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Docosahexaenoic acid supplementation in age-related cognitive decline: a systematic review and meta-analysis



To investigate the role of DHA supplementation in preventing age-related cognitive decline (ARCD) in individual cognitive domains by conducting systematic review and meta-analysis.


Relevant clinical trials were systematically searched at Medline, PubMed, Scopus, Cochrane, ProQuest, and Embase databases since inception to June 2018. The PRISMA guidelines were adhered for data abstraction, quality assessment, and validation of included studies. Study details such as participant characteristics, DHA supplementation, and cognitive function outcome measures, i.e., memory, attention, working memory, and executive function, were extracted to perform meta-analysis according to the Cochrane guidelines. Additional meta-regression and subgroup analyses were performed to detect confounding variables and sensitivity of results, respectively.


Ten studies including 2327 elderly individuals were part of the final results. Study exhibited minimal or no pooled incremental effects on memory (0.22, 95%CI = − 0.17 to 0.61, I2 = 94.36%), attention (0.1, 95%CI = − 0.04 to 0.25, I2 = 32.25%), working memory (0.01, 95%CI = − 0.10 to 0.12, I2 = 0%), and executive function (0.03, 95%CI = − 0.05 to 0.11, I2 = 78.48%) among the DHA-supplemented group. The results from standard mean difference between the groups, on memory (0.08, 95%CI = − 0.12 to 0.28, I2 = 76.82%), attention (0.04, 95%CI = − 0.09 to 0.23, I2 = 42.63%), working memory (− 0.08, 95%CI = − 0.26 to 0.10, I2 = 37.57%), and executive function (0.17, 95%CI = − 0.01 to 0.36, I2 = 78.48%) were similar to the results of pooled incremental analysis. Lastly, results remained unaffected by sensitivity and sub-group analyses.


Current pieces of evidence do not support the role of DHA supplementation, in preventing/retarding ARCD of memory, executive function, attention, and working memory.

Protocol registered at PROSPERO (ID: PROSPERO 2018 CRD42018099401).

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Author information

Rakesh Balachandar: Conceptualization, data curation, investigation, methodology, writing-original draft preparation, reviewing, and editing

Soundarya Soundararajan: Conceptualization, data curation, writing-review, and editing

Bhavani Shankara Bagepally: Conceptualization, data curation, formal analysis, investigation, methodology, writing-review, and editing

Correspondence to Bhavani Shankara Bagepally.

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The authors declare that they have no conflict of interest.

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The authors RB and BSB are employed as Clinical research scientists and received salary from Indian Council of Medical Research, India, while the author SS is a postdoctoral research fellow at the National Institute of Health, USA, and none of the authors received any financial support/sponsorship to execute this systematic review.

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Balachandar, R., Soundararajan, S. & Bagepally, B.S. Docosahexaenoic acid supplementation in age-related cognitive decline: a systematic review and meta-analysis. Eur J Clin Pharmacol (2020). https://doi.org/10.1007/s00228-020-02843-x

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  • Age-related cognitive decline
  • Memory
  • Executive function
  • Attention
  • Docosahexaenoic acid (DHA)