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Nutrition and cognitive impairment in the elderly

Published online by Cambridge University Press:  09 March 2007

M. González-Gross*
Affiliation:
Instituto de Nutrición y Bromatología (CSIC-UCM), Facultad de Farmacia, Ciudad Universitaria, E-28040 Madrid, Spain
Ascensión Marcos
Affiliation:
Institut für Ernährungswissenschaft, Abteilung Pathophysiologie der Ernährung, Rheinische Friedrich-Wilhelms-Universität, D-53115 Bonn, Germany
Klaus Pietrzik
Affiliation:
Instituto de Nutrición y Bromatología (CSIC-UCM), Facultad de Farmacia, Ciudad Universitaria, E-28040 Madrid, Spain
*
*Corresponding author: Dr Marcela González-Gross , present address Instituto de Nutrición y Bromatología CSIC-UCM, Facultad de Farmacia, Ciudad Universitaria, E-28040 Madrid, Spain, fax +34 91 394 22 83, email [email protected]
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Abstract

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As the number of older people is growing rapidly worldwide and the fact that elderly people are also apparently living longer, dementia, the most common cause of cognitive impairment is getting to be a greater public health problem. Nutrition plays a role in the ageing process, but there is still a lack of knowledge about nutrition-related risk factors in cognitive impairment. Research in this area has been intensive during the last decade, and results indicate that subclinical deficiency in essential nutrients (antioxidants such as vitamins C, E and β-carotene, vitamin B12, vitamin B6, folate) and nutrition-related disorders, as hypercholesterolaemia, hypertriacylglycerolaemia, hypertension, and diabetes could be some of the nutrition-related risk factors, which can be present for a long time before cognitive impairment becomes evident. Large-scale clinical trials in high-risk populations are needed to determine whether lowering blood homocysteine levels reduces the risk of cognitive impairment and may delay the clinical onset of dementia and perhaps of Alzheimer's disease. A curative treatment of cognitive impairment, especially Alzheimer's disease, is currently impossible. Actual drug therapy, if started early enough, may slow down the progression of the disease. Longitudinal studies are required in order to establish the possible link of nutrient intake – nutritional status with cognitive impairment, and if it is possible, in fact, to inhibit or delay the onset of dementia.

Type
Review article
Copyright
Copyright © The Nutrition Society 2001

References

Agronin, ME (1998) Personality and psychopathology in late life. Geriatrics 53, Suppl. 1, S35S40.Google ScholarPubMed
American Dietetic Association (1996) Positioning of the ADA: nutrition, aging, and the continuum of care. Journal of the American Dietetic Association 96, 10481052.Google Scholar
Araki, A, Sako, Y, lto, H & Orimo, H (1999) Plasma homocysteine, brain MR lesions, and cognitive functions in elderly diabetic patients. Amino Acids 17, 44, Abstr..Google Scholar
Basun, H, Fratiglioni, L & Winblad, B (1994) Cobalamin levels are not reduced in Alzheimer's disease: results from a population based study. Journal of the American Geriatric Society 42, 132136.CrossRefGoogle Scholar
Behl, C (1999) Vitamin E and other antioxidants in neuroprotection. International Journal of Vitamin and Nutrition Research 69, 213219.CrossRefGoogle ScholarPubMed
Behl, C & Holsboer, F (1998) Oxidative stress in the pathogenesis of Alzheimer's disease and antioxidant neuroprotection. Fortschrifte der Neurologie Psychiatrie 66, 113121.CrossRefGoogle ScholarPubMed
Bell, IR, Edman, JS, Selhub, J, Morrow, FD, Marby, DW, Kayne, HL & Cole, JO (1992) Plasma homocysteine in vascular disease and in nonvascular dementia of depressed elderly people. Acta Psychiatrica Scandinavica 86, 386390.Google Scholar
