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Journal of Brain Sciences

June 2018, Volume 2, 1, pp 1-12

Hawaii Dementia Prevention Trial: A Randomized Trial Evaluating a Multifaceted Nutritional Intervention to Slow Cognitive Decline in Mild Cognitive Impairment Patients

Steve Blake


George King


Nicole Kerr


Catherine Blake


Thomas Harding


Pat Borman


Katrina Moss


Paul Adapon


Kore Kai Liow

Steve Blake 1

George King 2
Nicole Kerr 3
Catherine Blake 4
Thomas Harding 5
Pat Borman 6
Katrina Moss 7
Paul Adapon 8
Kore Kai Liow 9

  1. Nutritional Biochemist, Neuroscience Research, Hawaii Pacific Neuroscience and Lecturer, University of Hawaii, Maui College, USA 1

  2. Department of Public Safety, State of Hawaii, USA 2

  3. Director, Wellness and Lifestyle Medicine Center, Castle Medical Center, USA 3

  4. Nutritional Educator, Hawaii Pacific Neuroscience and Lecturer, University of Hawaii, Maui College, USA 4

  5. Faculty Neuropsychologist and Brain Rehabilitation, Hawaii Alzheimer’s Disease Center, USA 5

  6. Director of Healthy Aging and Memory Center, Hawaii Pacific Neuroscience, USA 6

  7. Center for Behavioral Health, Faculty, Hawaii Pacific Neuroscience, USA 7

  8. Neuroscience Research & Clinical Trials, Hawaii Pacific Neuroscience, USA 8

  9. Professor of Clinical Neurology, John A. Burns School of Medicine, University of Hawaii; Neuroscience Research & Clinical Trials, Hawaii Pacific Neuroscience, USA 9

Pages: 1-12

DOI: 10.18488/journal.83.2018.21.1.12

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Article History:

Received: 12 October, 2018
Revised: 20 November, 2018
Accepted: 17 December, 2018
Published: 02 January, 2019


Introduction: Alzheimer's disease (AD) has no effective treatment, nor does its “precursor” mild cognitive impairment (MCI). Methods: This is a nine-month, randomized, open, pilot trial. We are using four dietary changes and twelve supplements to slow progression of dementia in patients with MCI. Patients were randomly assigned to the diet-plus-supplement intervention group (1) or to the supplement intervention group (2). Supplementary cobalamin, folate, and S-adenosylmethionine (SAM) may reduce secretase/amyloid production. Antioxidants coenzyme Q10, ascorbates, gamma-tocopherol, and extracts of ginkgo biloba and centella asiatica were used. Zinc, copper, manganese, and selenium support endogenous antioxidant enzymes. Dietary interventions include berries, walnuts, decreasing dietary advanced glycation endproduct intake, and limiting saturated fatty acids to seven percent of calories. Results: In this small pilot study, it was surprising that participants in the supplement-only group improved more than in the supplement-plus-diet group. The Mini Mental State Examination (MMSE) was administered at baseline and every 3 months. While 9.6% of MCI patients normally degenerate to dementia each year, over nine months, participants in the supplement-only group had an average improvement in the MMSE of 10 points (out of 30 points). At the end of the intervention, average score was 29 out of 30 points, indicating a normal cognitive state. In the food-plus-supplement group no degeneration was seen, although improvement was also not seen. Conclusions: This multifaceted nutritional intervention had a positive impact by slowing the progression of dementia and reducing the risk of Alzheimer’s disease. A larger, multicenter trial is needed to confirm these results.
Contribution/ Originality


Dementia, Mild cognitive, Impairment, Nutrition, Antioxidants, Amyloid plaque, Alzheimer’s disease, Supplements, Cognition, Memory.



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This study received no specific financial support.

Competing Interests:

The authors declare that they have no competing interests.


Ethics approval was by the Internal Review Board (IRB) of the office of research compliance, human studies program, University of Hawaii (CHS#21491). Supplements were donated by Life Extension Foundation, which had no role in designing or running the trial. We want to thank Hawaii Pacific Neuroscience for donating staff, clinic space, and doctors’ time to this trial. All authors read and approved the final manuscript.

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