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J Alzheimers Dis. 2014;42(4):1191-202. doi: 10.3233/JAD-140507.

Macular pigment, visual function, and macular disease among subjects with Alzheimer's disease: an exploratory study.

Author information

Macular Pigment Research Group, Department of Chemical and Life Sciences, Waterford Institute of Technology, Waterford, Ireland.
Howard Foundation, Cambridge, UK Downing College, University of Cambridge, Cambridge, UK.
Waterford Regional Hospital, Age-Related Care Unit, Waterford, Ireland.
Northern Ireland, Centre for Food and Health (NICHE), University of Ulster, Coleraine, UK.



The macula (central retina) contains a yellow pigment, comprising the dietary carotenoids lutein (L), zeaxanthin (Z), and meso-zeaxanthin, known as macular pigment (MP). The concentrations of MP's constituent carotenoids in retina and brain tissue correlate, and there is a biologically-plausible rationale, supported by emerging evidence, that MP's constituent carotenoids are also important for cognitive function.


To investigate if patients with Alzheimer's disease (AD) are comparable to controls in terms of MP and visual function.


36 patients with moderate AD and 33 controls with the same age range participated. MP was measured using dual-wavelength autofluorescence (Heidelberg Spectralis®); cognitive function was assessed using a battery of cognition tests (including Cambridge Neuropsychological Test Automated Battery). Visual function was recorded by measuring best corrected visual acuity (BCVA) and contrast sensitivity (CS). Serum L and Z concentrations (by HPLC) and age-related macular degeneration (AMD, by retinal examination) status were also assessed.


In the AD group, central MP (i.e., at 0.23┬░) and MP volume were significantly lower than the control group (p < 0.001 for both), as were measures of BCVA, CS, and serum L and Z concentrations (p < 0.05, for all).


AD patients were observed to exhibit significantly less MP, lower serum concentrations of L and Z, poorer vision, and a higher occurrence of AMD when compared to control subjects. A clinical trial in AD patients designed to investigate the impact of macular carotenoid supplementation with respect to MP, visual function, and cognitive function is merited.


Age-related macular degeneration; Alzheimer's disease; cognitive function; contrast sensitivity; lutein; meso-zeaxanthin; visual function; zeaxanthin

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