Table 2.
List of reports on the effects of MCTs on cognitive function [Modified from Avgerinos et al. (84)].
| Study | Country | Study design | Number and type of patients | Diagnostic criteria for inclusion | Study groups (composition of MCTs) | Intervention dose | Duration of intervention | Plasma BHB measurement method | Cognitive measure |
|---|---|---|---|---|---|---|---|---|---|
| Fortier (85) |
Canada | RCT | 52 with MCI | Subjective memory complaint, MoCA, MMSE | MCTs vs. Placebo (C8:0 = 60%, C10:0 = 40%) |
30 g/d | 6 months | Colorimetric assay using an automated clinical chemistry analyzer (Dade Behring Inc., Newark, US) | MMSE, MoCA, trail making test, Stroop test, verbal fluency, digit symbol substitute ion, Boston naming test |
| Ota Part A (86) |
Japan | RCT | 20 with mild/moderate AD | NINCDS-ADRDA | MCTs vs. Placebo (C8:0 = 30.3%, C10:0 = 9.8%, C12:0 = NR) |
20 g/d | 2 days | Enzymatic method (SRL Corp., Tokyo, Japan) | WAIS III, WMS-R, Stroop test, trail making test |
| Chan (87) |
Malaysia | RCT | 41 with mild/moderate/severe AD | MMSE | Coconut oil vs. Placebo (NR) | 60 ml/d | 6 months | NA | MMSE, clock drawing test |
| Rebello (88) |
USA | RCT | 6 with MCI | National Institute on Aging | MCTs vs. Placebo (NR) | 56 g/d | 6 months | NR | ADAS-Cog, trail making test digit symbol test |
| Yang (89) |
Spain | RCT | 44 with AD | Institutionalized AD patients (unclear diagnostic criteria) | Coconut oil vs. placebo (NR) | 40 ml/d | 3 weeks | NA | MMSE (Spanish version) |
| Henderson (90) |
USA | RCT | 152 with mild/moderate AD | NINCDS-ADRDA and DSM-IV criterial | MCTs vs. Placebo (C8:0 = 100%) |
20 g/d | 3 months | BHB Liquicolor diagnostic kit (Stanbio Laboratory, L.P., Boerne, US) | MMSE, ADAS-Cog |
| USA | RCT | 20 with probable AD or amnestic MCI | NINCDS-ADRDA criteria | MCTs vs. Placebo (C8:0 = 100%) |
40 ml/d | 2 days | Enzymatically, using procedure 310-UV (Sigma Diagnostics Inc., Livonia, US) | MMSE, ADAS-Cog, Stroop test, paragraph recall | |
| Ota Part B (86) |
Japan | 1 arm trial | 19 with mild/moderate AD | NINCDS-ADRDA criteria | MCTs (C8:0 = 30.3%, C10:0 = 9.8%, C12:0 = NR) |
20 g/d | 3 months | Enzymatic method (SRL Corp., Tokyo, Japan) | WAIS III, WMS-R, Stroop test, trail making test |
| USA | 1 arm trial | 10 with very mild/mild/moderate AD | National Institute on Aging | MCTs + low carb/ high fat diet (NR) | 22.5–45 ml/d | 3 months | NR | MMSE ADAS-cog | |
| Ohnuma (91) |
Japan | 1 arm trial | 20 with moderate/severe AD | NINCDS-ADRDA | MCTs (NR) | 20 g/d | 3 months | ELISA (KAINOS Laboratories Inc., Tokyo, Japan). | MMSE, ADAS-cog |
| USA | Case report | 55 with probable mild/moderate AD | MMSE | MCTs (C8:0 = 100%) | 20 g/d | 18.8 ± 9.2 months | NA | MMSE | |
| Newport (92) |
USA | Case report | Young onset sporadic AD | Clinical diagnosis, MMSE scores, MRI, APOE4 carriage | MCTs + coconut oil (NR) | 165 ml/d | 2.5 months | Precision Xtra Glucose and Ketone Monitoring System (Abbott Laboratories., Chicago, US) | MMSE, ADAS-cog |
| Farah (93) |
USA | Case report | Probable AD | MMSE, MoCA, FDG PET | MCTs (C8:0 = 100%) |
20 g/d | ~3 months | NA | MMSE, MoCA |
AD, Alzheimer's Disease; ADAS-Cog, Alzheimer's Dis. Assessment Scale-cognitive subscale; BHB, beta-hydroxybutyrate; CONTAB, Cambridge Neuropsychological Test Automated Battery; C-SSRS, Columbia Suicide Severity Rating Scale; C8, octanoic acid; C10, decanoic acid; FDG PET, fluorodeoxyglucose (18F) positron emission tomography; MCI, Mild Cognitive Impairment; MCTs, Medium Chain Triglycerides; MMSE, Mini Mental State Examination; MoCA, Montreal Cognitive Assessment Scale; NA, Not Applicable; NINCDS-ADRDA, National Institute of Neurological and Communicative Disease and Stroke and the Alzheimer's Disease and Related Disorder Association; NM scale, Nishimura geriatric rating scale; NR, Not Reported; WAIS, Wechsler Adult Intelligence Scale; WMS-R, Wechsler Memory Scale-Revised.