Docosahexaenoic acid-concentrated fish oil supplementation in subjects with mild cognitive impairment (MCI): a 12-month randomised, double-blind, placebo-controlled trial

Psychopharmacology - Tập 225 - Trang 605-612 - 2012
Lai Kuan Lee1, Suzana Shahar2, Ai-Vyrn Chin3, Noor Aini Mohd Yusoff4
1Nutrition Science Program, School of Health Care Sciences, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
2School of Health Care Sciences, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
3Department of Geriatrics, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
4Faculty of Therapeutic Sciences, Masterskill University College of Health Sciences, Cheras, Malaysia

Tóm tắt

Epidemiological studies have suggested a beneficial effect of fish oil supplementation in halting the initial progression of Alzheimer’s disease. However, it remains unclear whether fish oil affects cognitive function in older people with mild cognitive impairment (MCI). This study investigated the effects of fish oil supplementation on cognitive function in elderly person with MCI. This was a 12-month, randomised, double-blind, placebo-controlled study using fish oil supplementation with concentrated docosahexaenoic acid (DHA). Thirty six low-socioeconomic-status elderly subjects with MCI were randomly assigned to receive either concentrated DHA fish oil (n = 18) or placebo (n = 18) capsules. The changes of memory, psychomotor speed, executive function and attention, and visual-constructive skills were assessed using cognitive tests. Secondary outcomes were safety and tolerability of the DHA concentrate. The fish oil group showed significant improvement in short-term and working memory (F = 9.890; ηp 2 = 0.254; p < 0.0001), immediate verbal memory (F = 3.715; ηp 2 = 0.114; p < 0.05) and delayed recall capability (F = 3.986; ηp 2 = 0.121; p < 0.05). The 12-month change in memory (p < 0.01) was significantly better in the fish oil group. Fish oil consumption was well tolerated, and the side effects were minimal and self-limiting. This study suggested the potential role of fish oil to improve memory function in MCI subjects. Studies with larger sample sizes, longer intervention periods, different fish oil dosages and genetic determinations should be investigated before definite recommendations can be made.

