COMBI is a multi-center, randomized controlled trial among 70 older adults at risk of cognitive decline. The main goal is to investigate the effect of a 6-week colon-delivered multivitamin supplementation on the gut-brain axis in older adults, by assessing changes in brain function as well as intestinal changes compared to placebo.
Growing evidence indicates an important role for intestinal health in development of cognitive decline in ageing. Intestinal health, and especially the gut microbiome, is assumed to affect brain health and functioning via immunometabolic pathways captured in the gut-brain axis. However, it is unclear whether changes in intestinal health markers causally relate to cognitive decline in older adults and how. Nutritional interventions specifically targeting the gut were found beneficial for human cognition and brain function. An intervention based on colon-delivered vitamins (B2, B3, B6, B9, C, D3) is proposed to affect gut health using microbiome-dependent and independent pathways. In this study, it will be investigated whether this intervention affects neurocognition in ageing humans, to reveal causal gut-brain relationships in aging.Therefore, the primary goal of the COMBI study is to investigate the effect of a 6-week colon-delivered multivitamin supplementation on the gut-brain axis in older adults, by assessing changes in brain function as well as intestinal changes compared to placebo. Secondary, the effects of this 6-week colon-delivered multivitamin supplementation in older adults on the following parameters related to potential gut-brain pathways will also be investigated: (1) other relevant brain parameters, (2) other relevant intestinal parameters, (3) immunometabolic parameters related to gut-brain pathways, and (4) neuropsychological test battery scoring.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
BASIC_SCIENCE
Masking
TRIPLE
Enrollment
75
Colon-delivered multivitamin supplement containing the following dose of the indicated vitamin: vitamin B2 (10 mg), vitamin B3 (4.0 mg), vitamin B6 (1.4 mg), vitamin B9 (400 μg), vitamin C (200 mg) and vitamin D3 (15ug). Vitamin capsules are filled with microcrystalline cellulose and magnesium stearate up to 200 mg. Control of release in the colon is achieved by the Eudragit S 100 coating layer technology that surrounds the vitamins contained in the core capsules.
Placebo capsule containing microcrystalline cellulose and magnesium stearate up to 200 mg. Placebo capsules are coated with the Eudragit S 100 coating layer.
Radboud University, Donders Centre for Cognitive Neuroimaging
Nijmegen, Gelderland, Netherlands
Wageningen University and Research, Division of Human Nutrition and Health
Wageningen, Gelderland, Netherlands
Change in brain activity during working memory
Blood-oxygen level dependent activity in dlPFC and hippocampus during N-back fMRI task
Time frame: Change between Baseline (T0), Follow-up after 6 weeks (T1)
Change in working memory performance
Task accuracy during N-back fMRI task
Time frame: Change between Baseline (T0), Follow-up after 6 weeks (T1)
Change in faecal short-chain fatty acids
Total faecal short-chain fatty acid concentration measured by gas chromatograph mass spectrometry
Time frame: Change between Baseline (T0), Follow-up after 6 weeks (T1)
Change in brain myo-inositol levels (neuroimaging)
Brain myo-inositol levels reflecting neuroinflammation in dlPFC and hippocampus, measured by magnetic resonance spectroscopy
Time frame: Change between Baseline (T0), Follow-up after 6 weeks (T1)
Change in cerebral perfusion levels (neuroimaging)
Cerebral perfusion levels measured by arterial spin labelling
Time frame: Change between Baseline (T0), Follow-up after 6 weeks (T1)
Change in neuropsychological test-battery scoring
Z-scoring on cognitive domains predominantly affected by cognitive ageing: executive function (incl. working memory), episodic memory and processing speed.
Time frame: Change between Baseline (T0), Follow-up after 6 weeks (T1)
Change in microbiota profile (faecal)
16S rRNA based profile of gut microbiota in faeces
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.
Time frame: Change between Baseline (T0), Follow-up after 6 weeks (T1)
Change in individual short-chain fatty acids profile (faecal)
GCMS measurement to assess profile of individual SCFAs in faeces (acetic acid, formic acid, propionic acid, isobutyric acid, butyric acid, isovaleric acid, valeric acid, 4-methyl valeric acid, hexanoic acid, heptanoic acid)
Time frame: Change between Baseline (T0), Follow-up after 6 weeks (T1)
Change in stool water content (faecal)
Water content of stool, based on wet- and dry weight.
Time frame: Change between Baseline (T0), Follow-up after 6 weeks (T1)
Change in stool pH (faecal)
Faecal pH will be measured with a pH/redox meter in faeces
Time frame: Change between Baseline (T0), Follow-up after 6 weeks (T1)
Change in stool redox potential (faecal)
Redox potential will be measured with a pH/redox meter in faeces
Time frame: Change between Baseline (T0), Follow-up after 6 weeks (T1)
Change in intestinal inflammation profile (faecal)
Assay-based profile of intestinal inflammation measured in faeces
Time frame: Change between Baseline (T0), Follow-up after 6 weeks (T1)
Change in C-reactive protein concentration (blood)
hsCRP measured via finger prick analysis
Time frame: Change between Baseline (T0), Follow-up after 6 weeks (T1)
Change in white blood cell count (blood)
White blood cell count measured via finger prick analysis
Time frame: Change between Baseline (T0), Follow-up after 6 weeks (T1)
Change in inflammation profile (blood)
Assay-based profile of systemic inflammation measured in plasma
Time frame: Change between Baseline (T0), Follow-up after 6 weeks (T1)
Change in intestinal integrity profile (blood)
Assay-based profile of intestinal integrity measured in plasma
Time frame: Change between Baseline (T0), Follow-up after 6 weeks (T1)
Change in anti-oxidant status profile (blood)
Assay-based profile of anti-oxidant status and oxidative stress measured in plasma
Time frame: Change between Baseline (T0), Follow-up after 6 weeks (T1)
Change in metabolic profile (blood)
Assay-based profile of (energy) metabolism measured in plasma
Time frame: Change between Baseline (T0), Follow-up after 6 weeks (T1)
Change in brain health profile (blood)
Assay-based profile of brain health measured in plasma
Time frame: Change between Baseline (T0), Follow-up after 6 weeks (T1)
Change in vitamin profile (blood)
Assay-based profile of circulating vitamins from supplement measured in plasma
Time frame: Change between Baseline (T0), Follow-up after 6 weeks (T1)