Clinical Trials Logo

Clinical Trial Details — Status: Not yet recruiting

Administrative data

NCT number NCT06433037
Other study ID # NL85910.091.23
Secondary ID
Status Not yet recruiting
Phase N/A
First received
Last updated
Start date June 2024
Est. completion date September 2026

Study information

Verified date May 2024
Source Wageningen University
Contact Yannick Vermeiren, PhD
Phone +31618520620
Email yannick.vermeiren@wur.nl
Is FDA regulated No
Health authority
Study type Interventional

Clinical Trial Summary

As people around the world are living longer, the number of individuals with dementia, particularly Alzheimer's disease (AD), is expected to triple by 2050. There's growing evidence suggesting that our gut health might play a role in the prevention of dementia. The connection between our gut and brain, known as the gut-brain axis, is becoming an important area of study. Research in animals has shown that different types of dietary fibre can improve gut health, brain function, mood, blood sugar level and the immune system and may even prevent certain harmful brain changes seen in Alzheimer's disease. Subjective Cognitive Decline (SCD) is a condition where individuals notice a decline in their mental abilities, and it can be an early sign of Alzheimer's disease. The goal of this clinical trial is to learn if dietary fibres can improve gut and brain health in older individuals, between the ages of 60 and 79 years, who notice problems in their mental abilities, and meet the criteria of SCD. Three different dietary fibres will be given, and researchers will compare three different fibres to a placebo product to see if there is a difference between the fibres and the placebo. The main questions it aims to answer are: 1. Does dietary fibre improve working memory? 2. Does dietary fibre improve other markers of brain function? 3. Does dietary fibre improve gut health? 4. Does dietary fibre improve the immune system and blood glucose levels? 5. Does dietary fibre improve mood? Participants will: - Consume dietary fibres twice a day, mixed in water, tea or coffee, for a period of 26 weeks - Have two functional MRI scans, and three additional study visits, where blood, urine and feces will be collected - Undergo a number of neuropsychological tests, aimed at evaluating brain function - Fill out questionnaires on their general health, mood, dietary habits, gut health - Wear smartwatches for one week, at the beginning and the end of the study


Description:

Rationale: Due to the greying of society, a triplication of the number of people with dementia worldwide, with Alzheimer's disease (AD) as the commonest form, is expected by 2050. Compelling evidence points towards a crucial role of intestinal health as one potential etiological modifier of dementia, with the (microbiota) gut-brain axis (MGBA) receiving increasing attention. A number of preclinical studies have demonstrated benefit of various sources of dietary fibre for their capacity to improve gut health, cognitive functioning, general mood, glycaemia, immunogenicity, and, to inhibit tau phosphorylation, the latter which is a hallmark in AD brain. Subjective cognitive decline (SCD) lies on the continuum of AD, and subjects with this condition are at increased risk of further conversion to mild cognitive impairment (MCI) or AD. Currently, no cure is available for AD. Various symptomatic and a few disease-modifying treatments are available, but these treatments only have very limited or mild clinical effects and are often accompanied by severe side effects. Clinical follow-up studies to evaluate the effect of dietary fibre in older adults with suspected cognitive decline are required, but are still lacking to date. Objective: The primary objective of this study is to investigate the effect of 26 weeks of supplementation with three different dietary fibres (chicory inulin, resistant dextrin, and seaweed polysaccharide) compared to a placebo (maltodextrin) on microbiota gut-brain health effects in older adults (aged 60-79) with Subjective Cognitive Decline Plus (SCD+) by assessing changes in brain function and working memory by blood oxygen level dependant (BOLD) signal activity and task accuracy during n-back task functional magnetic resonance imaging (fMRI) assessment. The secondary objectives are to investigate the effects of 26 weeks of supplementation with dietary fibre (chicory inulin, resistant dextrin, and, seaweed polysaccharide) compared to placebo (maltodextrin) in older adults on the following parameters related to potential gut-brain pathways: 1. neuropsychological test battery scoring, 2. other relevant brain health parameters, 3. relevant intestinal health parameters, and 4. immune and metabolic parameters. Study population: 164 older adults (60-79 years) with SCD+. Study design implementation: Participants will undergo assessments at baseline (T0), mid-study (T1/2, after 13 weeks) and at study end (T1, after 26 weeks. Each participant will have five study visits in total: two at T0, one at T1/2 and two at T1. At each of the timepoints the following will be collected/performed at WUR: Sample collection (blood, urine (omitted in week 13), faeces); general cognitive assessments (see NTB; Cognitive Failure Questionnaire (CFQ) (baseline and end only), GDS-15, GAD-7); general physiological measures (blood pressure, BMI, grip-strength); dietary assessment (MIND-adjusted Eetscore, FFQ). At ZGV working memory will be evaluated using BOLD fMRI signalling and task accuracy using an n-back task paradigm. Additionally, high-resolution T1- and T2-weighted anatomical images of main regions of interest (hippocampi, (pre)frontal-, and temporal cortices) will be acquired. For two periods of one week, corresponding with the baseline and week 26 visits, participants will wear smartwatches. These watches will be worn continuously and data will be gathered regarding cardiovascular functioning (heart rate), physical activity and mood (push messages).


