Frailty is an accurate measure of the risk of early mortality in the elderly. In cases of frailty, you see atrophy of muscles associated with considerable weakness, impairment of memory, and deterioration of organ function.

A great deal of what constitutes frailty is secondary to a loss of muscle mass and strength. In most cases, attempts to build muscle and slow muscle loss in the elderly are unsuccessful.

Animal studies have shown that ketones can prevent and repair muscle atrophy. One recent study found that combining medium[1]chain triglyceride (MCT) oil with branched-chain amino acids (BCAAs) and vitamin D3 significantly improved muscle strength and muscle mass in previously frail elderly people.

In a follow-up study, the same researchers found that the treatment substantially improved mental functions as well. The second study researchers divided 36 elderly people in a nursing home into three dietary groups:

• Group 1: BCAA +MCT oil + vitamin D3

• Group 2: BCAAs + long-chain fatty acids (animal fats) + vitamin D3

• Group 3: Controls fed the usual nursing home diet but no vitamin D3

They used six grams of the two forms of fat and 800 IU of vitamin D3. Cognitive testing was done using the MMSE test, which is a patient questionnaire; and the NM scale, which was an evaluation by the nursing home staff based on five observations of performance (considered a more accurate test).

The subjects in Group 1 had the greatest improvements. The most significant changes occurred with the NM scoring, which demonstrated the ketone plus BCAAs group increased their scores an average of 30 percent.

Group 2 participants, who were taking the BCAAs plus long-chain fatty acids (animal fats), actually saw their scores drop some 26.1 percent.

Most impressively, conversation ability improved 46 percent in Group 1 and memory improved 42.6 percent in this group.

After the study was completed, the total score for Group 1 improved 46 percent on the MMSE scale and 92 percent on the NM scale. Group 2 improved as well, though far less than those in Group 1.

The patients that remained on the nursing home diet (Group 3) showed no improvement on the NM test.

If you have ever examined a typical nursing home diet this will not be a surprise. These nursing home patients did not have Alzheimer’s dementia, but were at an increased risk of developing the disorder. The Group 1 diet of BCAA +MCT oil + vitamin D3 appears to be an excellent and safe way to improve not just strength but also mental function in frail elderly people.

The branched-chain amino acids (BCAAs), which include leucine, isoleucine, and valine, play a major role in building muscle and protecting organs. Vitamin D3 has been shown to prevent cognitive decline in aged rats.

Low vitamin D3 level is associated with poor cognitive function and higher risk of Alzheimer’s disease in people.

Human studies using ketones on Alzheimer’s patients and those with age-related cognitive impairment have been few, but they did demonstrate some encouraging results. Several studies have also shown that a high ketone level has significant benefits in animal models of ALS (amyotrophic lateral sclerosis), with prolonged survival and significant reduction in spinal cord damage.

Animal studies of Parkinson’s disease also show significant benefits for protecting the substantia nigra, which is the principle brain area damaged by that disease.