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Omega-3 Fatty Acid Status Enhances the Prevention of Cognitive Decline by B Vitamins in Mild Cognitive Impairment.
J Alzheimers Dis 2016; 50(2):547-57JA

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.

Authors+Show Affiliations

Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, United Arab Emirates.OPTIMA, Department of Pharmacology, University of Oxford, Oxford, UK.OPTIMA, Department of Pharmacology, University of Oxford, Oxford, UK. Department of Nutrition, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, Oslo, Norway.OPTIMA, Department of Pharmacology, University of Oxford, Oxford, UK.Division of Geriatric Medicine, Department of Medicine, Faculty of Health Sciences, University of Cape Town, South Africa.

Pub Type(s)

Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

26757190

Citation

Oulhaj, Abderrahim, et al. "Omega-3 Fatty Acid Status Enhances the Prevention of Cognitive Decline By B Vitamins in Mild Cognitive Impairment." Journal of Alzheimer's Disease : JAD, vol. 50, no. 2, 2016, pp. 547-57.
Oulhaj A, Jernerén F, Refsum H, et al. Omega-3 Fatty Acid Status Enhances the Prevention of Cognitive Decline by B Vitamins in Mild Cognitive Impairment. J Alzheimers Dis. 2016;50(2):547-57.
Oulhaj, A., Jernerén, F., Refsum, H., Smith, A. D., & de Jager, C. A. (2016). Omega-3 Fatty Acid Status Enhances the Prevention of Cognitive Decline by B Vitamins in Mild Cognitive Impairment. Journal of Alzheimer's Disease : JAD, 50(2), pp. 547-57. doi:10.3233/JAD-150777.
Oulhaj A, et al. Omega-3 Fatty Acid Status Enhances the Prevention of Cognitive Decline By B Vitamins in Mild Cognitive Impairment. J Alzheimers Dis. 2016;50(2):547-57. PubMed PMID: 26757190.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Omega-3 Fatty Acid Status Enhances the Prevention of Cognitive Decline by B Vitamins in Mild Cognitive Impairment. AU - Oulhaj,Abderrahim, AU - Jernerén,Fredrik, AU - Refsum,Helga, AU - Smith,A David, AU - de Jager,Celeste A, PY - 2016/1/13/entrez PY - 2016/1/13/pubmed PY - 2016/11/5/medline KW - Alzheimer’s disease KW - B vitamins KW - clinical dementia rating scale KW - cognition KW - omega–3 fatty acids SP - 547 EP - 57 JF - Journal of Alzheimer's disease : JAD JO - J. Alzheimers Dis. VL - 50 IS - 2 N2 - 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. SN - 1875-8908 UR - https://www.unboundmedicine.com/medline/citation/26757190/Omega_3_Fatty_Acid_Status_Enhances_the_Prevention_of_Cognitive_Decline_by_B_Vitamins_in_Mild_Cognitive_Impairment_ L2 - https://content.iospress.com/openurl?genre=article&id=doi:10.3233/JAD-150777 DB - PRIME DP - Unbound Medicine ER -