Circulating Omega-3 and Omega-6 Fatty Acids, Cognitive Decline, and Dementia in Older Adults
Article type: Research Article
Authors: de Oliveira Otto, Marcia C.a; * | Wu, Jason H.Y.b | Thacker, Evan L.c | Lai, Heidi Tsz Mungd; e | Lemaitre, Rozenn N.f | Padhye, Nikhilg | Song, Xiaolingh | King, Irena B.i | Lopez, Oscarj | Siscovick, David S.k | Mozaffarian, Dariushd
Affiliations: [a] Division of Epidemiology, Human Genetics and Environmental Science, The University of Texas Health Science Center at Houston School of Public Health, Houston, TX, USA | [b] The George Institute for Global Health and the Faculty of Medicine, University of New South Wales, Sydney, Australia | [c] Department of Public Health, Brigham Young University, Provo, UT, USA | [d] Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA | [e] Department of Primary Care and Public Health, Imperial College London, London, UK | [f] Cardiovascular Health Research Unit, Department of Medicine, University of Washington, Seattle, WA, USA | [g] Center for Nursing Research, The University of Texas Health Science Center, School of Nursing, Houston, TX, USA | [h] Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA | [i] Department of Internal Medicine, University of New Mexico, Albuquerque, NM, USA | [j] Department of Neurology, University of Pittsburg School of Medicine, Pittsburg, PA, USA | [k] New York Academy of Medicine, New York, NY, USA
Correspondence: [*] Correspondence to: Marcia C de Oliveira Otto, PhD, Division of Epidemiology, Human Genetics and Environmental Science, The University of Texas Health Science Center at Houston School of Public Health, 1200 Pressler Street, Suite E-619, Houston, TX 77030-3900, USA. E-mail: marcia.c.otto@uth.tmc.edu.
Abstract: Background: Comprising nearly 35% of brain lipids, polyunsaturated fatty acids (PUFA) are essential for optimal brain function. However, the role of PUFA on cognitive health outcomes later in life is largely unknown. Objective: We investigated prospective associations of plasma phospholipid omega-3 (ALA [18 : 3], EPA [20 : 5], DPA [22 : 5], DHA [22 : 6]) and omega-6 (LA [18 : 2], AA [20 : 4]) PUFA with cognitive decline, risk of cognitive impairment and dementia among adults aged≥65 years in the Cardiovascular Health Study. Methods: Circulating fatty acid concentrations were measured serially at baseline (1992/1993), 6 years, and 13 years later. Cognitive decline and impairment were assessed using the 100-point Modified Mini-Mental State Examination (3MSE) up to 7 times. Clinical dementia was identified using adjudicated neuropsychological tests, and ICD-9 codes. Results: Among 3,564 older adults free of stroke and dementia at baseline, cognitive function declined annually by approximately -0.5 3MSE points; 507 participants developed cognitive impairment and 499 dementia over up to 23 years of follow-up. In multivariable models, higher circulating arachidonic acid (AA) concentrations were associated with slower cognitive decline and lower dementia risk, with associations growing stronger with greater length of follow-up (hazard ratio [HR,95% CI] of dementia per interquintile range, 0.74 [0.56-0.97] at 5 years, and 0.53 [0.37-0.77] at 15 years). Circulating docosapentaenoic (DPA) concentrations were associated with slower cognitive decline and lower risk of cognitive impairment (extreme-quintile HR, 0.72 [95% CI: 0.55, 0.95]). Findings were generally null or inconsistent for other omega-3 or omega-6 PUFA. Conclusion: Circulating AA and DPA, but not other PUFA, are associated with slower rate of cognitive decline and lower risk of dementia or cognitive impairment later in life.
Keywords: Aging, Alzheimer’s disease, cognition, dementia, diet, fatty acids
DOI: 10.3233/JAD-230083
Journal: Journal of Alzheimer's Disease, vol. 95, no. 3, pp. 965-979, 2023
