). In this regard, the role of
Conclusion and future perspective
Nutraceuticals represent both opportunities and challenges in prevention of age-associated cognitive decline and treatment of neurodegenerative conditions. Multiple neurocognitive benefits and wide spectrum of biological pathways including antioxidant defence, anti-inflammation, neural proliferation and differentiation and metabolic homeostasis offer holistic cognitive gain upon nutraceutical intervention (Fig. 1). On the other hand, nutraceutical supplementation to reverse cognitive aging
CRediT authorship contribution statement
Padmanabh Singh: Writing - original draft, Writing - review & editing. Thamil Mani Sivanandam: Writing - original draft, Writing - review & editing. Arpita Konar: Conceptualization, Writing - original draft, Writing - review & editing. M.K. Thakur: Conceptualization, Supervision, Writing - review & editing.
Acknowledgements
The work cited from the authors' laboratory was financially supported by Indian Council of Medical Research (5/4–5/153/Neuro/2015-NCD-I), Department of Science & Technology, Government of India (EMR/2015/002178) and University Grants Commission – Basic Science Research (UGC-BSR) Faculty fellowship (F.18-1/2011, BSR) to MKT. AK is supported by INSPIRE Faculty grant, Department of Science & Technology, Government of India (DST/INSPIRE/04/2014/002261).
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