Effects of n‐3 fatty acids on cognitive decline: A randomized, double‐blind, placebo‐controlled trial in stable myocardial infarction patients

Alzheimer's & Dementia - Tập 8 - Trang 278-287 - 2012
Johanna M. Geleijnse1, Erik J. Giltay2, Daan Kromhout1
1Division of Human Nutrition, Wageningen University, Wageningen, The Netherlands
2Department of Psychiatry, Leiden University Medical Center, Leiden, the Netherlands

Tóm tắt

AbstractBackground

Epidemiological studies suggest a protective effect of n‐3 fatty acids derived from fish (eicosapentaenoic acid [EPA] and docosahexaenoic acid [DHA]) against cognitive decline. For α‐linolenic acid (ALA) obtained from vegetable sources, the effect on cognitive decline is unknown. We examined the effect of n‐3 fatty acid supplementation on cognitive decline in coronary heart disease patients.

Methods

The analysis included 2911 coronary patients (78% men) aged 60 to 80 years who participated in a double‐blind placebo‐controlled trial of n‐3 fatty acids and cardiovascular diseases (Alpha Omega Trial). By using a 2 × 2 factorial design, patients were randomly assigned to margarines that provided 400 mg/d of EPA–DHA, 2 g/d of ALA, both EPA–DHA and ALA, or placebo for 40 months. Cognitive function was assessed by the Mini‐Mental State Examination (MMSE) at baseline and after 40 months. The effect of n‐3 fatty acids on change in MMSE score was assessed using analysis of variance. Logistic regression analysis was used to examine the effects on risk of cognitive decline, defined as a decrease of 3 or more points in MMSE score or incidence of dementia.

Results

Patients in the active treatment groups had an additional intake of 384 mg of EPA–DHA, 1.9 g of ALA, or both. The overall MMSE score in this cohort was 28.3 ± 1.6 points, which decreased by 0.67 ± 2.25 points during follow‐up. Changes in MMSE score during intervention did not differ significantly between EPA–DHA and placebo (−0.65 vs −0.69 points, P = .44) or between ALA and placebo (−0.60 vs −0.74 points, P = .12). The risk of cognitive decline was 1.03 (95% confidence interval: 0.84–1.26, P = .80) for EPA–DHA (vs placebo) and 0.90 (0.74–1.10, P = .31) for ALA (vs placebo).

Conclusion

This large intervention study showed no effect of dietary doses of n‐3 fatty acids on global cognitive decline in coronary heart disease patients.


Tài liệu tham khảo

W.S.Lim J.K.Gammack J.K.Van Niekerk A.Dangour.Omega 3 fatty acid for the prevention of dementia.Cochrane Database Syst Rev2006;CD005379 doi:10.1002/14651858.CD005379.pub2 10.3945/ajcn.2008.26987 10.1111/j.1471-4159.2004.02520.x 10.3945/jn.109.113910 10.1016/0197-4580(96)00113-3 10.1079/NRR2005113 10.1093/ajcn/63.1.116 10.1093/jn/134.11.2991 10.1007/s12263-009-0141-6 10.1093/ajcn/66.4.803 10.1001/archneur.60.7.940 10.1093/ajcn/85.4.1142 Laurin D., 2003, Omega‐3 fatty acids and risk of cognitive impairment and dementia, J Alzheimers Dis, 5, 315, 10.3233/JAD-2003-5407 10.3945/ajcn.2008.27037 10.3945/jn.109.113647 Terano T., 1999, Docosahexaenoic acid supplementation improves the moderately severe dementia from thrombotic cerebrovascular diseases, Lipids, 34, 345S, 10.1007/BF02562338 10.1001/archneur.63.10.1402 10.1017/S0007114507801097 10.1212/01.wnl.0000324268.45138.86 10.3945/ajcn.2009.29121 10.1093/gerona/62.10.1120 10.1093/ajcn/77.4.803 10.1093/ajcn/88.3.714 10.3109/00207459609070833 10.1016/j.jns.2009.02.004 10.1111/j.1532-5415.2005.53360.x 10.1016/S1567-4215(06)80096-2 10.1001/jama.1995.03530170043030 10.1056/NEJMoa012918 10.1016/j.metabol.2008.11.013 10.1016/j.ahj.2009.12.033 10.1056/NEJMoa1003603 10.1016/0022-3956(75)90026-6 10.1093/ajcn/58.4.489 10.1016/S0895-4356(97)00010-3 Soto M.E., 2008, Rapid cognitive decline in Alzheimer's disease. Consensus paper, J Nutr Health Aging, 12, 703, 10.1007/BF03028618 10.1001/archneur.58.3.449