Effect of Virgin Coconut Oil Supplementation on Cognition of Individuals with Mild-to-Moderate Alzheimer's Disease in Sri Lanka (VCO-AD Study): A Randomized Placebo-Controlled Trial

Background: Virgin coconut oil (VCO) is a potential therapeutic approach to improve cognition in Alzheimer's disease (AD) due to its properties as a ketogenic agent and antioxidative characteristics. Objective: This study aimed to investigate the effect of VCO on cognition in people with AD and to determine the impact of apolipoprotein E (APOE) epsilon 4 genotype on cognitive outcomes. Methods: Participants of this double-blind placebo-controlled trial (SLCTR/2015/018, 15.09.2015) were 120 Sri Lankan individuals with mild-to-moderate AD (MMSE = 15-25), aged > 65 years, and they were randomly allocated to treatment or control groups. The treatment group was given 30 mL/day of VCO orally and the control group, received similar amount of canola oil, for 24 weeks. The Mini-Mental Sate Examination (MMSE) and Clock drawing test were performed to assess cognition at baseline and at the end of the intervention. Blood samples were collected and analyzed for lipid profile and glycated hemoglobin (HbA1 C) levels. Results: There were no significant difference in cognitive scores, lipid profile, and HbA1C levels between VCO and control groups post-intervention. The MMSE scores, however, improved among APOE epsilon 4 carriers who had VCO, compared to non-carriers (2.37, p = 0.021). APOE epsilon 4 status did not influence the cognitive scores in the control group. The attrition rate was 30%. Conclusions: Overall, VCO did not improve cognition in individuals with mild-to-moderate AD following a 24-week intervention, compared to canola oil. However, it improved the MMSE scores in APOE epsilon 4 carriers. Besides, VCO did not compromise lipid profile and HbA1C levels and is thus safe to consume.