Synopsis

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

Beta-hydroxybutyrate (BHB) is a ketone body produced by the liver during periods of low carbohydrate intake, fasting, or ketogenic diets. Its use in supporting or treating dementia, particularly Alzheimer’s disease, is based on the concept of "brain energy rescue." In Alzheimer’s disease, glucose metabolism in the brain is impaired, which may contribute to cognitive decline. BHB provides an alternative energy substrate for neurons, potentially compensating for the decreased glucose utilization.

Scientific studies, primarily small-scale human trials and animal models, have shown that raising blood ketone levels through ketogenic diets, medium-chain triglyceride (MCT) supplementation, or direct BHB supplementation can modestly improve cognitive function or memory in individuals with mild cognitive impairment or early Alzheimer’s disease. For example, a 2018 randomized controlled trial (RCT) by Fortier et al. demonstrated improved cognitive outcomes in patients with mild cognitive impairment who received a ketogenic supplement.

However, the overall level of scientific evidence is still preliminary. Most studies are short-term, involve small sample sizes, and show only moderate benefit. There is currently insufficient evidence to recommend BHB as a stand-alone treatment for dementia. Large, long-term clinical trials are needed to confirm its efficacy and safety. At present, BHB and related ketogenic therapies are best considered as experimental adjuncts rather than established treatments for dementia.

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