Recruitment information / eligibility

Status Not yet recruiting
Enrollment 164
Est. completion date September 2026
Est. primary completion date September 2025
Accepts healthy volunteers No
Gender All
Age group 60 Years to 79 Years
Eligibility Inclusion Criteria: 1. Written informed consent 2. Fluency in Dutch (speaking, reading, writing) 3. Age between 60-79 years (at screening) 4. Subjective cognitive decline plus (SCD+), (criteria of Jessen et al.): 4.1 Self-reported worsening of memory; 4.2 Indication of repetitive concerns (worries) associated with SCD; 4.3 With at least one of the following two features present: (i) onset of SCD within the last 5 years; (ii) age at onset =60 years of age; 5. Presence of at least 2 self-reported risk factors for cognitive decline (based on LIBRA criteria): (i) Diabetes mellitus type II (ii) High cholesterol (iii) Hypertension (iv) High BMI (v) Heart disease (vi) Unhealthy diet (lower regular adherence to Mediterranean diet components such as fish, vegetables, olive oil, pasta and red wine) Exclusion Criteria: 1. Current participation in other intervention trials 2. Technologically illiterate (complete incompetence in working with computers, apps, online questionnaires, smartwatches etc.) 3. No internet access from home 4. Clinical diagnosis of =1 of the following: - Neurological pathology (e.g. MCI, dementia, multiple sclerosis, Parkinson's disease, epilepsy); - Current malignant disease(s), with or without treatment; - Current psychiatric disorder(s) (e.g. major depressive disorder, bipolar disorder, schizophrenia, anxiety, psychosis, PTSD); - Symptomatic/decompensated cardiovascular disease (e.g. stroke, angina pectoris, heart failure, recent myocardial infarction); - Severe visual impairment or blindness - Hearing or communicative impairment. - Gastrointestinal tract disorder such as irritable bowel syndrome or inflammatory bowel disease (e.g. Crohn's disease or ulcerative colitis). 5. Current or recent (<6 weeks) use of prebiotic, probiotic, or dietary fibre supplement that may modulate the microbiota, or unwilling to stop the use of supplements during the study 6. Current or recent (<6 weeks) of algae/phytoplankton supplements such as spirulina or chlorella, or unwilling to stop the use of supplements during the study 7. Use of psychotropic medication (anti-depressants, anti-psychotics) 8. Use of antibiotics in the 3 months before starting the study or planned use during the study 9. Being an employee of the Human Nutrition and Health Division of Wageningen University. 10. Significant cognitive impairment assessed using the Modified Telephone Interview for Cognitive Status battery (TICS-m score <23) 11. Request to have Apo-E genotype result disclosed 12. Allergies to fish or shellfish 13. Having a contra-indication to MRI scanning including: - Ferromagnetic implants: - Active implantable medical devices such as: insulin pump / medicine pump / neurostimulator; pacemaker / defibrillator; - Other passive implants such as: punctured port-a-cath; synthetic heart valve - Intra-orbital or intra-ocular metallic fragments - Claustrophobia

Study Design


Related Conditions & MeSH terms


Intervention

Dietary Supplement:
Chicory inulin
Chicory inulin (12g/day) divided over two dosages (6g per dose)
Resistant dextrin
Resistant dextrin (14g/day) divided over two dosages (7g per dose)
Seaweed polysaccharide
Seaweed polysaccharide (1g/day) divided over two dosages (0.5g per dose). Additionally contains 7g/day of placebo as a volumetric and isocaloric filler.
Placebo
Maltodextrin (7g/day) will be provided in two divided doses (3.5g per dose)

