Skip to main content
Top
Published in: European Journal of Nutrition 2/2022

01-03-2022 | Alzheimer's Disease | Review

Dietary and supplemental long-chain omega-3 fatty acids as moderators of cognitive impairment and Alzheimer’s disease

Authors: Amy H. R. Wood, Helen F. Chappell, Michael A. Zulyniak

Published in: European Journal of Nutrition | Issue 2/2022

Login to get access

Abstract

Purpose

There is an ever-growing body of literature examining the relationship between dietary omega-3 polyunsaturated fatty acids (ω3 PUFAs) and cerebral structure and function throughout life. In light of this, the use of ω3 PUFAs, namely, long-chain (LC) ω3 PUFAs (i.e., eicosapentaenoic acid and docosahexaenoic acid), as a therapeutic strategy to mitigate cognitive impairment, and progression to Alzheimer’s disease is an attractive prospect. This review aims to summarise evidence reported by observational studies and clinical trials that investigated the role of LC ω3 PUFAs against cognition impairment and future risk of Alzheimer’s disease.

Methods

Studies were identified in PubMed and Scopus using the search terms “omega-3 fatty acids”, “Alzheimer’s disease” and “cognition”, along with common variants. Inclusion criteria included observational or randomised controlled trials (RCTs) with all participants aged ≥ 50 years that reported on the association between LC ω3 PUFAs and cognitive function or biological markers indicative of cognitive function linked to Alzheimer’s disease.

Results

Evidence from 33 studies suggests that dietary and supplemental LC ω3 PUFAs have a protective effect against cognitive impairment. Synaptic plasticity, neuronal membrane fluidity, neuroinflammation, and changes in expression of genes linked to cognitive decline have been identified as potential targets of LC ω3 PUFAs. The protective effects LC ω3 PUFAs on cognitive function and reduced risk of Alzheimer’s disease were supported by both observational studies and RCTs, with RCTs suggesting a more pronounced effect in individuals with early and mild cognitive impairment.

