Study of the Effects of Cerefolin NAC on Inflammation Blood Markers in Older Individuals With Memory Complaints

• Assess the tolerability of Cerefolin NAC [ Time Frame: 6 months ] [ Designated as safety issue: Yes ]
• Assess if Cerefolin NAC reduces secondary measures of inflammation and oxidative stress [ Time Frame: 6 months ] [ Designated as safety issue: No ]
• Explore the effects of Cerefolin NAC on cognitive test performance, activities of daily living, mood, and physical function [ Time Frame: 6 months ] [ Designated as safety issue: No ]
• Explore how change in homocysteine levels is associated with change in inflammatory, oxidative stress, and beta-amyloid markers. [ Time Frame: 6 months ] [ Designated as safety issue: No ]
• Explore the interaction of genetic markers on the relationship between change in homocysteine levels and change in the measured biomarkers [ Time Frame: 6 months ] [ Designated as safety issue: No ]
• Explore relationship of vitamin B12 levels to cognitive function [ Time Frame: 6 months ] [ Designated as safety issue: No ]

The purpose of this six-month research study is to determine if Cerefolin NAC reduces levels of substances in the blood that may be associated with thinking ability and the health of brain cells in subjects with memory concerns when compared to a standard multivitamin. Cerefolin NAC is available as a dietary supplement via a prescription from a physician. The multivitamin used in the study contains the Recommended Daily Intake recommended for older persons.

Study Phase: Exploratory

Indication: Memory Complaints

Study Design:

A single-center, double-blind, placebo-controlled study with 100 subjects with memory complaints followed for 6 months (4 visits)using Cerefolin® NAC or placebo once a day in addition to a standardized multivitamin.

Sample Size:

100 subjects as follows:

1. 50 on Cerefolin® NAC + multivitamin; and,
2. 50 on Placebo + multivitamin.

Primary Objective:

To determine if Cerefolin® NAC (compared to multivitamin) decreases the blood level of homocysteine, increases the blood level of glutathione (a marker for oxidative stress), and increases the ratio of Aβ42 to Aβ40 (a marker for beta-amyloid) that may be related to neuronal injury and inflammation.

Secondary Objectives:

1. To determine if Cerefolin® NAC reduces hs-CRP and TNF-α blood levels, and increases IL-6 blood levels.
2. To determine if Cerefolin® NAC (compared to Placebo) reduces plasma F2 isoprostane and increases potential antioxidant (PAO) levels.
3. To assess the tolerability of Cerefolin® NAC
4. To explore the effects of Cerefolin® NAC on a 6-month change in: (a)global and specific cognitive domains in a standardized neuropsychological test battery,(b) quality of life as measured by SF-36, (c)instrumental and basic activities of daily living, (d)MADRS; and (e)performance-based physical function.
5. To explore if a change in homocysteine level is related to a change in the plasma glutathione, hs-CRP, IL-6, TNF-α, F2-isoprostane, and PAO levels and to a change in the ratio of Aβ42 to Aβ40.
6. To explore the effects of MS AG2756, APOE and MFTHR on the relationship examined in Secondary Objective #5.
7. To explore the relationship of B12 status and status to cognition

NOTE: For individuals successfully completing the 6-month blinded phase, there is an 12-month open-label extension of Cerefolin NAC + multivitamin. The primary purpose of the exploratory, open-label extension phase of the CERE-001 study is to systematically collect long-term safety data on CEREFOLIN NAC usage over an additional 12-month period.

• Other: Cerefolin NAC (a medical food)
  Cerefolin NAC one tablet each day
• Other: Cerefolin NAC placebo
  Placebo tablet once a day

• Experimental: 1
  On Cerefolin NAC and open-label multivitamin supplement
  Intervention: Other: Cerefolin NAC (a medical food)
• Placebo Comparator: 2
  On placebo and open label multivitamin supplement
  Intervention: Other: Cerefolin NAC placebo

Inclusion Criteria:

• Age greater than 60;

• Memory complaints as defined by two questions:

  1. "Do The subject think your have memory problems?"; and,
  2. "Has there been a decline in your memory over the last 10 years?"
• Fluency in English;
• Ability to ingest oral medications; and,
• Willing to replace current vitamin intake with a standardized multivitamin provided for the study.

Exclusion Criteria:

• Clinical stroke or Parkinson's disease;
• Taking FDA approved drug for symptomatic treatment of Alzheimer's disease (Aricept, Razadyne, Exelon, and/or Namenda);
• History of significant renal insufficiency (creatinine ≥1.5);
• History of renal stones or peptic ulcer disease;
• Use of vitamin supplements containing more than 400mcg of folic acid per day within 2 months of Screen Visit;
• As determined by the study physician, clinically significant serum folate and vitamin B12 deficiency on screening blood tests that would require further clinical evaluation and treatment
• As determined by the study physician, clinically significant medical conditions, physical exam findings or abnormal blood tests at screening that would require further clinical evaluation and treatment
• B12 injections 6 months prior to the Screen Visit;
• Confirmed clinical diagnosis of Mild Cognitive Impairment (MCI), vascular dementia or Alzheimer's Disease (AD); and,
• Known hypersensitivity to L-methylfolate, methyl-cobalamin or N-acetylcysteine.
• Use of any other investigational agent used during the 30 days prior to Screening.