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Cognitive DysfunctionPhase 2NCT07392723

ALA-enriched Nutrition for Prevention of Cognitive Decline in APOE4 Older Adults

A Phase 2 study testing Alpha-Linolenic Acid (2.6 g/day) in people with Cognitive Dysfunction and Alzheimer Disease, run by Michal Schnaider Beeri, Ph.D. at 1 site in United States.

Recruiting

Looking for participants now. Contact the study team or a site below to ask about taking part.

Sites and contacts
Official record
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Trial summary

This randomized, double-blind, placebo-controlled pilot trial will evaluate the effects of alpha-linolenic acid (ALA) supplementation on cognitive function, blood-brain barrier integrity, and brain vascular health in older adults with mild cognitive impairment and APOE4 genotype. Read more about this study

Who is it for?
Ages 60 years and olderHealthy volunteers can take part
What is being tested?
Alpha-Linolenic Acid (2.6 g/day)
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
20 participants
Where
1 siteUnited States
Study dates
12 Jan 2025to Oct 2027
Phase
Phase 2
Are there results?
Not yet: the study is under way

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 60 years and older
  • All sexes
  • Healthy volunteers accepted
  • Adult, Older adult

Who may be able to join

  • Age 60 years or older
  • Have amnestic Mild Cognitive Impairment (MCI) - memory problems that do not interfere with daily life.
  • Carry at least one APOE4 gene allele (determined by a blood test).
  • Be fluent in English or Spanish.
  • Have a study partner (family member or friend) who can provide information about daily function.
  • Have the ability to give informed consent and comply with study visits and procedures.

Who cannot join

  • A diagnosis of dementia or any other brain disease that significantly affects thinking or memory (e.g., Alzheimer's disease, Parkinson's disease, schizophrenia, epilepsy, traumatic brain injury).
  • History of stroke or other major neurological condition.
  • Short life expectancy due to end-stage disease or other serious medical condition.
  • Active cancer treatment that could interfere with study participation.
  • Allergy or sensitivity to flaxseed oil or corn oil.
  • Current use of flaxseed, flax oil, or fish oil supplements more than once per week.
Show all 9Show fewer
  • MRI contraindications, such as pacemakers, metallic implants, or severe claustrophobia.
  • Current or past history of prostate cancer, regardless of remission status, OR a prostate-specific antigen (PSA) level > 20 ng/mL at screening.
  • Use of experimental Alzheimer's treatments (e.g., amyloid monoclonal antibodies) unless on a stable regimen as confirmed by the treating physician.

Trial locations and contacts

1 site in 1 country. Contact the study team or a site near you to ask about taking part.

Claudio Mendes, MS contact

8489328412

alastudy@njms.rutgers.edu

Rebecca West-Mortimer, PHD contact

8489328415

alastudy@njms.rutgers.edu

United States1 site, 1 recruiting
  • Rutgers - Institute for Health

    New Brunswick, New Jersey, 08901

    Claudio Mendes, claudio.mendes@rutgers.edu

    Recruiting

Other trials in United States

About this study

Official title: Alpha Linolenic Acid-enriched Nutrition for Prevention of Cognitive Decline in APOE4 Older Adults With Mild Cognitive Impairment: Targeting Cerebrovascular and Blood-brain Barrier Health

This randomized, double-blind, placebo-controlled pilot trial will evaluate the effects of alpha-linolenic acid (ALA) supplementation on cognitive function, blood-brain barrier integrity, and brain vascular health in older adults with mild cognitive impairment and APOE4 genotype. By targeting the endogenous synthesis of docosahexaenoic acid (DHA) through ALA supplementation, the investigators aim to overcome the limitations of direct DHA supplementation, particularly in APOE4 carriers who exhibit low brain DHA levels and impaired blood-brain barrier function. This innovative approach offers a safe, cost-effective, and easily implementable therapeutic strategy for older adults at high risk for Alzheimer's dementia, especially APOE4 carriers, addressing a critical need given the limited cognitive benefits and significant adverse events of current amyloid-clearing drugs in this population.