Conclusion

The findings of this review suggest that individuals consuming higher amounts of LC ω3 PUFAs are less likely to develop cognitive impairment and that, as a preventative strategy against Alzheimer’s disease, it is most effective when dietary LC ω3 PUFAs are consumed prior to or in the early stages of cognitive decline.
Appendix
Available only for authorised users
Literature
2.
go back to reference Patterson C (2018) World Alzheimer report 2018. Alzheimer’s Disease International, London Patterson C (2018) World Alzheimer report 2018. Alzheimer’s Disease International, London
4.
go back to reference McKhann GM, Knopman DS, Chertkow H, Hyman BT, Jack CR Jr, Kawas CH, Klunk WE, Koroshetz WJ, Manly JJ, Mayeux R, Mohs RC, Morris JC, Rossor MN, Scheltens P, Carrillo MC, Thies B, Weintraub S, Phelps CH (2011) The diagnosis of dementia due to Alzheimer’s disease: recommendations from the National Institute on Aging-Alzheimer’s Association workgroups on diagnostic guidelines for Alzheimer’s disease. Alzheimers Dement 7(3):263–269. https://doi.org/10.1016/j.jalz.2011.03.005CrossRefPubMedPubMedCentral McKhann GM, Knopman DS, Chertkow H, Hyman BT, Jack CR Jr, Kawas CH, Klunk WE, Koroshetz WJ, Manly JJ, Mayeux R, Mohs RC, Morris JC, Rossor MN, Scheltens P, Carrillo MC, Thies B, Weintraub S, Phelps CH (2011) The diagnosis of dementia due to Alzheimer’s disease: recommendations from the National Institute on Aging-Alzheimer’s Association workgroups on diagnostic guidelines for Alzheimer’s disease. Alzheimers Dement 7(3):263–269. https://​doi.​org/​10.​1016/​j.​jalz.​2011.​03.​005CrossRefPubMedPubMedCentral
21.
go back to reference Muskiet FAJ (2010) Pathophysiology and evolutionary aspects of dietary fats and long-chain polyunsaturated fatty acids across the life cycle. In: Montmayeur JP, le Coutre J (eds) Fat detection taste, texture and post ingestive effects. CRC Press/Taylor and Francis, Boca Raton Muskiet FAJ (2010) Pathophysiology and evolutionary aspects of dietary fats and long-chain polyunsaturated fatty acids across the life cycle. In: Montmayeur JP, le Coutre J (eds) Fat detection taste, texture and post ingestive effects. CRC Press/Taylor and Francis, Boca Raton
23.
28.
55.
go back to reference Bell KE, Fang H, Snijders T, Allison DJ, Zulyniak MA, Chabowski A, Parise G, Phillips SM, Heisz JJ (2019) A multi-ingredient nutritional supplement in combination with resistance exercise and high-intensity interval training improves cognitive function and increases n-3 index in healthy older men: a randomized controlled trial. Front Aging Neurosci 11:107. https://doi.org/10.3389/fnagi.2019.00107CrossRefPubMedPubMedCentral Bell KE, Fang H, Snijders T, Allison DJ, Zulyniak MA, Chabowski A, Parise G, Phillips SM, Heisz JJ (2019) A multi-ingredient nutritional supplement in combination with resistance exercise and high-intensity interval training improves cognitive function and increases n-3 index in healthy older men: a randomized controlled trial. Front Aging Neurosci 11:107. https://​doi.​org/​10.​3389/​fnagi.​2019.​00107CrossRefPubMedPubMedCentral
58.
go back to reference Eriksdotter M, Vedin I, Falahati F, Freund-Levi Y, Hjorth E, Faxén-Irving G, Wahlund LO, Schultzberg M, Basun H, Cederholm T, Palmblad J (2015) 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. J Alzheimers Dis 48:805–812. https://doi.org/10.3233/JAD-150102CrossRefPubMed Eriksdotter M, Vedin I, Falahati F, Freund-Levi Y, Hjorth E, Faxén-Irving G, Wahlund LO, Schultzberg M, Basun H, Cederholm T, Palmblad J (2015) 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. J Alzheimers Dis 48:805–812. https://​doi.​org/​10.​3233/​JAD-150102CrossRefPubMed
65.
go back to reference Andrieu S, Guyonnet S, Coley N, Cantet C, Bonnefoy M, Bordes S, Bories L, Cufi MN, Dantoine T, Dartigues JF et al (2017) Effect of long-term omega 3 polyunsaturated fatty acid supplementation with or without multidomain intervention on cognitive function in elderly adults with memory complaints (MAPT): a randomised, placebo-controlled trial. Lancet Neurol 16:377–389. https://doi.org/10.1016/S1474-4422(17)30040-6CrossRefPubMed Andrieu S, Guyonnet S, Coley N, Cantet C, Bonnefoy M, Bordes S, Bories L, Cufi MN, Dantoine T, Dartigues JF et al (2017) Effect of long-term omega 3 polyunsaturated fatty acid supplementation with or without multidomain intervention on cognitive function in elderly adults with memory complaints (MAPT): a randomised, placebo-controlled trial. Lancet Neurol 16:377–389. https://​doi.​org/​10.​1016/​S1474-4422(17)30040-6CrossRefPubMed
66.
go back to reference Tabue-Teguo M, Barreto de Souza P, Cantet C, Andrieu S, Simo N, Fougère B, Dartigues JF, Vellas B (2018) Effect of multidomain intervention, omega-3 polyunsaturated fatty acids supplementation or their combination on cognitive function in non-demented older adults according to frail status; results from the mapt study. J Nutr Health Aging 22:923–927. https://doi.org/10.1007/s12603-018-1024-6CrossRefPubMed Tabue-Teguo M, Barreto de Souza P, Cantet C, Andrieu S, Simo N, Fougère B, Dartigues JF, Vellas B (2018) Effect of multidomain intervention, omega-3 polyunsaturated fatty acids supplementation or their combination on cognitive function in non-demented older adults according to frail status; results from the mapt study. J Nutr Health Aging 22:923–927. https://​doi.​org/​10.​1007/​s12603-018-1024-6CrossRefPubMed
74.