Brige, SJ (1997) The role of estrogen in the treatment and prevention of dementia: introduction. American Journal of Medicine 22, 1S2S.CrossRefGoogle Scholar
Birge, SJ (1998) Hormones and the aging brain. Geriatrics 53, S28S30.Google ScholarPubMed
Birkhäuser, MH, Strnad, J, Kämpf, C & Bahro, M (2000) Oestrogens and Alzheimer's disease. International Journal of Geriatric Psychiatry 15, 600609.3.0.CO;2-7>CrossRefGoogle ScholarPubMed
Bonarek, M, Barberger-Gateau, P, Letenneur, L, Deschamps, V, Iron, A, Dubroca, B & Dartigues, JF (2000) Relationships between cholesterol, apolipoprotein E polymorphism and dementia: a cross-sectional analysis from the PAQUID study (2000). Neuroepidemiology 19, 141148.Google Scholar
Botez, MI, Fontaine, F, Botez, T & Bachevalier, J (1977) Folate-responsive neurological and mental disorders: report of 16 cases. Neuropsychological correlates of computerized transaxial tomography and radionuclide cisternography in folic acid deficiencies. European Neurology 16, 230246.CrossRefGoogle ScholarPubMed
Bottiglieri, T (1996) Folic acid, vitamin B12, and neuropsychiatric disorders. Nutrition Reviews 54, 382390.CrossRefGoogle ScholarPubMed
Brönstrup, A, Hages, M & Pietrzik, K (1999) Lowering of homocysteine concentrations in elderly men and women. International Journal of Vitamin and Nutrition Research 69, 187193.CrossRefGoogle ScholarPubMed
Callahan, CM, Hendrie, HC & Tierney, WM (1995) Documentation and evaluation of cognitive impairment in elderly primary care patients. Annals of International Medicine 122, 422429.CrossRefGoogle ScholarPubMed
Carmel, R, Gott, PS, Waters, CH, Cairo, K, Green, R, Bondareff, W, De Giorgio, CM, Cummings, JL, Jacobsen, DW & Buckwalter, G (1995) The frequently low cobalamin levels in dementia usually signify treatable metabolic, neurologic and electrophysiologic abnormalities. European Journal of Haematology 54, 245253.Google Scholar
Carr, DB, Goate, A, Phil, D & Morris, JC (1997) Current concepts in the pathogenesis of Alzheimer's disease. American Journal of Medicine 103, 3S10S.Google Scholar
Cattin, L, Bordin, P, Fonda, M, Adams, C, Barbone, I, Bovenzi, M, Manto, A, Pedone, C & Pahor, M (1997) Factors associated with cognitive impairment among older italian inpatients. Journal of American Geriatric Society 45, 13241330.CrossRefGoogle ScholarPubMed
Chandra, RK (1997) Graying of the immune system. Can nutrient supplements improve immunity in the elderly? Journal of the American Medical Association 277, 13981399.Google Scholar
Chandra, RK, Imbach, A, Moore, C, Skelton, D & Woolcott, D (1991) Nutrition of the elderly. Canadian Medical Association Journal 145, 14751487.Google Scholar
Chapman, J, Wang, N, Treves, TA, Korczyn, AD & Bornstein, NM (1998) ACE, MTHFR, factor V Leiden, and ApoE polymorphisms in patients with vascular and Alzheimer's dementia. Stroke 29, 14011404.Google Scholar
Chui, HC, Victoroff, JI, Jagust, W, Saakle, R & Katzman, R (1992) Criteria for the clinical diagnosis of ischemic vascular dementia prepared by the State of California Alzheimer's Disease Diagnostic and Treatment Centers. Neurology 42, 473480.CrossRefGoogle Scholar
Clarke, R, Smith, AD, Jobst, KA, Refsum, H, Sutton, L & Ueland, PM (1998) Folic acid, vitamin B12, and serum homocysteine levels in confirmed Alzheimer's disease. Archives of Neurology 55, 14491455.CrossRefGoogle Scholar
Desmond, DW, Tatemichi, TK, Paik, M & Stern, Y (1993) Risk factors for cerebrovascular disease as correlates of cognitive function in a stroke-free cohort. Archives of Neurology 50, 162166.CrossRefGoogle Scholar
Diaz Brinton, R & Yamazaki, RS (1998) Advances and challenges in the prevention and treatment of Alzheimer's disease. Pharmaceutical Research 15, 386398.CrossRefGoogle ScholarPubMed
Doraiswamy, PM & Steffens, DC (1998) Combination therapy for early Alzheimer's disease: what are we waiting for? Journal of the American Geriatric Society 46, 13221324.CrossRefGoogle ScholarPubMed
