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二十二碳六烯酸在与年龄相关的认知能力下降中的补充作用:系统评价和荟萃分析。

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

机构信息

Clinical Epidemiology, ICMR-National Institute of Occupational Health, Ahmedabad, Gujarat, India.

Section on Human Psychopharmacology, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda Maryland, USA.

出版信息

Eur J Clin Pharmacol. 2020 May;76(5):639-648. doi: 10.1007/s00228-020-02843-x. Epub 2020 Feb 14.

Abstract

PURPOSE

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.

METHODS

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.

RESULTS

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, I = 94.36%), attention (0.1, 95%CI = - 0.04 to 0.25, I = 32.25%), working memory (0.01, 95%CI = - 0.10 to 0.12, I = 0%), and executive function (0.03, 95%CI = - 0.05 to 0.11, I = 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, I = 76.82%), attention (0.04, 95%CI = - 0.09 to 0.23, I = 42.63%), working memory (- 0.08, 95%CI = - 0.26 to 0.10, I = 37.57%), and executive function (0.17, 95%CI = - 0.01 to 0.36, I = 78.48%) were similar to the results of pooled incremental analysis. Lastly, results remained unaffected by sensitivity and sub-group analyses.

CONCLUSIONS

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).

摘要

目的

通过系统评价和荟萃分析,研究 DHA 补充剂在预防与年龄相关的认知衰退(ARCD)方面在各认知领域的作用。

方法

从 MEDLINE、PubMed、Scopus、Cochrane、ProQuest 和 Embase 数据库系统地检索了自成立以来至 2018 年 6 月的相关临床试验。根据 Cochrane 指南,采用 PRISMA 指南进行数据提取、质量评估和纳入研究的验证。提取研究细节,如参与者特征、DHA 补充剂和认知功能结果测量,即记忆、注意力、工作记忆和执行功能,以根据 Cochrane 指南进行荟萃分析。此外,还进行了额外的荟萃回归和亚组分析,以分别检测混杂变量和结果的敏感性。

结果

最终纳入了 10 项研究,共包括 2327 名老年人。研究表明,DHA 补充剂对记忆(0.22,95%CI=−0.17 至 0.61,I=94.36%)、注意力(0.1,95%CI=−0.04 至 0.25,I=32.25%)、工作记忆(0.01,95%CI=−0.10 至 0.12,I=0%)和执行功能(0.03,95%CI=−0.05 至 0.11,I=78.48%)没有明显或没有累积效果。DHA 补充组与对照组之间的标准均数差值的结果在记忆(0.08,95%CI=−0.12 至 0.28,I=76.82%)、注意力(0.04,95%CI=−0.09 至 0.23,I=42.63%)、工作记忆(−0.08,95%CI=−0.26 至 0.10,I=37.57%)和执行功能(0.17,95%CI=−0.01 至 0.36,I=78.48%)方面也相似。最后,敏感性和亚组分析结果不受影响。

结论

目前的证据并不支持 DHA 补充剂在预防/延缓记忆、执行功能、注意力和工作记忆与年龄相关的认知衰退方面的作用。方案在 PROSPERO(ID:PROSPERO 2018 CRD42018099401)注册。

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