Format

Send to

Choose Destination
J Alzheimers Dis. 2019;69(1):189-197. doi: 10.3233/JAD-181148.

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.

Author information

1
Department of Pharmaceutical Biosciences, Uppsala University, Uppsala, Sweden.
2
Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
3
Theme Ageing, Karolinska University Hospital, Stockholm, Sweden.
4
Department of Nutrition, University of Oslo, Oslo, Norway.
5
Department of Pharmacology, University of Oxford, Oxford, United Kingdom.
6
Departments of Medicine and Hematology, Karolinska University Hospital Huddinge, and the Karolinska Institutet, Stockholm, Sweden.
7
Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden.
8
Center for Alzheimer Research, Division of Clinical Geriatrics, Karolinska Institutet, Huddinge, Sweden.
9
Department of Psychiatry in Region Örebro County and School of Medical Sciences, Faculty of Medicine and Health, Örebro University, Örebro.
10
Department of Old Age Psychiatry, Psychology & Neuroscience, King's College, London, UK.

Abstract

BACKGROUND:

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.

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 with 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.

KEYWORDS:

Alzheimer’s disease; B vitamins; cognition; dementia; homocysteine; omega-3 fatty acids

PMID:
30958356
DOI:
10.3233/JAD-181148

Supplemental Content

Full text links

Icon for IOS Press
Loading ...
Support Center