Tài liệu tham khảo

Barberger-Gateau P, Raffaitin C, Letenneur L, Berr C, Tzourio C, Dartigues JF, Alpérovitch A (2007) Dietary patterns and risk of dementia: the Three-City cohort study. Neurology 69:1921–1930 Boston PF, Bennett A, Horrobin DF, Bennett CN (2004) Ethyl-EPA in Alzheimer’s disease—a pilot study. Prostaglandins Leukot Essent Fatty Acids 71:341–346 Calviello G, Serini S, Piccioni E (2008) Alzheimer’s disease and n−3 polyunsaturated fatty acids: beneficial effects and possible molecular pathways involved. Curr Signal Trans T 3:152–157 Chiu CC, Su KP, Chen TC, Liu HC, Chang CJ (2008) The effects of omega-3 fatty acids monotherapy in Alzheimer’s disease and mild cognitive impairment: a preliminary randomized double-blind placebo-controlled study. Prog Neuropsychopharmacol Biol Psychiatry 32:1538–1544 Cropley V, Croft R, Silber B, Neale C, Scholey A, Stough C, Schmitt J (2012) Does coffee enriched with chlorogenic acids improve mood and cognition after acute administration in healthy elderly? A pilot study. Psychopharmacology 219:737–749 Cunnane SC, Plourde M, Pifferi F, Féart C, Barberger-Gateau P (2009) Fish, docosahexaenoic acid and Alzheimer’s disease. Prog Lipid Res 48:239–256 Dangour AD, Allen E, Elbourne D, Fasey N, Fletcher AE, Hardy P, Holder GE, Knight R, Letley L, Richards M, Uauy R (2010) Effect of 2-y n-3 long-chain polyunsaturated fatty acid supplementation on cognitive function in older people: a randomized, double-blind, controlled trial. Am J Clin Nutr 91:1725–1732 Dullemeijer C, Durga J, Brouwer IA, Van de rest O, Kok FJ, Brummer RJM, Van Boxtel MPJ, Verhoef P (2007) n 3 fatty acid proportions in plasma and cognitive performance in older adults. Am J Clin Nutr 86:1479–1485 Fagherazzi EV, Garcia VA, Maurmann N, Bervanger T, Halmenschlager LH, Busato SB, Hallak JE, Zuardi AW, Crippa JA, Schröder N (2012) Memory-rescuing effects of cannabidiol in an animal model of cognitive impairment relevant to neurodegenerative disorders. Psychopharmacology 219:1133–1140 Folch J, Lees M, Sloanes-Stanley JH (1957) A simple method for isolation and purification of total lipids from animal tissues. J Biol Chem 226:497–509 Folstein MF, Folstein SE, McHugh PR (1975) Mini-Mental State: a practical method for grading the cognitive state of patients for the clinician. J Psychiatry Res 12:189–198 Fontani G, Corradeschi F, Felici A, Alfatti F, Migliorini S, Lodi L (2005) Cognitive and physiological effects of omega-3 polyunsaturated fatty acid supplementation in healthy subjects. Eur J Clin Invest 35:691–699 Freund-Levi Y, Eriksdotter-Jonhagen M, Cederholm T, Basun H, Faxén-Irving G, Garlind A, Vedin I, Vessby B, Wahlund L-O, Palmblad J (2006) Omega-3 fatty acid treatment in 174 patients with mild to moderate Alzheimer disease: omegAD study: a randomized double-blind trial. Arch Neurol 63:1402–1408 Huang TL, Zandi PP, Tucker KL, Fitzpatrick AL, Kuller LH, Fried LP, Burke GL, Carlson MC (2005) Benefits of fatty fish on dementia risk are stronger for those without APOE epsilon4. Neurology 65:1409–1414 Kotani S, Sakaguchi E, Warashina S, Matsukawa N, Ishikura Y, Kiso Y, Sakakibara M, Yoshimoto T, Guo J, Yamashima T (2006) Dietary supplementation of arachidonic and docosahexaenoic acids improves cognitive dysfunction. Neurosci Res 56:159–164 Lee LK, Shahar S, Chin AV, Yusoff NAM, Rajab NF, Aziz S (2012a) Prevalence of gender disparities and predictors affecting the occurrence of mild cognitive impairment (MCI). Arch Gerontol Geriatr 54:185–191 Lee LK, Shahar S, Rajab N, Mohd Yusoff NA, Jamal RA, Then SM (2012b) The role of long chain omega-3 polyunsaturated fatty acids in reducing lipid peroxidation among elderly patients with mild cognitive impairment: a case–control study. J Nutr Biochem. doi:10.1016/j.jnutbio.2012.04.014 Lu P, Mamiya T, Lu LL, Mouri A, Ikejima T, Kim H-C, Zou L-B, Nabeshima T (2012) Xanthoceraside attenuates amyloid β peptide25–35-induced learning and memory impairments in