Doty, RL (1991) Olfactory capacities in aging and Alzheimer's disease:psychophysical and anatomic considerations. Annals of the New York Academy of Science 640, 2027.Google Scholar
Durnbaugh, T, Haley, B & Roberts, S (1996) Assessing problem feeding behaviors in mid-stage Alzheimer's disease. Geriatric Nursing 17, 6367.Google Scholar
Elias, MF (1998) Effects of chronic hypertension on cognitive functioning. Geriatrics 53, S49S52.Google Scholar
Elsborg, L, Hansen, T & Rafaelsen, OJ (1979) Vitamin B12 concentrations in psychiatric patients. Acta Psychiatrica Scandinavica 59, 145152.Google Scholar
Fassbender, K, Mielke, O, Bertsch, T, Nafe, B, Fröschen, S & Hennerici, M (1999) Homocysteine in cerebal macroangiography and microangiopathy. Lancet 353, 15861587.CrossRefGoogle Scholar
Fekkes, D, van der Cammen, TJM, van Loon, CPM, Verschoor, C, van Harskamp, F, de Koning, I, Schudel, WJ & Pepplinkhuizen, L (1998) Abnormal amino acid metabolism in patients with early stage Alzheimer dementia. Journal of Neural Transmission 105, 287294.CrossRefGoogle Scholar
Fernström, JD & Wurtman, RJ (1972) Brain serotonin content: physiological regulation by plasma neutral amino acids. Science 178, 414416.CrossRefGoogle ScholarPubMed
Folstein, MF, Folstein, SE & McHugh, PR (1975) Mini Mental State. A practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Reasearch 12, 189198.CrossRefGoogle Scholar
Foy, CJ, Passmore, AP, Vahidassr, MD, Young, IS & Lawson, JT (1999) Plasma chain-breaking antioxidants in Alzheimer's disease, vascular dementia and Parkinson's disease. Quarterly Journal of Medicine 92, 3945.CrossRefGoogle ScholarPubMed
Fraser, GE, Singh, PN & Bennett, H (1996) Variables associated with cognitive function in elderly California Seventh-day adventist. American Journal of Epidemiology 143, 11811190.CrossRefGoogle Scholar
Frey, WH 2nd, Najarian, MM, Kumar, KS, Emory, CR, Menning, PM, Frank, JC, Johnson, MN & Ala, TA (1996) Endogenous Alzheimer's brain factor and oxidized glutathione inhibit antagonist binding to the muscarinic receptor. Brain Research 714, 8794.CrossRefGoogle Scholar
Galan, P, Preziosi, P, Monget, AL, Richard, MJ, Arnaud, J & Lesourd, B, Girodon, F, Alfarez, MJ, Bourgeois, C, Keller, H, Iavier, A & Hercberg, S (1997) Effects of trace element and/or vitamin supplementation on vitamin and mineral status, free radical metabolism and immunological markers in elderly long term-hospitalized subjects. International Journal of Vitamin and Nutrition Research 67, 450460.Google Scholar
Gale, CR, Martyn, CN & Cooper, C (1996) Cognitive impairment and mortality in a cohort of elderly people. British Medical Journal 312, 608611.CrossRefGoogle Scholar
Gomes-Trolin, C, Regland, B & Oreland, L (1995) Decreased methionine adenosyltransferase activity in erythrocytes of patients with dementia disorders. European Neuropsychopharmacology 5, 107114.Google Scholar
Gomez de Caso, JA, Rodriguez-Artalejo, F, Claveria, LE & Coria, F (1994) Value of Hodkinson's test for detecting dementia and mild cognitive impairment in epidemiological surveys. Neuroepidemiology 13, 6468.Google Scholar
Goodwin, J, Goodwin, J & Garry, P (1983) Association between nutritional status and cognitive functioning in a healthy elderly population. Journal of the American Medical Association 249, 29172921.Google Scholar
Gottfries, CG, Lehmann, W & Regland, B (1998) Early diagnosis of cognitive impairment in the elderly with the focus on Alzheimer's disease. Journal of Neural Transmission 105, 773786.CrossRefGoogle ScholarPubMed
Gray, GE (1989) Nutrition and dementia. Journal of the American Dietetic Association 89, 17951802.Google Scholar
Haller, J, Weggemans, RM, Ferry, M & Guigoz, Y (1996) Mental health: minimental state examination and geriatric depression score of elderly europeans in the SENECA study of 1993. European Journal of Clinical Nutrition 50, S112S116.Google ScholarPubMed
