Effect of advanced glycation end products on cognition in older adults with type 2 diabetes: Results from a pilot clinical trial

Roni Lotan*, Ithamar Ganmore, Abigail Livny, Nofar Itzhaki, Mark Waserman, Shahar Shelly, Moran Zacharia, Erin Moshier, Jaime Uribarri, Paul Beisswenger, Weijing Cai, Aron M. Troen, Michal Schnaider Beeri

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

17 Scopus citations


Background: Dietary advanced glycation end-products (AGEs) are linked to cognitive decline. However, clinical trials have not tested the effect of AGEs on cognition in older adults. Objective: The aim of the current pilot trial was to examine the feasibility of an intervention to reduce dietary AGEs on cognition and on cerebral blood flow (CBF). Methods: The design is a pilot randomized controlled trial of dietary AGEs reduction in older adults with type 2 diabetes. Seventy-five participants were randomized to two arms. The control arm received standard of care (SOC) guidelines for good glycemic control; the intervention arm, in addition to SOC guidelines, were instructed to reduce their dietary AGEs intake. Global cognition and CBF were assessed at baseline and after 6 months of intervention. Results: At baseline, we found a reverse association between AGEs and cognitive functioning, possibly reflecting the long-term toxicity of AGEs on the brain. There was a significant improvement in global cognition at 6 months in both the intervention and SOC groups which was more prominent in participants with mild cognitive impairment. We also found that at baseline, higher AGEs were associated with increased CBF in the left inferior parietal cortex; however, 6 months of the AGEs lowering intervention did not affect CBF levels, despite lowering AGEs exposure in blood. Conclusion: The current pilot trial focused on the feasibility and methodology of intervening through diet to reduce AGEs in older adults with type 2 diabetes. Our results suggest that participants with mild cognitive impairment may benefit from an intensive dietary intervention.

Original languageAmerican English
Pages (from-to)1785-1795
Number of pages11
JournalJournal of Alzheimer's Disease
Issue number4
StatePublished - 2021

Bibliographical note

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  • Advanced glycation end products
  • diet
  • feasibility
  • mild cognitive impairment
  • pilot
  • randomized controlled trial
  • type 2 diabetes


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