Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.
Neurobiol Aging. 2012 Jul;33(7):1482.e17-29. doi: 10.1016/j.neurobiolaging.2011.12.014. Epub 2012 Feb 3.
Higher intake of omega-3 fatty acids (n-3 FAs) is associated with a reduced risk of Alzheimer's disease (AD) and milder forms of cognitive impairment (e.g. cognitive impairment no dementia [CIND]); however, findings from interventional trials are inconsistent. This meta-analysis examined the neuropsychological benefit of n-3 FAs in randomized double-blind placebo-controlled studies (RCTs) including healthy, CIND, or AD subjects.
Literature was searched using Medline, Embase, PsycInfo, Cochrane Library, Allied and Complementary Medicine Database (AMED), and Cumulative Index to Nursing and Allied Health Literature (CINAHL) up to September 2011. Treatment effects were summarized across cognitive subdomains, and effect sizes were estimated using Hedge's g and random effects modeling.
Ten RCTs were combined quantitatively. There was no effect of n-3 FAs on composite memory (g = 0.04 [95% CI: -0.06-0.14], N = 934/812, p = 0.452). When examined by domain, no overall benefit for immediate recall (0.04 [-0.05-0.13], N = 934/812, p = 0.358) was detected; however, an effect in CIND subjects (0.16 [0.01-0.31], N = 349/327, p = 0.034) was found. A benefit for attention and processing speed was also detected in CIND (0.30 [0.02-0.57], N = 107/86, p = 0.035), but not healthy subjects. Benefits for delayed recall, recognition memory, or working memory and executive function were not observed. Treatment did not benefit AD patients as measured by the Mini-Mental State Examination (MMSE) or Alzheimer's Disease Assessment Scale-Cognitive Subscale (ADAS-cog). No differences in adverse events (AE), dropout, or dropout due to AE between groups were observed.
These results suggest an effect of n-3 FAs within specific cognitive domains in CIND, but not in healthy or AD subjects.
摄入较多的ω-3 脂肪酸(n-3 FAs)与阿尔茨海默病(AD)风险降低以及认知障碍(如认知障碍但无痴呆[CIND])的严重程度降低有关;然而,干预试验的结果并不一致。本项 meta 分析检查了 n-3 FAs 在包括健康、CIND 或 AD 受试者的随机双盲安慰剂对照研究(RCT)中的神经心理学益处。
使用 Medline、Embase、PsycInfo、Cochrane 图书馆、补充与综合医学数据库(AMED)和 Cumulative Index to Nursing and Allied Health Literature(CINAHL)检索文献,检索截至 2011 年 9 月。通过认知子领域总结治疗效果,并使用 Hedge's g 和随机效应模型估计效应大小。
10 项 RCT 被定量结合。n-3 FAs 对复合记忆无影响(g = 0.04 [95%CI:-0.06-0.14],N = 934/812,p = 0.452)。按域检查时,未发现即时回忆的整体益处(0.04 [-0.05-0.13],N = 934/812,p = 0.358);然而,在 CIND 受试者中发现了效果(0.16 [0.01-0.31],N = 349/327,p = 0.034)。在 CIND 中还发现了注意力和处理速度的益处(0.30 [0.02-0.57],N = 107/86,p = 0.035),但在健康受试者中未发现。未观察到延迟回忆、识别记忆、工作记忆和执行功能的益处。用简易精神状态检查(MMSE)或阿尔茨海默病评估量表认知分量表(ADAS-cog)测量,治疗对 AD 患者没有益处。未观察到组间不良事件(AE)、辍学或因 AE 辍学的差异。
这些结果表明 n-3 FAs 在 CIND 中的特定认知域中有效,但在健康或 AD 受试者中无效。