Huijbregts, PPCW, Feskens, EJM, Räsänen, L, Fidanza, F, Alberti-Fidanza, A, Nissinen, A, Giampaoli, S & Kromhout, D (1998) Dietary patterns and cognitive function in elderly men in Finland, Italy and the Netherlands. European Journal of Clinical Nutrition 52, 826831.Google Scholar
lhl, R, Brinkmeyer, J, Janner, M & Kerdar, MS (2000) A comparison of ADAS and EEG in the discrimination of patients with dementia of the Alzheimer type from healthy controls. Neuropsychobiology 41, 102107.Google Scholar
Jama, I, Launer, LJ, Witterman, JCM, den Breeijen, JH, Breteler, MMB & Grobbee, DE (1996) Dietary antioxidants and cognitive function in a population-based sample of elder people. American Journal of Epidemiology 144, 275280.CrossRefGoogle Scholar
Joosten, E, Lesaffre, E, Riezler, R, Ghekiere, V, Dereymaeker, L, Pelemans, W & Dejaeger, E (1997) Is metabolic evidence for vitamin B-12 and folic acid deficiency more frequent in elderly patients with Alzheimer's disease? Journal of Gerontology A Biological Science and Medical Science 52, M76M79.CrossRefGoogle ScholarPubMed
Kalmijn, S, Fesikens, EJ, Launer, LJ & Kromhout, D (1997) Polyunsaturated fatty acids, antioxidants, and cognitive functions in very old men. American Journal of Epidemiology 145, 3341.Google Scholar
Kelly, GS (1998) Folic acids: supplemental forms and therapeutic applications. Alternative Medicine Review 3, 208220.Google Scholar
Knopman, DS (1998) Current pharmacotherapies for Alzheimer's disease. Geriatrics 53, S31S34.Google Scholar
Koehler, KM, Pareo-Tubbeh, SL, Romero, LJ, Baumgartner, RN & Garry, PJ (1997) Folic acid nutrition and older adults: challenges and opportunities. Journal of American Dietetic Association 97, 167173.CrossRefGoogle ScholarPubMed
Lappalainen, R, Koikkalainen, M, Julkunen, J, Saarinen, T & Mykkänen, H (1998) Association of sociodemographic factors with barriers reported by patients receiving nutrition counselling as part of cardiac rehabilitation. Journal of American Dietetic Association 98, 10261029.Google Scholar
Launer, LJ (1992) Overview of incidence studies of dementia conducted in Europe. Neuroepidemiology 11, 213.CrossRefGoogle ScholarPubMed
Lethem, R & Orrell, M (1997) Antioxidants and dementia. Lancet 349, 11891190.Google Scholar
Lewis, CJ, Crane, NT, Wilson, DB & Yetley, EA (1999) Estimated folic acid intakes: data updated to reflect food fortification, increased bioavailability, and dietary supplement use. American Journal of Clinical Nutrition 70, 198207.Google Scholar
Lopez, GH, Ilincheta de Boschero, MG, Castagnet, PI & Giusto, NM (1995) Age-associated changes in the content and fatty acids composition of brain glycerophospholipids. Comparative Biochemistry and Physiology Part B Biochemistry and Molecular Biology 112, 331343.Google Scholar
Lutjohann, D, Papassotiropoulos, A, Bjorkhem, K, Locotelli, S, Bagli, M, Oehring, RD, Schlegel, U, Jessen, I, Rao, ML, von Bergmann, K & Heur, R (2000) Plasma 24S-hydroxycholesterol (cerebrosterol) is increased in Alzheimer and vascular demented patients. Journal of Lipid Research 41, 195198.Google Scholar
McCaddon, A, Davies, G, Hudson, P, Tandy, S & Cattell, H (1998) Total serum homocysteine in senile dementia of Alzheimer type. International Journal of Geriatric Psychiatry 13, 235239.3.0.CO;2-8>CrossRefGoogle ScholarPubMed
Marcus, EL & Berry, EM (1998) Refusal to eat in the elderly. Nutrition Reviews 56, 163171.CrossRefGoogle ScholarPubMed
Markesbery, WR & Carney, JM (1999) Oxidative alterations in Alzheimer's disease. Brain Pathology 9, 133146.Google Scholar
Mattis, S (1976) Mental status examination for organic mental syndrome in the elderly patient. In Geriatric Psychiatry pp. 77121 [Bellak, L and Karasu, TE, editors]. New York, NY: Grune & Stratton.Google Scholar
