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

Geleijnse, J.; Giltay, E.; Kromhout, D.

Alzheimer's and Dementia 7(4)


DOI: 10.1016/j.jalz.2011.05.1432
Accession: 036221712

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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 ?-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. The analysis included 2911 coronary patients (78% men) aged 6 to 8 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 4 mg/d of EPA DHA, 2 g/d of ALA, both EPA DHA and ALA, or placebo for 4 months. Cognitive function was assessed by the Mini-Mental State Examination (MMSE) at baseline and after 4 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. 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 .67 2.25 points during follow-up. Changes in MMSE score during intervention did not differ significantly between EPA DHA and placebo (?.65 vs ?.69 points,P= .44) or between ALA and placebo (?.6 vs ?.74 points,P= .12). The risk of cognitive decline was 1.3 (95% confidence interval: .84 1.26,P= .8) for EPA DHA (vs placebo) and .9 (.74 1.1,P= .31) for ALA (vs placebo). This large intervention study showed no effect of dietary doses of n-3 fatty acids on global cognitive decline in coronary heart disease patients.