Gerontopole of Toulouse, Institute of Ageing, Toulouse University Hospital (CHU Toulouse), Toulouse, France.
Gerontopole of Toulouse, Institute of Ageing, Toulouse University Hospital (CHU Toulouse), Toulouse, France; UPS/Inserm UMR1027, University of Toulouse III, Toulouse, France.
Maturitas. 2020 Nov;141:39-45. doi: 10.1016/j.maturitas.2020.06.012. