Erythrocyte omega-3 fatty acids are inversely associated with incident dementia: Secondary analyses of longitudinal data from the Women's Health Initiative Memory Study (WHIMS)

Objective: To assess whether red blood cell (RBC) docosahexaenoic acid and eicosapentaenoic acid (DHA + EPA) levels have a protective association with the risk of dementia in older women. Methods: RBC DHA + EPA levels were assessed at baseline, and cognitive status was evaluated annually in a cohort of 6706 women aged >= 65 years who participated in the Women's Health Initiative Memory Study (WHIMS). Cox regression was used to quantify the association between RBC DHA + EPA and the risk of probable dementia, independent of major dementia risk factors. Results: During a median follow-up period of 9.8 years, 587 incident cases of probable dementia were identified. After adjusting for demographic, clinical, and behavioral risk factors, a one standard deviation increase in DHA + EPA levels was associated with a significantly lower risk of dementia (HR = 0.92, 95% CI: 0.84, 1.00; p < 0.05). This effect estimate did not meaningfully change after further adjustment for baseline cognitive function and APOE genotype. For women with high DHA + EPA exposure (1 SD above mean) compared to low exposure (1 SD below mean), the adjusted 15-year absolute risk difference for dementia was 2.1% (95% CI: 0.2%, 4.0%). In secondary analyses, we also observed a protective association with longitudinal change in Modified Mini-Mental State (3MS) Exam scores, but no significant association with incident MCI, PD/MCI, or baseline 3MS scores. Discussion: Higher levels of DHA + EPA may help protect against the development of dementia. Results from prospective randomized controlled trials of DHA + EPA supplementation are needed to help clarify whether this association is causal.