Maurer, K, Ihl, R, Dierks, T & Frolich, L (1997) Clinical efficacy of Ginkgo biloba special extract EGb761 in dementia of the Alzheimer type. Journal of Psychiatric Research 31, 645655.Google Scholar
Medline: National Library of Medicine (1999) www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed.Google Scholar
Miller, JW (1999) Homocysteine and Alzheimer's disease. Nutrition Reviews 57, 126129.Google ScholarPubMed
Moroney, JT, Tang, MX, Berglund, L, Small, S, Merchant, C, Bell, K, Stern, Y & Mageux, R (1999) Low-density lipoprotein cholesterol and the risk of dementia with stroke. Journal of the American Medical Association 21, 254260.Google Scholar
Morris, MC, Beckett, LA, Scherr, PA, Hebert, LE, Bennett, DA, Field, TS & Evans, DA (1998) Vitamin E and vitamin C supplement use and risk of incident Alzheimer disease. Alzheimer Disease and Associated Disorders 12, 121126.Google Scholar
National Center for Health Statistics (NCHS) (1999) www.cdc.gov/nchs/about/major/dvs/mortdata/htmGoogle Scholar
Nilsson, K, Gustafson, L, Faldt, R, Andersson, A, Brattstrom, L, Lindgren, A, Israelsson, B & Hultberg, B (1996) Hyperhomocysteinaemia – a common finding in a psychogeriatric population. European Journal of Clinical Investigation 26, 853859.CrossRefGoogle Scholar
Norberg, A & Athlin, E (1989) Eating problems in severely demented patients: issues and ethical dilemmas. Nursing Clinics of North America 24, 781789.Google Scholar
Paleologos, M, Cumming, RG & Lazarus, R (1998) Cohort study of vitamin C intake and cognitive impairment. American Journal of Epidemiology 148, 4550.Google Scholar
Parnetti, L, Bottiglieri, T & Lowenthal, D (1997) Role of homocysteine in age-related vascular and non-vascular diseases. Aging (Milano) 9, 241257.Google Scholar
Pietrzik, K & Brönstrup, A (1997) Folic acid in preventive medicine: a new role in cardiovascular disease, neural tube defects and cancer. Annals of Nutrition and Metabolism 41, 331343.Google Scholar
Pitchumoni, SS & Doraiswamy, PM (1998) Current status of antioxidant therapy for Alzheimer's disease. Journal of the American Geriatric Society 46, 15661572.Google Scholar
Prince, M, Lovestone, S, Cervilla, J, Joels, S, Powell, J, Russ, C & Mann, A (2000) The association between apoE and dementia does not seem to be mediated by vascular factors. Neurology 25, 397402.Google Scholar
Ramirez-Lassepas, M (1998) Stroke and the aging of the brain and the arteries. Geriatrics 53, S44S48.Google ScholarPubMed
Regland, B, Blennow, K, Germgard, T, Koch-Schmidt, AC & Gottfries, CG (1999) The role of the polymorphic genes apolipoprotein E and methylene-tetrahydrofolic acid reductase in the development of dementia of the Alzheimer type. Dementia and Geriatric Cognitive Disorders 10, 245251.Google Scholar
Riggs, KM, Spiro, A, Tucker, K & Rush, D (1996) Relations of vitamin B12, vitamin B6, and homocysteine to cognitive performance in the Normative Aging Study. American Journal of Clinical Nutrition 63, 306314.CrossRefGoogle ScholarPubMed
Riviere, S, Birlouey-Aragon, I, Nourhashemi, F & Vellas, B (1998) Low plasma vitamin C in Alzheimer patients despite an adequate diet. International Journal of Geriatric Psychiatry 13, 749754.Google Scholar
Rosenberg, IH & Miller, JW (1992) Nutritional factors in physical and cognitive functions of elderly people. American Journal of Clinical Nutrition 55, 1237S1243S.CrossRefGoogle ScholarPubMed
Rosler, M, Retz, W, Thome, J & Riederer, P (1998) Free radicals in Alzheimer's dementia: currently available therapeutic strategies. Journal of Neural Transmission 54, Suppl., 211219.CrossRefGoogle ScholarPubMed
Roth, M, Tym, E, Mountjoy, CQ, Huppert, FA, Hendrie, H, Verma, S & Goddard, R (1986) CAMEX: A standardised instrument for the diagnosis of medical disorder in the elderly with special reference to the early detection of dementia. British Journal of Psychiatry 149, 698709.Google Scholar
