Omega-3 helped Alzheimer’s only if good level of B vitamins – RCT

Created April 2019

Homocysteine Status Modifies the Treatment Effect of Omega-3 Fatty Acids on Cognition in a Randomized Clinical Trial in Mild to Moderate Alzheimer's Disease: The OmegAD Study.

J Alzheimers Dis. 2019 Apr 1. doi: 10.3233/JAD-181148.

Jernerén F1, Cederholm T2,3, Refsum H4,5, Smith AD5, Turner C5, Palmblad J6, Eriksdotter M3,7, Hjorth E7, Faxen-Irving G7, Wahlund LO7, Schultzberg M7, Basun H2, Freund-Levi Y7,8,9,10.

Items in both categories Omega-3 and Cognitive are listed here: {category}

BACKGROUND:

Trials of supplementation with omega-3 fatty acids (ω3-FAs) in patients with mild cognitive impairment or Alzheimer's disease (AD) have given inconsistent effects on cognitive decline. There is evidence of an interaction between B vitamin status and ω3-FAs in relation to brain atrophy and cognitive decline.

OBJECTIVE:

We investigated whether baseline levels of plasma total homocysteine (tHcy), a marker of B vitamin status, modify the effects of ω3-FAs supplementation on cognitive performance in moderate AD.

METHODS:

This post hoc analysis of the OmegAD trial included 171 community-based patients with AD (MMSE≥15): 88 patients received daily doses of 1.7 g docosahexaenoic acid and 0.6 g eicosapentaenoic acid for 6 months. Treatment outcome on cognition was analyzed according to baseline levels of tHcy using a general linear model and ANCOVA.

RESULTS:

We found significant interactions between ω3-FA supplementation and tHcy on cognition and clinical stage assessed by

  • MMSE (p = 0.040), global

  • CDR (p = 0.059), and

  • CDRsob (p = 0.023),

but not on ADAS-cog (p = 0.649). In patients with tHcy levels <11.7μmol/L, ω3-FA supplementation improved cognitive performance as measured by MMSE (+7.1%, 95% CI: 0.59 to 13.7%, p = 0.033) and clinical status as measured by CDRsob (-22.3%, 95% CI: -5.8 to -38.7%, p = 0.009) compared to placebo.

CONCLUSION:

The effect of ω3-FA supplementation on MMSE and CDR appears to be influenced by baseline tHcy, suggesting that adequate B vitamin status is required to obtain beneficial effects of ω3-FA on cognition.

Tags: Cognitive Omega-3