Read the detailed description

This randomized, double-blind, placebo-controlled pilot study will evaluate the effects of alpha-linolenic acid (ALA)-enriched nutrition on cognitive function, blood-brain barrier (BBB) integrity, and brain vascular health in a high-risk population of older adults with MCI and APOE4 genotype. Docosahexaenoic acid (DHA), a critical fatty acid for brain health, is synthesized from ALA. Despite previous research showing limited cognitive benefits from DHA supplementation, APOE4 carriers have low brain DHA levels. This deficiency may stem from impaired transport across the BBB and compromised BBB integrity. The investigators hypothesize that ALA supplementation will enhance endogenous DHA synthesis, leading to improved cognitive outcomes through increased brain levels of DHA and its metabolites, including eicosapentaenoic acid (EPA) and docosapentaenoic acid (DPA), and improved BBB and brain vascular integrity. The study will include 60 older adults with MCI who carry at least one APOE4 allele. Participants will be randomized to either daily supplementation of 2.6 grams of ALA or a placebo (corn oil) for six months. The specific aims will compare ALA and placebo on: 1) Cognition: The investigators hypothesize improvement in global cognition at 6 months in the ALA-treated group. Secondary outcomes will be episodic memory and executive functions. 2) Cerebral vasculature: The primary neurobiological outcome will be BBB integrity, assessed via MRI. The investigators hypothesize that the ALA group will exhibit reduced BBB leakage compared to placebo. Secondary measures will include cerebral blood flow, brain vascular reactivity, and white matter hyperintensities. 3) Blood Biomarkers: The investigators will measure blood biomarkers indicative of BBB integrity (including mfsd2a, s100B, and GFAP). The investigators expect lower levels of these markers in the ALA group at six months, reflecting improved BBB function. Additionally, the investigators will analyze in plasma ALA and its downstream pathway (DHA, EPA). Finally, to distinguish the specific effects of ALA on cerebral vascular integrity from ADRD processes, the investigators will also explore its effects on plasma p-tau 217 and Neurofilament Light. This pilot study will lay the groundwork for a larger multi-site RCT testing the cognitive, BBB, and cerebrovascular benefits of ALA supplementation in APOE4 carriers at risk for Alzheimer's dementia. With current amyloid-clearing drugs showing limited success in preventing or reversing dementia symptoms-especially among APOE4 carriers-this research has potential for high public health impact by offering a promising new, low cost, safe therapeutic avenue for older adults at high dementia risk.

Being tested
Alpha-Linolenic Acid (2.6 g/day), Placebo Control Group
Keywords
Alpha-Linolenic Acid, Flaxseed Oil, Apolipoprotein E4, Nutritional Intervention, APOE4 Dysfunction, Cognitive Function, Brain MRI, Blood Biomarkers, Vascular Integrity, Neurodegeneration, Aging Brain, Memory Loss Prevention, AD Prevention Trial, Alzheimer's Disease, Cognitive decline prevention, Blood-brain barrier, Dementia prevention, Older adults, Biomarkers, Magnetic resonance imaging (MRI)
Medical subject headings
Cognitive Dysfunction, Alzheimer Disease, Apolipoprotein E, Deficiency or Defect of, Nerve Degeneration

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Alpha-Linolenic Acid (2.6 g/day)Drug

    Also called Flaxseed Oil, ALA

    Participants in this group will take flaxseed oil that contains 2.6 grams of alpha-linolenic acid (ALA) each day for six months. The oil will be provided in 5 mL prefilled oral syringes prepared by the Rutgers Clinical Research Pharmacy. Participants will take one syringe daily in the morning with food. They may mix the oil with cold foods such as yogurt or applesauce but should not heat it.

    The ALA supplement is intended to improve cognitive and brain health by enhancing the body's natural production of DHA that supports blood-brain barrier integrity and brain function.

  • Placebo Control GroupDietary supplement

    Also called Corn Oil, Placebo Control

    Participants in this group will take corn oil that does not contain ALA. The oil will be provided in the same 5 mL prefilled oral syringes as the active supplement and will look, taste, and smell similar to the ALA oil. Participants will take one syringe daily in the morning with food for six months.

    The placebo is used to compare effects against the ALA supplement and to maintain blinding for both participants and study staff.

Study groups in NCT07392723
Study groupRoleWhat they receive
ALA GroupExperimentalParticipants receive flaxseed oil in 5 mL oral syringes containing 2.6g of ALA, taken daily for six months.
Receives: Drug: Alpha-Linolenic Acid (2.6 g/day)
Placebo Control GroupPlacebo comparatorParticipants receive corn oil without ALA (iso-caloric placebo) in 5 mL oral syringes that are identical in appearance to those containing ALA, taken daily for six months.
Receives: Dietary Supplement: Placebo Control Group

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Change in global cognitive (score) function

    Change in global cognition score from baseline to 6 months measured by an average of the z-scores across a broad cognitive battery, will be compared between ALA and placebo groups.

