Synopsis

Source of validity: Scientific
Rating (out of 5): 2

Nicotinamide riboside (NR) is a form of vitamin B3 and a precursor to nicotinamide adenine dinucleotide (NAD+), a critical coenzyme in cellular energy metabolism and cellular repair. The rationale for using NR in Alzheimer's disease (AD) is primarily based on preclinical research. Studies in animal models of Alzheimer's have shown that boosting NAD+ levels through NR supplementation can improve mitochondrial function, reduce neuroinflammation, and enhance neuronal survival. NAD+ depletion has been observed in aging and neurodegenerative diseases, including AD, suggesting that restoring NAD+ might be neuroprotective. For example, mouse studies have demonstrated that NR administration can reduce amyloid-beta accumulation, improve cognitive performance, and increase synaptic plasticity. However, human data are limited. A few early-phase clinical trials have explored the safety and NAD+-boosting effects of NR in older adults, with some reporting improved metabolic markers and modest cognitive benefits, but these studies are small and not specifically powered to assess efficacy in Alzheimer's patients. No large, definitive clinical trials have yet confirmed NR's effectiveness in treating or preventing Alzheimer's disease in humans. In summary, the use of nicotinamide riboside for Alzheimer's is justified by preclinical scientific studies and a plausible biological mechanism, but the human evidence remains preliminary. Therefore, its use is rated as "scientific" with an evidence score of 2 out of 5.

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