IJCEM Copyright © 2008-All rights reserved. Published by e-Century Publishing Corporation, Madison, WI 53711
Int J Clin Exp Med 1(2),181-191;2008

Review Article
Flavanols, Mild Cognitive Impairment, and Alzheimer’s Dementia

Ami K. Patel, Jack T. Rogers and Xudong Huang

Conjugate and Medicinal Chemistry Laboratory, Department of Radiology, Brigham and Women's Hospital and Harvard Medical
School, Boston, MA 02115, USA. Neurochemistry Laboratory, Department of Psychiatry, Massachusetts General Hospital and Harvard
Medical School, Charlestown, MA 02129, USA.

Received March 17, 2008; accepted April 14, 2008; available online April 15, 2008

Abstract: Alzheimer’s disease (AD) is a dementing neurological disorder that results in progressive memory loss and cognitive
decline thought to be associated with buildup of amyloid plaques and neurofibrillary tangles in the brain. Vascular Dementia (VaD) is
another common dementing disorder characterized by decreased brain perfusion. Together, AD and VaD constitute mixed dementia,
an extremely common type of dementia associated with aging. Neuroimaging research suggests that brain vascular atrophy results in
mild cognitive impairment (MCI), a possible precursor for AD. Additionally, literature suggests that attention to cardiovascular risk
factors such as hypertension could reduce or delay the incidence of mixed dementia. Furthermore, foods and beverages rich in natural
antioxidant flavanoids (i.e. epicatechin and catechin) are currently being advocated as possible preventative agents for a number of
pathological conditions ranging from coronary heart disease to dementia. Experimental evidence is mounting that oxidative stress is
involved in the pathophysiology of AD, and numerous studies are indicating that polyphenolic antioxidants found in fruits and
vegetables can be useful in countering this and blocking neuronal death. More specifically, several cocoa studies suggest that daily
intake of cocoa flavanols leads to cardiovascular benefits including vasodilatation via a nitric oxide mechanism and increased brain
perfusion. The following text will consider an important question that thus arises regarding the potential of flavanols as effective agents
for the prevention and delay of the onset of brain vascular atrophy and subsequently MCI and AD. It will also review the molecular
mechanisms through which flavanols operate to accomplish their protective effects. (IJCEM803002).

Key Words: Brain vascular atrophy, mild cognitive impairment, Alzheimer’s Disease, flavanols, oxidative stress, antioxidants

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Address all correspondence to: Xudong Huang, Ph.D., Conjugate and Medicinal Chemistry Laboratory, Department of Radiology,
Brigham and Women's Hospital and Harvard Medical School, Boston, MA 02115, USA.; Tel: (617) 525-7279; Fax: (617)732-8552; E-
mail:
xhuang3@partners.org