    Measured: Baseline and 6 months

  2. Change in Blood-Brain Barrier Integrity - Permeability of the BBB

    Blood-brain barrier (BBB) permeability will be assessed using the water exchange rate constant (Kw), derived from a validated motion-corrected diffusion-weighted pseudocontinuous arterial spin labeling (MCDW-pCASL) MRI sequence. Values will be extracted from whole-brain and region-specific areas, including hippocampus, dorsolateral frontal cortex, and parietal cortex. Changes from baseline to 6 months will be compared between ALA and placebo groups.

    Measured: Baseline and 6 months

  3. Levels of blood biomarkers of BBB Integrity

    Changes in protein levels in serum of: mfsd2a, s100B, and Glial Fibrillary Acidic Protein (GFAP) indicative of BBB function. Changes from baseline to 6 months will be compared between ALA and placebo groups.

    Measured: baseline and 6 months

Secondary outcomes (7)
  1. Episodic Memory

    Changes in episodic memory scores - the average z-score of the immediate and delayed word recall task, and the word recognition task will be assessed. Changes from baseline to 6 months will be compared between ALA and placebo groups.

    Measured: Baseline and 6 months

  2. Executive Function

    Changes in executive function scores - the average z-score of: Trail Making Test Parts A and B, Digit Span Forward and Backward, Animal Fluency, and Vegetable Fluency assessments. Changes from baseline to 6 months will be compared between ALA and placebo groups.

    Measured: Baseline and 6 months

  3. Cerebral Blood Flow

    Changes in cerebral blood flow will be assessed by MRI sequence measured by PSeudo Continuous Arterial Spin Labelling Sequence (pCASL). Values will be extracted from whole-brain and region-specific areas: hippocampus, as well as parietal, superior temporal, dorsolateral prefrontal, and precuneus cortex. Changes from baseline to 6 months will be compared between ALA and placebo groups.

    Measured: Baseline and 6 months

  4. Brain Vascular Reactivity

    Changes in brain vascular reactivity measured by a EPI BOLD scan tracing a CO2 concentration. Changes from baseline to 6 months will be compared between ALA and placebo groups.

    Measured: Baseline and 6 months

  5. White Matter Hyperintensity (WMH)

    Changes in WMH volume will be assessed using 3D T2-FLAIR MRI. Changes from baseline to 6 months will be compared between ALA and placebo groups.

    Measured: Baseline and 6 months

  6. Alzheimer's Disease and Related Dementia (ADRD) Blood Biomarkers - Phosphorylated tau 217 (p-tau217) and Neurofilament Light (NfL)

    Changes in plasma levels of Phosphorylated tau 217 (p-tau217) and Neurofilament Light (NfL) will be assessed. Changes from baseline to 6 months will be compared between ALA and placebo groups.

    Measured: Baseline and 6 months

  7. Blood fatty acids markers

    Changes in plasma levels of fatty acids including ALA, DHA, and EPA will be analyzed by TLC-GC-MS. Changes from baseline to 6 months will be compared between ALA and placebo groups.

    Measured: Baseline and 6 months

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted6 Feb 2026
  2. Study start12 Jan 2025
  3. Primary completionApr 2027 (estimated)
  4. Study completionOct 2027 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 2
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Model description
Two groups: 1. Flaxseed oil (ALA 2.6 g/day) 2. Placebo (corn oil, iso-caloric control)
Masking
Quadruple blind
Who is masked
Participant, Care provider, Investigator, Outcomes assessor
Enrolment
20 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT07392723
Sponsor's protocol ID
Pro2025000006
Status last verified
Jan 2026
First submitted
20 Oct 2025
Last updated
6 Feb 2026
Results posted
No
Data monitoring committee
No
FDA-regulated drug
Yes
FDA-regulated device
No
Individual data sharing
Yes: We will share non-identifiable (no PHI) data with other investigators upon participants' approval.

Questions about this trial

What is this clinical trial studying?

A Phase 2 study testing Alpha-Linolenic Acid (2.6 g/day) in people with Cognitive Dysfunction and Alzheimer Disease, run by Michal Schnaider Beeri, Ph.D. at 1 site in United States.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 6 inclusion and 9 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: looking for participants now, as of the sponsor's last update on 6 Feb 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in United States. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. Some participants in this study may receive a placebo. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

Contact Claudio Mendes, MS (8489328412, alastudy@njms.rutgers.edu), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Change in global cognitive (score) function (time frame: Baseline and 6 months). The study lists 3 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 6 Feb 2026.

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