It’s normal to lose some mental sharpness as you age, but cognitive decline and dementia can result in a reduced quality of life and the loss of independence.
Scientific evidence shows that ketone supplements and the keto diet can reduce inflammation in your brain, enhance the health of neurons, and provide your brain with a healthy, clean energy source[*][*].
That’s why there’s a good chance that ketones and ketosis can also help people retain their faculties as they age.
For the first time ever, scientists recently tested the effects of a ketogenic medium-chain triglyceride drink in senior citizens with mild cognitive impairment. Read on to learn what they found and what it means for aging people.
The Study: At-Risk Alzheimer’s Patients Given a Ketogenic Drink
In a clinical trial published April 23, 2019, in the journal Alzheimer’s & Dementia, a team of Canadian researchers led by Mélanie Fortier set out to explore the effects of a ketogenic drink with medium-chain triglycerides (MCTs) on senior-aged patients with mild cognitive impairment (MCI).
Mild cognitive impairment is a mental state somewhere between the normal, expected decline that comes with age and the more severe effects of dementia. People with MCI have a heightened risk of developing Alzheimer’s disease and other forms of dementia.
The scientists knew that while aging brains often lose the ability to use glucose, a simple sugar, for energy, people with mild cognitive impairment retain the capacity to use ketones for brain fuel.
They speculated that bypassing defective carbohydrate metabolism with a ketogenic drink might enhance the mental functioning of the participants, or even reverse their symptoms.
To test their hypothesis, the team randomized the 52 subjects with MCI into groups receiving a drink containing either glucose (placebo) or 30 grams of ketogenic MCTs. The patients in each group then consumed their drink once per day for six months.
The study participants took a cognitive assessment and MRI before starting the drink, and during the final week of the study. Each month they met with researchers to have blood drawn and ensure they stuck with the protocol.
Because they wanted to trace the uptake of the drink into participants’ brains, the team also conducted PET neuroimaging scans with tracer-laced beverages at the beginning and end.
And the Results Were…
As they expected, the team found that the ketogenic MCT drink bypassed the metabolic issue and allowed the participants’ brains to function better. The brain ketone metabolism of the MCT group increased by an impressive 230%, while the glucose metabolism of each group remained unchanged.
In the MCT group, there were big increases in blood levels of the medium-chain fatty acids octanoic acid (C8) and decanoic acid (C10) as well as the ketones beta-hydroxybutyrate and acetoacetate.
In the keto drink group, members who completed the trial, the researchers measured statistically significant improvements in the following areas:
- Episodic memory
- Language
- Executive function
- Processing speed
A total of 13 patients dropped out — eight from the MCT group and five from the glucose group. The most common reason they gave was intolerance to the drink. In total, 75% of people completed the trial.
Half of the participants reported at least one side effect. The most common ones were stomach issues like discomfort, reflux, diarrhea, or nausea. One person got a headache.
What Can We Learn From the 2019 Keto Drink Study?
The biggest finding of the study is that in people who are already cognitively impaired, and who are at an increased risk of Alzheimer’s dementia, can ingest MCT oil and produce ketones to fuel their brains.
Insulin resistance in the brain appears to be a significant cause of Alzheimer’s disease[*]. Other studies have shown that ketones (whether they’re exogenous or made in your body) reduce inflammation in your brain, help repair neurons, and have an antioxidant effect[*][*].
The study by Mélanie Fortier and her colleagues shows that without going full keto or using exogenous ketones, simply consuming about two tablespoons of MCTs per day can exert a remarkable effect on the mental performance and cognition of older adults.
Had the researchers also added exogenous ketones or had subjects go full-on keto, the results probably would probably be even more impressive.
Also note that the study used MCT oil, which tends to have more side effects compared to MCT powder. It’s possible the study wouldn’t have had as many drop-outs if they had gone the powder route.
Study Criticisms
While the study did a fantastic job of showing the physiological effects of ketone production from MCTs — a whopping 230% increase in brain ketone metabolism–it did have a few shortcomings in terms of the cognitive measures.
Critics might accuse Fortier and her team of fishing for results, or possibly even hacking the statistical data.
Not counting the blood tests and brain metabolism changes, the scientists tested over 90 physical and cognitive parameters in total. They compared the results before, after, and between groups.
Out of all 90 metrics, about four of them yielded positive, statistically significant results.
If someone wanted to criticize the study, they could argue that the team measured all the different parameters so they could find something positive.
It’s doubtful that the researchers did this intentionally–this is a valid way to conduct an exploratory study. It doesn’t negate their findings.
But it does mean that without more studies, the cognitive outcome results remain open to questioning.
The Takeaway: Ketones Reduce Cognitive Impairment
This study is the first of its kind to show that real people with mild cognitive impairment can benefit from consuming MCTs every day, without adopting the keto diet or supplementing exogenous ketones.
While further studies are necessary to confirm the cognitive measures, the brain metabolic changes in this study were robust and undeniable.
Hopefully, future studies will also examine the quality of life and other subjective outcomes of MCTs and other ketogenic aids in senior citizens.
A longer-term study to examine MCT effects on the risk of Alzheimer’s over time, and any preventive effect on cognitive decline, would provide valuable insight, too. Since ketones can repair neurons and reduce inflammation, there’s a good chance they could reduce Alzheimer’s risk and prevent cognitive decline.
In the meantime, the best way to gauge the effectiveness of MCT products or the keto diet is to try it for yourself. If you do, you can learn the effects and health benefits firsthand, without waiting for the perfect study.