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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
- Source :
- Journal of Alzheimer's Disease. 69:189-197
- Publication Year :
- 2019
- Publisher :
- IOS Press, 2019.
-
Abstract
- Trials of supplementation with omega-3 fatty acids (ω3-FAs) in patients with mild cognitive impairment or Alzheimer's disease (AD) have produced 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.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.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.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 levels11.7μmol/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 with placebo.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.
- Subjects :
- Male
0301 basic medicine
medicine.medical_specialty
Neurology
Homocysteine
Disease
law.invention
03 medical and health sciences
chemistry.chemical_compound
Cognition
0302 clinical medicine
Randomized controlled trial
Alzheimer Disease
law
Internal medicine
Fatty Acids, Omega-3
Humans
Medicine
Dementia
Treatment effect
Aged
business.industry
General Neuroscience
General Medicine
medicine.disease
Psychiatry and Mental health
Clinical Psychology
B vitamins
Treatment Outcome
030104 developmental biology
chemistry
Dietary Supplements
Female
Geriatrics and Gerontology
business
030217 neurology & neurosurgery
Subjects
Details
- ISSN :
- 18758908 and 13872877
- Volume :
- 69
- Database :
- OpenAIRE
- Journal :
- Journal of Alzheimer's Disease
- Accession number :
- edsair.doi.dedup.....411c755c3133cb31caca34e97b06b1ad