Locations

Country Name City State
Netherlands Wageningen University Wageningen

Sponsors (6)

Lead Sponsor Collaborator
Wageningen University Cosun Nutrition Center, Oceanium Ltd., Roquette Frères, Sensus BV, Technical University of Eindhoven (TU/e)

Country where clinical trial is conducted

Netherlands, 

Outcome

Type Measure Description Time frame Safety issue
Other Effect on heart rate Heart rate as determined by wearable Samsung Active 2.0 Smartwatches Measured at baseline and week 26
Other Effect on physical activity Physical activity (pedometer) as determined by wearable Samsung Active 2.0 Smartwatches Measured at baseline and week 26
Other Effect on BMI Measured in kg/m^2 Measured at baseline, week 13 and week 26
Other Effect on blood pressure Systolic and diastolic blood pressure as measured by sphygmomanometer Measured at baseline, week 13 and week 26
Other Effect on mood as measured by Samsung Active 2.0 Smartwatches Mood determined by push notifications (sad, stressed, neutral, happy, or angry) as determined by wearable Samsung Active 2.0 Smartwatches Measured at baseline, week 13 and week 26
Other Effect on mood as determined by GDS-15 questionnaire Self-reported depressive symptoms by Geriatric Depression Scale-15 (GDS-15) questionnaire Measured at baseline, week 13 and week 26
Other Effect on mood as determined by GAD-7 questionnaire Self-reported anxiety symptoms by Generalised Anxiety Disorder-7 (GAD-7) questionnaire Measured at baseline, week 13 and week 26
Primary Effect on working memory during n-back task fMRI Effects on working memory will be assessed by blood-oxygen level dependant (BOLD) signal activity during 2-back task performed during fMRI scanning Measured at baseline and week 26
Primary Effect on working memory performance during n-back task fMRI Effects on working memory performance will be assessed by task accuracy during 2-back task performed during fMRI scanning Measured at baseline and week 26
Secondary Effect on cognitive functioning as measured by a neuropsychological test battery Effect on z-scoring of cognitive domains- episodic memory, executive function and working memory as measured by Cognitive Function Composite test battery Measured at baseline, week 13 and week 26
Secondary Effect on ADAS-Cog Word Recall cognitive assessment (episodic memory) Mean number of correct responses across three trials; Score 0 to 10. Higher score indicates better outcome. Measured at baseline, week 13 and week 26
Secondary Effect on ADAS-Cog Word Recognition cognitive assessment (episodic memory) Mean number of correct responses across three trials. Score 0 to 12. Higher score indicates better outcome. Measured at baseline, week 13 and week 26
Secondary Effect on Digit Symbol Substitution Test cognitive assessment (executive function) Amount of symbols correctly substituted. Score 0 - 90. Higher score indicates better outcome Measured at baseline, week 13 and week 26
Secondary Effect on Digit Span Backward Task cognitive assessment (working memory) Longest span of digits correctly recalled. Score 2-8. Higher score indicates better outcome Measured at baseline, week 13 and week 26
Secondary Effect on Category Fluency Test cognitive assessment (executive function) Number of uniquely named items from category within 60 seconds. Higher score indicates better outcome Measured at baseline, week 13 and week 26
Secondary Effect on ADAS-Cog Orientation cognitive assessment (episodic memory) The number of correct responses on orientation. Score 0 to 8. Higher score indicates better outcome Measured at baseline, week 13 and week 26
Secondary Effect on tryptophan metabolites Tryptophan related neurotransmitters and metabolites (plasma) Measured at baseline and week 26
Secondary Effect on amyloid-beta (Aß) biomarker Aß1-42/Aß1-40 ratio (plasma) Measured at baseline and week 26
Secondary Effect on neuroplasticity Brain-derived neurotrophic factor (BDNF) levels (serum) Measured at baseline and week 26
Secondary Effect on brain regions of interest Structural MRI with T1- and T2-weighted anatomical images of regions of interest (hippocampi, (pre)frontal-and temporal cortices) Measured at baseline and week 26
Secondary Effect on hypothalamic-pituitary adrenal axis Cortisol levels (serum) Measured at baseline and week 26
Secondary Effect on intestinal barrier integrity Assay-based panel of intestinal barrier integrity markers measured in blood Measured at baseline, week 13 and week 26
