Brain Energy and Aging With Triheptanoin

Inclusion criteria

• Men and women ≥65 years old;
• Score ≥26/30 on the Montreal Cognitive Assessment; -≥10% lower brain glucose uptake in the frontal cortex as determined by PET imaging.

Exclusion criteria

• Score <26/30 on the Montreal Cognitive Assessment;
• Medications likely to affect the primary cognitive outcome;
• Medical or psychiatric conditions that could interfere with study participation (Peterson et al. 2005);
• Fasting plasma glucose ≥7.0 mM (to avoid recruiting diabetics or pre-diabetics, both of which are risk factors for cognitive impairment in older persons (Mortimer et al. 2010) and also inhibit ketogenesis (Fukao et al. 2004);
• Clinically-significant gastro-intestinal disease/conditions;
• Clinically-significant liver disease/dysfunction : ALT ≥37 UI/L, AST ≥36 UI/L, Total bilirubin ≥26 μmol/L;
• Clinically-significant renal disease/dysfunction : creatinine ≥92 μmol/L, glomerular filtration rate <60 ml/min/1.73 m2 or >90 ml/min/1.73 m2;
• Clinically-significant cardiac disease/conditions;
• Clinically-significant abnormal coagulation laboratory results or coagulation disorders at screening;
• Poorly controlled dyslipidemia (total cholesterol ≥6.2 mmol/L or triglycerides ≥2.20 mmol/L)
• Hypertension: ≥140/90 mmHg;
• Substance abuse;
• Already on MCT supplementation;
• Visual or hearing impairment impeding comprehension;
• Non-French speaking;
• Any condition with life expectancy less than 5 years;
• Institutionalized or intending to move out of area within 1 year;
• Participation in other intervention trials.