mice. Psychopharmacology 219:181–190 Macpherson H, Ellis KA, Sali A, Pipingas A (2012) Memory improvements in elderly women following 16 weeks treatment with a combined multivitamin, mineral and herbal supplement. Psychopharmacology 220:351–365 Milte CM, Sinn N, Street SJ, Buckley JD, Coates AM, Howe PRC (2011) Erythrocyte polyunsaturated fatty acid status, memory, cognition and mood in older adults with mild cognitive impairment and healthy controls. Prostaglandins Leukot Essent Fatty Acids 84:153–161 Ng TP, Gao Q, Niti M, Feng L, Yap KB (2011) Omega-3 polyunsaturated fatty acid supplements and cognitive decline: Singapore longitudinal aging studies. JNHA 15:32–35 Otsuka M (2000) Analysis of dietary factors in Alzheimer’s disease: clinical use of nutritional intervention for prevention and treatment of dementia. Nippon Ronen Igakkai Zasshi 37:970–973 Parker G, Gibson NA, Brotchi H, Heruc G, Rees A, Hadzi-Pavlovic D (2006) Omega-3 fatty acids and mood disorders. Am J Psychiatry 163:969–978 Petersen RC (2007) Mild cognitive impairment. Continuum Lifelong Learning Neurol 13:15–38 Pomponi M (2008) DHA deficiency and Alzheimer’s disease. Clin Nutr 27:170 Quinn JF, Raman R, Thomas RG, Yurko-Mauro K, Nelson EB, Van Dyck C, Galvin JE, Emond J, Jack CR, Weiner M, Shinto L, Aisen PS (2010) Docosahexaenoic acid supplementation and cognitive decline in Alzheimer disease: a randomized trial. JAMA 304:1903–1911 Rey A (1964) L’examen clinique en psychologie. In: Presses Universitaires de France. Paris (in French) Schaefer EJ, Bongard V, Beiser AS, Lamon-Fava S, Robins SJ, Au R, Tucker KL, Kyle DJ, Wilson PWF, Wolf PA (2006) Plasma phosphatidylcholine docosahexaenoic acid content and risk of dementia and Alzheimer disease: the Framingham Heart Study. Arch Neurol 63:1545–1550 Scholey A, Ossoukhova A, Owen L, Ibarra A, Pipingas A, He K, Roller M, Stough C (2010) Effects of American ginseng (Panax quinquefolius) on neurocognitive function: an acute, randomised, double-blind, placebo-controlled, crossover study. Psychopharmacology 212:345–356 Sheikh JI, Yesavage JA (1986) Geriatric Depression Scale: recent evidence and development of a shorter version. Clin Gerontol 5:165–173 Shinto L, Quinn J, Montine T, Baldauf-Wagner SB, Bourdette D, Oken DB, Kaye J (2008) Omega-3 fatty acids and lipoic acid in Alzheimer’s disease. Neurology 70:A393 Sinn N, Milte CM, Street SJ, Buckley JD, Coates AM, Petkov J, Howe PRC (2012) Effects of n−3 fatty acids, EPA v. DHA, on depressive symptoms, quality of life, memory and executive function in older adults with mild cognitive impairment: a 6-month randomised controlled trial. Br J Nutr 107:1682–1693 Sonobe N, Hata R, Ishikawa T, Sonobe T, Matsumoto T, Toyota Y, Mori T, Fukuhara R, Komori K, Ueno SI, Tanimukai S, Ikeda M (2011) Risk of progression from mild memory impairment to clinically diagnosable Alzheimer’s disease in a Japanese community (from the Nakayama Study). Int Psychogeriatr 23:772–779 Sunderland T, Hill JL, Mellow AM, Lawlor BA, Gundersheimer J, Newhouse PA, Grafman JH (1989) Clock drawing in Alzheimer’s disease: a novel measure of dementia severity. J Am Geriatr Soc 37:725–729 Van de Rest O, Geleijnse JM, Kok FJ, van Staveren WA, Dullermeijer C, Olderikkert MG, Beekman AT, de Groot CP (2008) Effect of fish oil on cognitive performance in older subjects: a randomized, controlled trial. Neurology 71:430–438 Wechsler D (1984) Wechsler memory scale—revised manual. The Psychological Co, New York Wechsler D (1997) Wechsler adult intelligence scale. Harcourt Assessment, London Whalley LJ, Deary IJ, Starr JM, Wahle KW, Rance KA, Bourne VJ, Fox HC (2008) n−3 Fatty acid erythrocyte membrane content, APOE epsilon4, and cognitive variation: an observational follow-up study in late adulthood. Am J Clin Nutr 87:449–454 Yehuda S, Rabinovtz S, Carasso RL, Mostofsky DI (1996) Essential fatty acids preparation (SR-3) improves Alzheimer’s patients quality of life. Int J Neurosci 87:141–149