Secondary Effect on intestinal inflammation Assay-based panel of intestinal inflammatory markers measured in faeces Measured at baseline, week 13 and week 26
Secondary Effect on gastrointestinal transit time Gut transit time measured by blue muffin consumption and appearance of blue colour in faeces Measured at baseline, week 13 and week 26
Secondary Effect on gastrointestinal symptoms Self-rated gastrointestinal symptoms as measured by the Gastrointestinal Symptom Rating Scale (GSRS) questionnaire Measured at baseline, week 13 and week 26
Secondary Effect on self-reported stool consistency Effect on stool consistency as measured by Bristol Stool Scale (BSS) Measured at baseline, week 13 and week 26
Secondary Effect on stool consistency Effect on stool consistency as measured by faecal water content Measured at baseline, week 13 and week 26
Secondary Effect on qualitative faecal microbiota composition Qualitative faecal microbiota composition as measured by 16s rRNA sequencing Measured at baseline, week 13 and week 26
Secondary Effect on quantitative faecal microbiota composition Quantitative faecal microbiota composition as measured by digital droplet PCR Measured at baseline, week 13 and week 26
Secondary Effect on faecal metabolites Faecal short-chain fatty acids (acetic acid, propionic acid, butyric acid, valeric acid, hexanoic acid, heptanoic acid) and branched-chain fatty acids (isobutyric acid, isovaleric acid, 4-methyl valeric acid) as measured by gas chromatography-flame ionization detection (GC-FID) Measured at baseline, week 13 and week 26
Secondary Effect on faecal pH Faecal pH measurement Measured at baseline, week 13 and week 26
Secondary Effect on immune parameters Inflammatory cytokine panel measured in blood Measured at baseline, week 13 and week 26
Secondary Effect on glucose homeostasis Assay-based panel of markers to evaluate glucose homestasis in blood Measured at baseline, week 13 and week 26
Secondary Effect on lipid profile Assay-based panel of markers to analyse lipid profile in blood Measured at baseline, week 13 and week 26
See also
  Status Clinical Trial Phase
Active, not recruiting NCT04121728 - Modulation of Attention in Event Related Potential (ERPs) as a Marker of Early Cognitive Decline by Ginkgo Biloba N/A
Active, not recruiting NCT03271190 - Impact of a Cognitive Intervention Enriched With Leisure Activities in Persons With Subjective Cognitive Decline N/A
Recruiting NCT06078748 - The Lifestyle Exercise and Diet Trial (LEAD) 2.0 N/A
Recruiting NCT06287489 - Effects of Mediterranean Diet on Subjective Cognitive Decline N/A
Recruiting NCT05331144 - Impact of Intensive Treatment of SBP on Brain Perfusion, Amyloid, and Tau (IPAT Study) Phase 2
Completed NCT02969460 - Neurotrack Virtual Cognitive Health Study N/A
Completed NCT03495037 - Preventing Cognitive and Functional Decline Among Seniors at Risk N/A
Recruiting NCT06095063 - dTMS for Subjective Cognitive Decline N/A
Recruiting NCT06110858 - Efficacy of Tinkering Activities in Individuals With Subjective Cognitive Decline N/A
Active, not recruiting NCT04330404 - Effects of Cognitive Strategy Training on Daily Function in People With Subjective Cognitive Decline N/A
Enrolling by invitation NCT03772977 - The Brain Health Champion Study N/A
Completed NCT03236454 - tDCS-enhanced Working Memory Training in Subjective Cognitive Decline N/A
Not yet recruiting NCT06358404 - Developing a Peer Support Intervention for Depression in SCD N/A
Completed NCT04796415 - DEMA-Pro Intervention for Seniors With Subjective Cognitive Decline and Living at Home N/A
Completed NCT04439500 - Effects of Online Training Aimed at Increasing Participation in Everyday Life During a Pandemic (SCD Online). N/A
Completed NCT04265378 - Cognitive Training and Brain Stimulation in Prodromal Alzheimer's Disease N/A
Completed NCT04880252 - Neuropsychological Indicators of SCD Progression
Completed NCT03370744 - Prediction of Cognitive Decline by Neuroimaging Techniques and the Application in Diagnosis and Treatment of Preclinical AD
Recruiting NCT06335836 - The Effects of Social Isolation and Social Interaction on the Risk of Dementia Progression and Brain Function in SCD (Subjective Cognitive Decline, SCD)
Not yet recruiting NCT05225181 - Effects of the Combining Physical Exercise and Cognitive Training for the Community-based Elderly N/A