Omega-3 Fatty Acid Status Enhances the Prevention of Cognitive Decline by B Vitamins in Mild Cognitive Impairment

You're going to have to have your doctor translate this into a dementia prevention protocol with actual amounts to take. Don't do anything on your own, that would be total guesswork.

Omega-3 Fatty Acid Status Enhances the Prevention of Cognitive Decline by B Vitamins in Mild Cognitive Impairment

Article type: Research Article

Authors: Oulhaj, Abderrahim^{a; *} | Jernerén, Fredrik^b | Refsum, Helga^{b; c} | Smith, A. David^b | de Jager, Celeste A.^{d; *}

Affiliations: [a] Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, United Arab Emirates | [b] OPTIMA, Department of Pharmacology, University of Oxford, Oxford, UK | [c] Department of Nutrition, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, Oslo, Norway | [d] Division of Geriatric Medicine, Department of Medicine, Faculty of Health Sciences, University of Cape Town, South Africa

Correspondence: [*] Correspondence to: Celeste de Jager, PhD, Division of Geriatric Medicine, Department of Medicine, IAA, L51, Old Main Building, Groote Schuur Hospital, Observatory, 7925, Western Cape, South Africa. Tel.: +27 21 406 6538; Fax: +27 0 21 406 6846; E-mail: Celeste.DeJager@uct.ac.za.

Correspondence: [*] Correspondence to: Abderrahim Oulhaj, PhD, Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, United Arab Emirates. Tel.: +971 3 713 7461; Fax: +971 3 767 2022; E-mail: aoulhaj@uaeu.ac.ae.

Keywords: Alzheimer’s disease, B vitamins, clinical dementia rating scale, cognition, omega–3 fatty acids

DOI: 10.3233/JAD-150777

Journal: Journal of Alzheimer's Disease, vol. 50, no. 2, pp. 547-557, 2016

Accepted 26 October 2015

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Published 6 January 2016

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Supplementary Materials: Supplementary Material

Abstract

A randomized trial (VITACOG) in people with mild cognitive impairment (MCI) found that B vitamin treatment to lower homocysteine slowed the rate of cognitive and clinical decline. We have used data from this trial to see whether baseline omega-3 fatty acid status interacts with the effects of B vitamin treatment. 266 participants with MCI aged ≥70 years were randomized to B vitamins (folic acid, vitamins B6 and B12) or placebo for 2 years. Baseline cognitive test performance, clinical dementia rating (CDR) scale, and plasma concentrations of total homocysteine, total docosahexaenoic and eicosapentaenoic acids (omega-3 fatty acids) were measured. Final scores for verbal delayed recall, global cognition, and CDR sum-of-boxes were better in the B vitamin-treated group according to increasing baseline concentrations of omega-3 fatty acids, whereas scores in the placebo group were similar across these concentrations. Among those with good omega-3 status, 33% of those on B vitamin treatment had global CDR scores >0 compared with 59% among those on placebo. For all three outcome measures, higher concentrations of docosahexaenoic acid alone significantly enhanced the cognitive effects of B vitamins, while eicosapentaenoic acid appeared less effective. When omega-3 fatty acid concentrations are low, B vitamin treatment has no effect on cognitive decline in MCI, but when omega-3 levels are in the upper normal range, B vitamins interact to slow cognitive decline. A clinical trial of B vitamins combined with omega-3 fatty acids is needed to see whether it is possible to slow the conversion from MCI to AD.