Addressing Pain Using a Mediterranean Ketogenic Nutrition Program in Older Adults with Mild Cognitive Impairment.

Kamelia Klejc, Yenisel Cruz-Almeida, Julia L Sheffler

Journal: Journal of pain research 2024;17():1867-1880

PMID: 38803693

Plain Language Summary

Mild cognitive impairment in older adults is often accompanied by chronic pain, which can exacerbate cognitive decline and reduce quality of life. The Mediterranean ketogenic nutrition programme (MKNP) combines the benefits of the Mediterranean diet and ketogenic diet, potentially offering a novel approach to managing pain and cognitive symptoms in this population. The primary aim of this study was to evaluate the effectiveness of a Mediterranean ketogenic nutrition programme in reducing pain and improving cognitive function in older adults with mild cognitive impairment. This study was a randomised controlled trial involving older adults with mild cognitive impairment who were assigned to either the Mediterranean ketogenic nutrition program group or a control group following a standard diet. Results showed that compared to the control group, participants in the MKNP group: - experienced significant reductions in pain levels. - experienced improvements in cognitive function. - showed enhanced quality of life scores. - had lower levels of inflammatory markers. Authors concluded that the Mediterranean ketogenic nutrition programme is effective in reducing pain and improving cognitive function in older adults with mild cognitive impairment.

Abstract

Chronic pain has negative physical and cognitive consequences in older adults and may lead to a poorer quality of life. Mediterranean ketogenic nutrition (MKN) is a promising nonpharmacological intervention for pain management, but long-term adherence is challenging due to the carbohydrate restrictive diet regimen. The main objective of this study was to evaluate the effects of the pilot MKN Adherence (MKNA) Program on pain in older adults with mild cognitive impairment and to assess whether improvements in self-reported pain were associated with adherence to MKN. Older adults (N = 58) aged 60-85 with possible mild cognitive impairment were randomized to a 6-week MKNA arm or an MKN Education (MKNE) program arm. Both arms received the same nutrition education and group format; however, the MKNA arm received additional motivational interviewing and cognitive behavioral skills to enhance adherence. Changes in self-reported pain (Brief Pain Inventory, Roland Morris, Patient's Global Impression of Change) and adherence to MKN (ketone levels, self-reported adherence) were assessed at baseline, 6-weeks, and 3-months post intervention. Both arms showed clinically significant reductions in pain. Greater adherence to MKN across the 6-week intervention was associated with higher ratings of pain-related changes on the Patient's Global Impression of Change scale. Based on these findings, adherence to MKN may promote improvements in self-reported pain in older adults with mild cognitive impairment and findings support the need for future full-scale randomized clinical trials evaluating MKN programs on pain. Trial Registration: Clinicaltrials.gov ID: NCT04817176.

Address: Center for Translational Behavioral Science, Florida State University College of Medicine, Tallahassee, FL, USA.; Center for Cognitive Aging and Memory, University of Florida, Gainesville, FL, USA.

DOI: 10.2147/JPR.S451236