Sano, M, Ernesto, C, Thomas, RG, Klauber, MR, Schafer, K, Grundmann, M, Woodbury, P, Growdon, J, Cotman, CW, Pfeiffer, E, Schneider, LS & Thal, LJ (1997) A controlled trial of selegiline, alpha-tocopherol, or both as treatment for Alzheimer's disease. New England Journal of Medicine 336, 12161222.Google Scholar
Schmidt, R, Haydn, M, Reinhard, B, Roob, G, Schmidt, H, Schumacher, M, Watzinger, N & Launer, LJ (1998) Plasma antioxidants and cognitive performance in middle-aged and older adults: results of the Austrian Stroke Prevention Study. Journal of American Geriatric Society 46, 14071410.CrossRefGoogle ScholarPubMed
Schneider, LS (1998) New therapeutic approaches to cognitive impairment. Journal of Clinical Psychiatry 59, 813.Google ScholarPubMed
Selkoe, DJ (1997) Alzheimer's disease: genotypes, phenotype, and treatments. Science 275, 630631.Google Scholar
Simonson, W (1998) Promising agents for treating Alzheimer's disease. American Journal of Health Systems Pharmacy 55, S11S16.CrossRefGoogle ScholarPubMed
Sinclair, AJ, Bayer, AJ, Johnston, J, Warner, C & Maxwell, SR (1998) Altered plasma antioxidant status in subjects with Alzheimer's disease and vascular dementia. International Journal of Geriatric Psychiatry 13, 840845.3.0.CO;2-R>CrossRefGoogle ScholarPubMed
Skoog, I, Lernfelt, B, Landahl, S, Palmertz, B, Andreasson, LA, Nilsson, L, Persson, G, Oden, A & Svanborg, A (1996) Fifteen-year longitudinal study of blood pressure and dementia. Lancet 347, 11411145.Google Scholar
Small, GW & Leiter, F (1998) Neuroimaging for diagnosis of dementia. Journal of Clinical Psychiatry 59, 47.Google ScholarPubMed
Snowdon, DA, Tully, CL, Smith, CD, Perez Riley, K & Markesberry, WR (2000) Serum folate and the severity of atrophy of the neocortex in Alzheimer disease: findings from the Nun Study. American Journal of Clinical Nutrition 71, 993998.CrossRefGoogle ScholarPubMed
Solfrizzi, V, Panza, F, Torres, F, Mastroianni, F, Del Parigi, A, Venezia, A & Capurso, A (1999) High monounsaturated fatty acids intake protects against age-related cognitive decline. Neurology 52, 15631569.CrossRefGoogle ScholarPubMed
Swain, R (1995) An update of vitamin B12 metabolism and deficiency states. Journal of Family Practice 41, 595600.Google Scholar
Tang, JL, Armitage, JM, Lancaster, T, Silagy, CH, Fowler, GH & Neil, HA (1998) Systematic review of dietary intervention trials to lower blood total cholesterol in free-living subjects. British Medical Journal 18, 12131220.CrossRefGoogle Scholar
Tysoe, C, Galinsky, D, Robinson, D, Brayne, CE, Easton, DF, Huppert, FA, Dening, T, Paybel, ES & Rubinstein, DC (1997) Analysis of alpha-1 antichymotrypsin, persenilin-1, angiotensin-converting enzyme, and methylenetetrahydrofolic acid reductase loci as candidates for dementia. American Journal of Medical Genetics 74, 207212.Google Scholar
Varela, G (1992) La Dieta Mediterránea (The Mediterranean diet). In Aciete de Oliva de la Comunidad Europea (Olive Oil from the European Community),Madrid: Vegeland-Farma.Google Scholar
Venters, HD Jr, Bonilla, LE, Jensen, T, Garner, HP, Bordayo, EZ, Najarian, MM, Ala, TA, Mason, RP & Frey, WH 2nd (1997) Heme from Alzheimer's brain inhibits muscarinic receptor binding via thiyl radical generation. Brain Research 764, 93100.CrossRefGoogle ScholarPubMed
Wehr, H, Parnowski, T, Puzynski, S, Bednarska-Makanick, M, Bisko, M, Kotapka-Minc, S, Rodo, M, Wolkowska, M (2000) Apolipoprotein E genotype and lipid and lipoprotein levels in dementia. Dementia and Geriatric Cognitive Disorders 11, 7073.Google Scholar
Wolfram, G (1995) Diet therapy in gout. Therapeutische Umshau 52, 524527.Google Scholar
World Health Organization (1999) World Health Day will focus on ageing. Bulletin of the World Health Organization 77, 293294.Google Scholar
World Health Organization (2000). The World Health Report 2000. www.who.int/whrGoogle Scholar