Ketogenic therapies in Parkinson's disease, Alzheimer's disease, and mild cognitive impairment: An integrative review.
Level 1 - systematic review of randomized trials
Integrative review of clinical studies across multiple electronic databases
PubMed 38007248 · doi:10.1016/j.apnr.2023.151745
What was done
An integrative literature review was conducted across PubMed, Scopus, and Google Scholar to evaluate the efficacy of ketogenic therapies in Parkinson's disease (PD), Alzheimer's disease (AD), and mild cognitive impairment (MCI). Interventions included ketogenic diets, modified Atkins diets, low-carbohydrate diets, Mediterranean diets with coconut oil, and various medium-chain triglyceride (MCT) supplements or oral ketogenic compounds (Axona, AC-1202).
What was found
A total of 2,565 records were identified, and 15 studies met inclusion criteria (3 for PD and 12 for MCI/AD). In PD, all 3 studies used a ketogenic diet and reported significant motor function improvements (vocal quality, gait, freezing, tremor, or balance), though no numerical values or effect sizes were reported in the abstract. In MCI and AD, ketogenic diets showed a non-significant trend toward cognitive improvement. Low-carbohydrate, modified Atkins, and coconut oil-supplemented Mediterranean diets showed statistically significant improvements on some cognitive measures. Ketogenic drinks and MCT supplements showed variable results, with most MCT supplements showing cognitive gains only after 6 months of adherence. Axona and AC-1202 showed no significant cognitive improvement at the end of 90-day trials. Diet adherence was problematic across most studies.
Why it matters
This review synthesizes early human evidence on ketogenic strategies across major neurodegenerative conditions, indicating potential motor and cognitive benefits while identifying adherence as a major obstacle to clinical adoption.
Limits
Only 15 studies were identified across three distinct conditions, with only 3 studies in PD. The interventions were highly heterogeneous, ranging from strict diets to isolated supplements. The abstract reports no quantitative effect sizes, patient counts, or confidence intervals. Poor adherence substantially limits real-world feasibility.
Cited by
- supports The medical food formulation Axona consists of caprylic triglyceride (C8).