Plasma Fatty Acid Profiles in Relation to Cognition and Gender in Alzheimer’s Disease Patients During Oral Omega-3 Fatty Acid Supplementation: The OmegAD Study

Article type: Research Article

Authors: Eriksdotter, Maria^{a; d; *} | Vedin, Inger^b | Falahati, Farshad^a | Freund-Levi, Yvonne^a | Hjorth, Erik^c | Faxen-Irving, Gerd^a | Wahlund, Lars-Olof^{a; d} | Schultzberg, Marianne^c | Basun, Hans^{e; g} | Cederholm, Tommy^{f; g} | Palmblad, Jan^b

Affiliations: [a] Department of Neurobiology, Care Sciences and Society (NVS), Division of Clinical Geriatrics, Karolinska Institutet, Huddinge, Stockholm | [b] Department of Medicine, Division of Hematology, Karolinska Institutet, Huddinge, Stockholm | [c] Department of Neurobiology, Care Sciences and Society (NVS), Division of Neurodegeneration, Karolinska Institutet, Huddinge, Stockholm | [d] Department of Geriatric Medicine, Karolinska University Hospital, Huddinge, Stockholm | [e] Division of Geriatrics, Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden | [f] Division of Clinical Nutrition and Metabolism, Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden | [g] Department of Geriatric Medicine, Akademiska sjukhuset, Uppsala, Sweden

Correspondence: [*] Correspondence to: Maria Eriksdotter, MD, PhD, Department NVS, Division of Clinical Geriatrics, Novum, 5th floor, Karolinska University Hospital Huddinge, SE-14186 Stockholm, Sweden. Tel.: +46858586449; [email protected]

Abstract: Background: ω3 fatty acids (ω3 FAs) may slow the rate of decline in cognitive performance in mild forms of cognitive impairment and Alzheimer’s disease (AD). However, the relationship between changes of plasma ω3 FA levels and cognitive performance, as well as effects of gender, are poorly known. Objective: To study the effect of 6-month administration of DHA-rich ω3 FA supplementation on plasma FA profiles in patients with mild to moderate AD in relation to cognitive performance and gender. This investigation is part of the OmegAD Study. Methods: 174 AD patients (74 ± 9 years) were randomized to a daily intake of 2.3 g ω3 FA or placebo for 6 months; subsequently all received the ω3 FA preparation for the next 6 months. Baseline as well as changes in plasma levels of the main ω3 FAs in 165 patients, while receiving ω3 FA supplementation for 6 months, were analyzed for association to cognitive performance (assessed by ADAS-cog and MMSE scores) as well as to gender. Results: Preservation of cognitive functioning, assessed by ADAS-cog or its sub-items (but not MMSE) scores, was significantly associated to increasing plasma ω3 FA levels over time. Thus, the higher ω3 FA plasma levels rose, the lower was the rate of cognitive deterioration. This effect was not related to gender; since although females displayed higher ω3 FA plasma levels than did males after 6 months of supplementation, this difference disappeared when adjusted for body weight. Conclusions: Since our study suggests dose-response relationships between plasma levels of ω3 FA and preservation of cognition, future ω3 FA trials in patients with mild AD should consider exploring graded (and body weight adjusted) doses of ω3 FA.

Keywords: Alzheimer’s disease, cognition, DHA, EPA, gender, ω3 fatty acids, ClinicalTrials.gov identifier: NCT00211159

DOI: 10.3233/JAD-150102

Journal: Journal of Alzheimer's Disease, vol. 48, no. 3, pp. 805-812, 2015