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Public Health Nutr. 2018 Jul;21(10):1921-1932. doi: 10.1017/S136898001800037X. Epub 2018 Mar 19.

Association between fish consumption and risk of dementia: a new study from China and a systematic literature review and meta-analysis.

Author information

1Faculty of Education,Health and Wellbeing,University of Wolverhampton,Wolverhampton WV1 1DT,UK.
2Department of Practice and Policy,University College London,London,UK.
3Royal Wolverhampton NHS Trust,Wolverhampton,UK.
4Department of Primary Care and Public Health Sciences,King's College London,London,UK.
5Department of Preventive Medicine, School of Public Health,Guangzhou Medical University,Guangzhou 510182,People's Republic of China.
6Division of Population Health,Health Services Research and Primary Care,Faculty of Biology,Medicine and Health,University of Manchester,Manchester,UK.
7Epidemiology Branch,Division of Intramural Population Health Research,Eunice Kennedy Shriver National Institute of Child Health and Human Development,National Institutes of Health,Bethesda,MD, USA.
8Department of Epidemiology and Biostatistics,Guangdong Medical University,Dongguan, Guangdong,People's Republic of China.



To assess the association of fish consumption with risk of dementia and its dose-response relationship, and investigate variations in the association among low-, middle- and high-income countries.


A new community-based cross-sectional study and a systematic literature review.SettingsUrban and rural communities in China; population-based studies systematically searched from worldwide literature.


Chinese adults aged ≥60 years in six provinces (n 6981) took part in a household health survey of dementia prevalence and risk factors. In addition, 33 964 participants from eleven published and eligible studies were included in the systematic review and meta-analysis.


In the new study in China, 326 participants were diagnosed with dementia (4·7 %); those who consumed any amount of fish in the past two years v. those who consumed no fish had reduced risk of dementia (adjusted OR=0·73, 95 % CI 0·64, 0·99), but the dose-response relationship was not statistically significant. The meta-analysis of available data from the literature and the new study showed relative risk (RR) of dementia of 0·80 (95 % CI 0·74, 0·87) for people with fish consumption; the impact was similar among countries with different levels of income. Pooled dose-response data revealed RR (95 % CI) of 0·84 (0·72, 0·98), 0·78 (0·68, 0·90) and 0·77 (0·61, 0·98) in people with low, middle and high consumption of fish, respectively. Corresponding figures for Alzheimer's disease were 0·88 (0·74, 1·04), 0·79 (0·65, 0·96) and 0·67 (0·58, 0·78), respectively.


Greater consumption of fish is associated with a lower risk of dementia. Increasing fish consumption may help prevent dementia worldwide regardless of income level.


Alzheimer’s disease; Dementia; Fish consumption


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