Feasibility of implementing time-restricted eating in women with mild cognitive impairment

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Project Summary Alzheimer’s disease (AD) is an incurable neurodegenerative disease affecting 6.5 million Americans above the age of 65. Currently, no pharmacological therapy prevents AD or markedly slows the progression to severe dementia. Women have twice the lifetime risk of developing AD compared to men, so it is critical to study disease progression and develop interventions in women. Clinical studies show that circadian rhythm and sleep disruption are associated with cognitive impairment and preclinical markers of AD. Thus, therapeutics that improve circadian rhythms and sleep may prevent AD development and progression. Numerous preclinical and clinical studies have shown that time-restricted eating (TRE), a circadian behavioral intervention that aligns food intake to the active phase, improves cardiometabolic health outcomes. Recent studies have shown that TRE can also improve cognition. Thus, TRE is a promising intervention strategy for AD, but no study has investigated its efficacy at improving cognition in cognitively impaired individuals. A first step toward our long- term goal of studying TRE efficacy for cognition is to determine whether TRE is feasible in a population with cognitive impairment. This feasibility study will examine the implementation of an 8-week 10-h TRE intervention in postmenopausal women with mild cognitive impairment (MCI). We will recruit 15 women with MCI from an ongoing longitudinal study of cognitive aging at the University of Kentucky. Cognitive impairment, sleep and activity rhythms, diet composition, metabolic assessment, body composition, and anthropometric measures will be assessed at baseline and after the 8-week TRE intervention. For the duration of the study, the times of first and last meals will be collected from participants with an SMS texting system that we developed. Participants will be instructed to eat during a 10-h eating window and fast at night. The primary outcome of this study will be adherence to the TRE protocol regimen. This pilot study will also provide preliminary data about the effects of TRE on cognition, which are essential for powering a future randomized clinical efficacy trial.