Brain atrophy in cognitively impaired elderly: the importance of long-chain ω-3 fatty acids and B vitamin status in a randomized controlled trial
Am J Clin Nutr July 2015, vol. 102 no. 1 215-221
Fredrik Jernerén 3, fredrik.jerneren at pharm.ox.ac.uk, Amany K Elshorbagy 3,4, Abderrahim Oulhaj 5, Stephen M Smith 6, Helga Refsum 3,7, and A David Smith 3
3From the Oxford Project to Investigate Memory and Ageing (OPTIMA), Department of Pharmacology, University of Oxford, Oxford, United Kingdom;
4Department of Physiology, Faculty of Medicine, University of Alexandria, Alexandria, Egypt;
5Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates;
6Functional Magnetic Resonance Imaging of the Brain Centre, Nuffield Department of Clinical Neurosciences, University of Oxford, John Radcliffe Hospital, Oxford, United Kingdom; and
7Department of Nutrition, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, Oslo, Norway
↵1 Supported by grants from the Charles Wolfson Charitable Trust, The Medical Research Council, Norwegian Research Council, Norman Collisson Foundation, Alzheimer's Research UK, Henry Smith Charity, John Coates Charitable Trust, Thames Valley Dementias and Neurodegenerative Diseases Research Network of the National Institute for Health Research, the Sidney and Elizabeth Corob Charitable Trust, and Meda AB/Recip AB.
Background: Increased brain atrophy rates are common in older people with cognitive impairment, particularly in those who eventually convert to Alzheimer disease. Plasma concentrations of omega-3 (ω-3) fatty acids and homocysteine are associated with the development of brain atrophy and dementia.
Objective: We investigated whether plasma ω-3 fatty acid concentrations (eicosapentaenoic acid and docosahexaenoic acid) modify the treatment effect of homocysteine-lowering B vitamins on brain atrophy rates in a placebo-controlled trial (VITACOG).
Design: This retrospective analysis included 168 elderly people (≥70 y) with mild cognitive impairment, randomly assigned either to placebo (n = 83) or to daily high-dose B vitamin supplementation (
- folic acid, 0.8 mg;
- vitamin B-6, 20 mg;
- vitamin B-12, 0.5 mg) (n = 85).
The subjects underwent cranial magnetic resonance imaging scans at baseline and 2 y later. The effect of the intervention was analyzed according to tertiles of baseline ω-3 fatty acid concentrations.
Results: There was a significant interaction (P = 0.024) between B vitamin treatment and plasma combined ω-3 fatty acids (eicosapentaenoic acid and docosahexaenoic acid) on brain atrophy rates. In subjects with high baseline ω-3 fatty acids (>590 μmol/L), B vitamin treatment slowed the mean atrophy rate by 40.0% compared with placebo (P = 0.023). B vitamin treatment had no significant effect on the rate of atrophy among subjects with low baseline ω-3 fatty acids (<390 μmol/L). High baseline ω-3 fatty acids were associated with a slower rate of brain atrophy in the B vitamin group but not in the placebo group.
Conclusions: The beneficial effect of B vitamin treatment on brain atrophy was observed only in subjects with high plasma ω-3 fatty acids. It is also suggested that the beneficial effect of ω-3 fatty acids on brain atrophy may be confined to subjects with good B vitamin status. The results highlight the importance of identifying subgroups likely to benefit in clinical trials. This trial was registered at www.controlled-trials.com as ISRCTN94410159.
Items in BOTH the categories Cognition and Omega-3
- Seafood (Omega-3) during pregnancy increased childhood IQ by 8 points – review Dec 2019
- Omega-3 index of 6 to 7 associated with best cognition in this study – Nov 2019
- Eating fish improves cognition (Omega-3 fish during pregnancy in this case) - Oct 2019
- Mental disorders fought by Omega-3 etc. - meta-meta-analysis Oct 2019
- Omega-3 prevents Parkinson’s Disease – Review of RCT July 2019
- Omega-3 helps brains of seniors – May 2019
- Omega-3 helped Alzheimer’s only if good level of B vitamins – RCT April 2019
- Standard Omega-3 not get past BB barrier in seniors at high risk of Alzheimer’s – Patrick hypothesis Oct 2018
- APOE4 gene problems (Alzheimer’s) reduced by both Vitamin D and Omega-3 - Dec 2018
- Omega-3 is important for Brain Health during all phases of life – Aug 2018
- Hypothesis: Omega-3 reduces Alzheimer’s directly and via the gut – Sept 2018
- Improve Cognitive Health and Memory with Vitamin D and Omega-3 – World Patent March 2018
- IQ levels around the world are falling (perhaps lower Vitamin D, Iodine, or Omega-3)
- Adding Vitamin D, Omega-3, etc to children’s milk improved memory (yet again) – RCT June 2018
- Omega-3, Vitamin D, Folic acid etc. during pregnancy and subsequent mental illness of child – March 2018
- Why Alzheimer’s studies using Omega-3 have mixed results – quality, dose size, Omega-6, genes, etc. March 2018
- Benefits of Omega-3 beyond heart health - LEF Feb 2018
- Supplementation while pregnant and psychotic – 20 percent Omega-3, 6 percent Vitamin D – June 2016
- ADHD, Autism, Early Psychosis and Omega-3 – review Dec 2017
- Mild Traumatic Brain Injury prevented with Omega-3, Resveratrol, etc (in rats) – Oct 2017
- Omega-3 found to treat Alzheimer’s and Parkinson’s in animals – Sept 2017
- The End of Alzheimer's - if custom adjust Vitamin D, B-12, Iron, Omega-3, etc.
- Violent schizophrenia patients treated by 3 months of Omega-3 – RCT Aug 2017
- Psychosis risk reduced for 80 weeks by just 12 weeks of Omega-3 – RCT Aug 2017
- Alzheimer’s (apoE4) may require more than Omega-3 - May 2017
- Infants getting 1 g of Omega-3 for 12 weeks got better brains – RCT March 2017
- Omega-3 reduces many psychiatric disorders – 2 reviews 2016
- Cognitive Impairment 1.8 times more likely if low Omega-3– Oct 2016
- Omega-3 may treat schizophrenia
- Benefits of Omega-3 on brain development
- Omega-3 helps childhood cognition – meta-analysis April 2016
- Football Brain injuries prevented by Omega-3 – RCT Jan 2016
- Schizophrenia treated by 6 months of Omega-3 – RCT Nov 2015
- Omega-3 and infant development - dissertation Sept 2015
- Omega-3 etc improved both cognition and mobility of older women – Aug 2015
- Schizophrenia relapses reduced 3X by Omega-3 – RCT Mar 2015
- Cognitive decline in elderly slowed by Omega-3 – meta-analysis May 2015
- Cognitively impaired brain atrophy was slowed 40 percent by Omega-3 and B vitamins – RCT July 2015
- Omega-3, Vitamin D, and other nutrients decrease mental health problems – March 2015
- Vitamin D, Omega-3 supplementation helps cognition – perhaps due to serotonin – Feb 2015
- Vitamin D and Omega-3 may reduce cortical atrophy with age – Nov 2013
- Alzheimer’s and Vitamins D, B, C, E, as well as Omega-3, metals, etc. – June 2013
- Spinal cord problems more likely if TBI if little Omega-3 in diet – June 2013
- Traumatic brain injury treated by Vitamin D Progesterone Omega-3 and glutamine – May 2013