Dementia is a growing global concern, as highlighted by the recent London G8 summit on this topic. As the debate grows about how to provide the best care to patients and those caring for people diagnosed with early Alzheimer’s disease, the use of medical nutrition during the early stages has been reviewed by a panel of Alzheimer’s disease experts as a potential new approach.

Published in the March edition of The Journal of Nutrition, Health & Aging, the review, “Souvenaid®: a new approach to management of early Alzheimer’s disease” explores the potential for medical nutrition to support the formation of new synapses in the brain. A loss of synapses, particularly in the hippocampus and cortex, is a key feature of early Alzheimer’s disease and is associated with a decline in cognitive performance. 

The panel, which consisted of a variety of experts in the field of Alzheimer’s disease, looked specifically at synaptic loss, which may play an important role in the development of early Alzheimer’s disease symptoms. Previous studies have shown that by the time someone is diagnosed with Alzheimer’s disease, they may have lost approximately 40% of their synapses. Therefore, slowing the rate of synapse loss and stimulating the formation of new synaptic connections represent important therapeutic aims. The review explored the evidence and scientific rationale for Souvenaid®, the first medical nutrition product to be designed to support synapse formation in early Alzheimer’s disease.

A specific combination of nutrients is required in synaptogenesis. In particular, DHA, choline and uridine work in synergy in a process known as “The Kennedy Pathway”. Souvenaid® has undergone an extensive 12-year development programme by researchers at the Massachusetts Institute of Technology and contains a unique patented combination of nutrients (Fortasyn™ Connect) that includes omega-3 polyunsaturated fatty acids (docosahexaenoic acid and eicosapentaenoic acid), uridine (as uridine monophosphate) and choline, which are nutritional precursors required for synaptic membrane phospholipid synthesis. Souvenaid also contains phospholipids and other cofactors which increase the bioavailability of the precursors. These precursors are known to diminish in availability with age, and it has additionally been shown that people with Alzheimer's disease have relatively low levels of these nutrients despite eating a normal diet.

The expert review panel concluded that two randomised, double-blind, placebo controlled trials (duration 12 and 24 weeks) in patients with mild Alzheimer’s disease untreated with acetylcholinesterase inhibitors and/or memantine have demonstrated that Souvenaid® is well tolerated and improves episodic memory performance (MMSE ≥20). The large amount of preclinical and clinical data available for Souvenaid®, and the scientific rationale for its use, should reassure clinicians, patients and carers that the product’s use has a strong empirical basis. Furthermore, Souvenaid® is well tolerated by patients with no reported adverse events.

Dr Craig Ritchie, Consultant Psychiatrist and Clinical Senior Lecturer said, “Synaptic loss and the role of diet and nutrition are two new areas of interest for the early stages of Alzheimer’s disease as we prepare to cope with more and more patients living with dementia. In an area where there has been little progression towards any new medications for a number of years, exploring other avenues such as this is very important. The current data on Souvenaid® is encouraging and presents a new option for healthcare professionals to recommend, and perhaps more importantly, for patients and their carers to try and give them greater control over the active management of the disease.”

A recent UK opinion poll of people aged 50 plus revealed that just 12% are aware that people living with early Alzheimer's disease have been shown to have relatively low levels of a range of nutrients in their body, despite eating a normal diet. Furthermore, 86% believe more advice on lifestyle (eg. exercise and nutrition) should be given to help those living with early Alzheimer's disease.

The review paper highlights the potential benefits of Souvenaid® for those in a caregiving role, recognising the struggle to manage the diet of patients with early Alzheimer’s disease due to changes in food habits and increased dependency on the caregiver. As a convenient once-daily, low-volume drink, Souvenaid® can be incorporated into patients’ daily routine to safeguard nutrient intake and support synapse formation.

An ongoing, 24-month, European Union-funded trial in subjects with prodromal Alzheimer’s disease (LipiDiDiet) is evaluating the potential benefits of Souvenaid® in slowing disease progression.

Souvenaid® is a “Food for Special Medical Purposes”, for the dietary management of early Alzheimer’s disease. It should be taken as part of an Alzheimer’s disease care plan and used under medical supervision. People with early Alzheimer’s disease must speak with a doctor, specialist nurse, dietitian or pharmacist to see if Souvenaid® is right for them. Souvenaid® comes in two pleasant tasting flavours (vanilla and strawberry) and is designed to be incorporated into the daily routine, such as taking it at breakfast.

It takes time for these nutrients to be taken up and used in the body, so there is no noticeable effect straight away. Therefore, it is important to keep taking Souvenaid every day to ensure a continuous and adequate supply of important nutrients for the brain.