期刊
EBIOMEDICINE
卷 59, 期 -, 页码 -出版社
ELSEVIER
DOI: 10.1016/j.ebiom.2020.102883
关键词
DHA; Omega-3; RCT; Alzheimer's disease; Dementia; APOE
资金
- NCATS NIH HHS [UL1 TR001855] Funding Source: Medline
- NIA NIH HHS [P50 AG005142, R01 AG055770, R01 AG054434, R21 AG056518, R01 AG067063] Funding Source: Medline
Background: Past clinical trials of docosahexaenoic Acid (DHA) supplements for the prevention of Alzheimer's disease (AD) dementia have used lower doses and have been largely negative. We hypothesized that larger doses of DHA are needed for adequate brain bioavailability and that APOE4 is associated with reduced delivery of DHA and eicosapentaenoic acid (EPA) to the brain before the onset of cognitive impairment. Methods: 33 individuals were provided with a vitamin B complex (1 mg vitamin B12, 100 mg of vitamin B6 and 800 mcg of folic acid per day) and randomized to 2,152 mg of DHA per day or placebo over 6 months. 26 individuals completed both lumbar punctures and MRIs, and 29 completed cognitive assessments at baseline and 6 months. The primary outcome was the change in CSF DHA. Secondary outcomes included changes in CSF EPA levels, MRI hippocampal volume and entorhinal thickness; exploratory outcomes were measures of cognition. Findings: A 28% increase in CSF DHA and 43% increase in CSF EPA were observed in the DHA treatment arm compared to placebo (mean difference for DHA (95% CI): 0.08 mu g/mL (0.05, 0.10), p<0.0001; mean difference for EPA: 0.008 mu g/mL (0.004, 0.011), p<0.0001). The increase in CSF EPA in non-APOE4 carriers after supplementation was three times greater than APOE4 carriers. The change in brain volumes and cognitive scores did not differ between groups. Interpretation: Dementia prevention trials using omega-3 supplementation doses equal or lower to 1 g per day may have reduced brain effects, particularly in APOE4 carriers. (C)2020 The Author(s). Published by Elsevier B.V.
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