Treating Mild Cognitive Impairment and sleep disturbances by Medium Chain Triglycerides supplementation: a study protocol for patients with a recent diagnosis

Mild Cognitive Impairment (MCI) is an early stage of cognitive decline associated with an increased risk of developing Alzheimer’s disease (AD). Among the modifiable risk factors, sleep disorders and metabolic dysfunctions play a key role in accelerating neurodegenerative processes. Medium chain triglycerides (MCTs) provide an alternative energy source for neurons, overcoming the difficulties in glucose metabolism often encountered in people with MCI. In addition, MCT supplementation could regulate circadian rhythms and improve sleep quality, both of which are key to cognitive health. On these grounds, we hypothesize that appropriate nutritional interventions in the early stage of MCI could delay the onset, mitigate the symptomatology and reduce the risk of progression toward AD. Here, we propose a randomized controlled trial to evaluate the impact of a Mediterranean diet enriched with MCTs on cognitive performance and sleep quality in MCI patients. The study involves 120 participants, divided into two groups: a control group to follow the Mediterranean diet and an intervention group that will follow the same diet supplemented with 30g/day of MCT. Primary outcomes include assessment of cognitive function and sleep quality. To this end, specific tests such as MoCA, ACE, and CDR will be employed to determine, among others, attention, memory, fluent speech, space-time orientation, problem-solving abilities, and conceptual thinking. Sleep quality will be assessed using Pittsburgh and Epworth scales. To corroborate the primary findings, secondary objective data will be collected that include biochemical markers of ketone metabolism, neuroimaging (FDG-PET) and regulation of circadian rhythms. Through the analysis of the interaction between MCT metabolism, sleep and cognitive function, the study aims to offer new perspectives on non-pharmacological strategies to slow cognitive decline and improve quality of life in the elderly population.