go back to reference Hamel, R, Köhler S, Sistermans N, Koene T, Pijnenburg Y, van der Flier W, Scheltens P, Aalten P, Verhey F, Visser PJ, Ramakers I (2015) The trajectory of cognitive decline in the pre-dementia phase in memory clinic visitors: findings from the 4C-MCI study. Psychol Med 45:1509–1519. https://doi.org/10.1017/s0033291714002645 Hamel, R, Köhler S, Sistermans N, Koene T, Pijnenburg Y, van der Flier W, Scheltens P, Aalten P, Verhey F, Visser PJ, Ramakers I (2015) The trajectory of cognitive decline in the pre-dementia phase in memory clinic visitors: findings from the 4C-MCI study. Psychol Med 45:1509–1519. https://​doi.​org/​10.​1017/​s003329171400264​5
77.
go back to reference Shinto L, Quinn J, Montine T, Dodge HH, Woodward W, Baldauf-Wagner S, Waichunas D, Bumgarner L, Bourdette D, Silbert L, Jeffrey K (2014) A randomized placebo-controlled pilot trial of omega-3 fatty acids and alpha lipoic acid in Alzheimer’s disease. J Alzheimers Dis 38:111–120. https://doi.org/10.3233/JAD-130722CrossRefPubMed Shinto L, Quinn J, Montine T, Dodge HH, Woodward W, Baldauf-Wagner S, Waichunas D, Bumgarner L, Bourdette D, Silbert L, Jeffrey K (2014) A randomized placebo-controlled pilot trial of omega-3 fatty acids and alpha lipoic acid in Alzheimer’s disease. J Alzheimers Dis 38:111–120. https://​doi.​org/​10.​3233/​JAD-130722CrossRefPubMed
79.
go back to reference Freund-Levi Y, Hjorth E, Lindberg C, Cederholm T, Faxen-Irving G, Vedin I, Palmblad J, Wahlund LO, Schultzberg M, Basun H, Eriksdotter-Jönhagen M (2009) Effects of Omega-3 fatty acids on inflammatory markers in cerebrospinal fluid and plasma in Alzheimer’s disease: the OmegAD study. Dement Geriatr Cogn Disord 27:481–490. https://doi.org/10.1159/000218081CrossRefPubMed Freund-Levi Y, Hjorth E, Lindberg C, Cederholm T, Faxen-Irving G, Vedin I, Palmblad J, Wahlund LO, Schultzberg M, Basun H, Eriksdotter-Jönhagen M (2009) Effects of Omega-3 fatty acids on inflammatory markers in cerebrospinal fluid and plasma in Alzheimer’s disease: the OmegAD study. Dement Geriatr Cogn Disord 27:481–490. https://​doi.​org/​10.​1159/​000218081CrossRefPubMed
80.
go back to reference Freund-Levi Y, Vedin I, Hjorth E, Basun H, Faxén-Irving G, Schultzberg M, Eriksdotter M, Palmblad J, Vessby B, Wahlund LO, Cederholm T, Basu S (2014) Effects of supplementation with Omega-3 fatty acids on oxidative stress and inflammation in patients with Alzheimer’s disease: the OmegAD study. J Alzheimers Dis 42:823–831. https://doi.org/10.3233/JAD-132042CrossRefPubMed Freund-Levi Y, Vedin I, Hjorth E, Basun H, Faxén-Irving G, Schultzberg M, Eriksdotter M, Palmblad J, Vessby B, Wahlund LO, Cederholm T, Basu S (2014) Effects of supplementation with Omega-3 fatty acids on oxidative stress and inflammation in patients with Alzheimer’s disease: the OmegAD study. J Alzheimers Dis 42:823–831. https://​doi.​org/​10.​3233/​JAD-132042CrossRefPubMed
81.
go back to reference Schwarz C, Wirth M, Gerischer L, Grittner U, Witte AV, Köbe T, Flöel A (2017) Effects of omega-3 fatty acids on resting cerebral perfusion in patients with mild cognitive impairment: a randomized controlled trial. J Prev Alzheimers Dis 5:26–30. https://doi.org/10.14283/jpad.2017.23 Schwarz C, Wirth M, Gerischer L, Grittner U, Witte AV, Köbe T, Flöel A (2017) Effects of omega-3 fatty acids on resting cerebral perfusion in patients with mild cognitive impairment: a randomized controlled trial. J Prev Alzheimers Dis 5:26–30. https://​doi.​org/​10.​14283/​jpad.​2017.​23
83.
go back to reference Faxén-Irving G, Freund-Levi Y, Eriksdotter-Jönhagen M, Basun H, Hjorth E, Palmblad J, Vedin I, Cederholm T, Wahlund LO (2013) Effects on Transthyretin in plasma and cerebrospinal fluid by DHA-Rich n-3 fatty acid supplementation in patients with Alzheimer’s disease: the OmegAD study. J Alzheimers Dis 36:1–6. https://doi.org/10.3233/JAD-121828CrossRefPubMed Faxén-Irving G, Freund-Levi Y, Eriksdotter-Jönhagen M, Basun H, Hjorth E, Palmblad J, Vedin I, Cederholm T, Wahlund LO (2013) Effects on Transthyretin in plasma and cerebrospinal fluid by DHA-Rich n-3 fatty acid supplementation in patients with Alzheimer’s disease: the OmegAD study. J Alzheimers Dis 36:1–6. https://​doi.​org/​10.​3233/​JAD-121828CrossRefPubMed
Metadata
Title
Dietary and supplemental long-chain omega-3 fatty acids as moderators of cognitive impairment and Alzheimer’s disease
Authors
Amy H. R. Wood
Helen F. Chappell
Michael A. Zulyniak
Publication date
01-03-2022
Publisher
Springer Berlin Heidelberg
Published in
European Journal of Nutrition / Issue 2/2022
Print ISSN: 1436-6207
Electronic ISSN: 1436-6215
DOI
https://doi.org/10.1007/s00394-021-02655-4

Other articles of this Issue 2/2022

European Journal of Nutrition 2/2022 Go to the issue
Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin
Prof. Florian Limbourg
Prof. Anoop Chauhan
Developed by: Springer Medicine
Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Highlights from the ACC 2024 Congress

Year in Review: Pediatric cardiology

Watch Dr. Anne Marie Valente present the last year's highlights in pediatric and congenital heart disease in the official ACC.24 Year in Review session.

Year in Review: Pulmonary vascular disease

The last year's highlights in pulmonary vascular disease are presented by Dr. Jane Leopold in this official video from ACC.24.

Year in Review: Valvular heart disease

Watch Prof. William Zoghbi present the last year's highlights in valvular heart disease from the official ACC.24 Year in Review session.

Year in Review: Heart failure and cardiomyopathies

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.