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Defining the Optimal Target Population for Trials of Polyunsaturated Fatty Acid Supplementation Using the Erythrocyte Omega-3 Index: A Step Towards Personalized Prevention of Cognitive Decline?

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The journal of nutrition, health & aging

Abstract

Objectives

to identify the optimal erythrocyte omega-3 index cut-off for predicting cognitive decline and/or polyunsaturated fatty acid (PUFA) treatment response, in order to better define the target population for future dementia prevention trials.

Design & Setting

Secondary exploratory analysis of the randomized controlled MAPT prevention trial.

Participants

724 dementia-free subjects aged 70 or older with subjective memory complaints, limitations in one instrumental activity of daily living, and/or slow gait speed.

Intervention

800mg docosahexaenoic acid (DHA) and 225mg eicosapentaenoic acid (EPA) daily versus placebo.

Measurements

Erythrocyte omega-3 index was measured at baseline. Cognition was measured over 3 years with a composite cognitive score (mean of 4 z-scores).

Results

Placebo group subjects in the lowest quartile of baseline erythrocyte omega-3 index (i.e. ≤4.83%) underwent significantly more 3-year cognitive decline than the other quartiles (mean composite score difference 0.14, 95%CI [0.00, 0.28], p=0.048). In a ROC curve analysis, the optimal omega-3 index cut-off for predicting notable cognitive decline was 5.3%. There was a consistent but non-significant difference in 3-year cognitive decline of approximately 0.12 points between PUFA-treated and placebo subjects with “low” baseline omega-3 index when the cut-off was set at ≤5.27%.

Conclusions

Dementia-free older adults with an omega-3 index below approximately 5% are at increased risk of cognitive decline, and could be a good target population for testing the cognitive effects of PUFA supplementation.

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Author information

Authors and Affiliations

  1. INSERM-Toulouse University UMR1027, Toulouse, France

    Nicola Coley, B. Vellas & S. Andrieu

  2. Toulouse University Hospital, Department of Epidemiology and Public Health, Toulouse, France

    Nicola Coley & S. Andrieu

  3. Alzheimer’s Therapeutic Research Institute, University of Southern California, San Diego, CA, USA

    R. Raman, M. C. Donohue & P. S. Aisen

  4. Toulouse University Hospital, Gérontopôle, Department of Geriatric Medicine, Toulouse, France

    B. Vellas

  5. Faculté de Médecine, 37 allées Jules Guesde, 31000, Toulouse, France

    Nicola Coley

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  1. Nicola Coley
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  2. R. Raman
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  3. M. C. Donohue
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  4. P. S. Aisen
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  5. B. Vellas
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MAPT/DSA Study Group

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Correspondence to Nicola Coley.

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Coley, N., Raman, R., Donohue, M.C. et al. Defining the Optimal Target Population for Trials of Polyunsaturated Fatty Acid Supplementation Using the Erythrocyte Omega-3 Index: A Step Towards Personalized Prevention of Cognitive Decline?. J Nutr Health Aging 22, 982–988 (2018). https://doi.org/10.1007/s12603-018-1052-2

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