Higher CoQ10 levels linked with reduced dementia risk

Tuesday, December 23, 2014. The December 2014 issue of the journal Atherosclerosis revealed an association in older men and women between higher levels of the lipid-soluble antioxidant coenzyme Q10 (CoQ10) and a lower risk of developing dementia.

Kazumasa Yamagishi of Japan's University of Tsukuba and colleagues conducted a case-control study of individuals aged 40 to 69 years upon enrollment in the Circulatory Risk in Communities Study between 1984 and 1994. Serum CoQ10 levels were measured in 65 men and women who developed disabling dementia between 1999 and 2004, and in 130 age- and gender-matched control subjects.

An association was observed between higher CoQ10 levels and a decline in the risk of developing dementia. Subjects whose CoQ10 levels were among the highest 25% of participants had a risk of dementia that was 77% less than those whose levels were among the lowest 25%. When the ratio of CoQ10 to total cholesterol was examined, a similar relationship was observed.

"This is the first prospective study to examine the association between CoQ10 and incident dementia in a general setting," the authors announce. They observe that CoQ10 has lowered brain oxidative stress and amyloid plaque in a mouse model of Alzheimer's disease, and that rats with damaged areas of the brain experienced a reversal of markers of oxidative damage with CoQ10 supplementation.

"Mitochondria play an essential role in energy production within cells, and energy is generated through oxidative phosphorylation in the form of adenosine triphosphate (ATP)," noted Yukihiko Momiyama of National Hospital Organization Tokyo Medical Center in an accompanying commentary. "Mitochondrial impairment and increased oxidative stress are considered to be involved in the pathogenesis of neurodegenerative diseases, such as Alzheimer's disease, which is the most common form of dementia in the elderly."

"Coenzyme Q10 (CoQ10), also known as ubiquinone, is a component of the electron transport chain, which is located at the inner membrane of the mitochondria and plays a major role in ATP synthesis," he continued. "In addition to this bioenergetic activity required for ATP synthesis, CoQ10 also has antioxidant activity in both mitochondrial and lipid membranes, which protects them against the reactive oxidative species generated during oxidative phosphorylation."

Dr. Yamagishi and colleagues recommend the evaluation of dietary or supplementary intake of CoQ10 in a randomized trial and conclude that "higher serum CoQ10 levels may have a beneficial effect on the prevention of dementia."

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Review summarizes benefits of CoQ10 supplementation

The March 2013 issue of Nutrition Reviews published an article by Michael S. Pepper and his colleagues at the University of Pretoria in South Africa which provides an overview of coenzyme Q10 (CoQ10) supplementation in primary and secondary deficiency states. Primary CoQ10 deficiency occurs when the body's synthesis of this coenzyme is decreased due to mutations in specific enzymes involved in its production. Secondary deficiency is mainly observed among men and women who have been prescribed statin drugs which reduce a precursor in the pathway of CoQ10 synthesis, although there may be other causes.

In their review, the authors describe CoQ10's benefits, including its antioxidant effect and its role in energy production and cell function. They note that CoQ10 has a remarkable safety profile as a supplement and has shown little in the way of adverse effects, which have not been observed to occur in greater frequency among those consuming relatively high doses in comparison with low doses. They add that no adverse effects have been demonstrated in association with amounts of up to 3,000 milligrams per day.

Supplementation is critical for those who are deficient in CoQ10 because of the minimal amount contributed by the diet. Although researchers do not yet agree upon routine supplementation to prevent adverse muscle events associated with statin-induced reductions in CoQ10, the authors of the review note that decreased coenzyme Q10 levels have been associated with consequences other than those that impact muscle, including an increased risk of mortality in heart failure patients. Monitoring patients who use statin drugs for plasma CoQ10 levels may be advisable, in addition to testing for a variation in a gene that is associated with statin intolerance.

"In patients in whom CoQ10 depletion is detected, appropriate supplementation should be administered at an optimal dose, using a formulation with proven superior bioavailability, to achieve normal plasma levels," the authors conclude. "In addition, a pharmacogenetic analysis may provide important information about the potential for statin-induced adverse effects in high-risk patients."

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Health Concern

Alzheimer's disease

Coenzyme Q10 (CoQ10) has been found to improve outcomes in several neurodegenerative disorders involving loss of mitochondrial function (Galpern 2007; Manacuso 2010).

Studies have shown that levels of CoQ10 are altered in Alzheimer's disease (Dhanasekaran 2005), and supplementation has been suggested as part of an integrated approach to improve mitochondrial function in Alzheimer's disease (Kidd 2005).

In one animal study, CoQ10 counteracted mitochondrial deficiencies in rats that had been treated with amyloid beta (Moreira 2005). While in another experiment, CoQ10 reduced the overproduction of amyloid beta (Yang 2008). Coenzyme Q10 was also shown to destabilize amyloid plaques in laboratory studies (Ono 2005).

Several clinical trials have evaluated the effects of synthetic CoQ10 analogs in Alzheimer's patients and shown good results. For example, a trial comparing tacrine, a pharmaceutical acetylcholinesterase inhibitor, to a CoQ10 analog among 203 Alzheimer's patients showed the CoQ10 analog was associated with greater improvements on some standardized cognitive assessments (Gutzmann 2002). Another trial revealed dose-dependent improvements on cognitive assessments in Alzheimer's patients receiving a CoQ10 analog compared to a placebo. This trial also showed the CoQ10 analog to be safe and well tolerated (Gutzmann 1998). Similarly, in a trial conducted on 102 Alzheimer's patients, a CoQ10 analog improved memory, attention, and behavior compared to a placebo (Senin 1992).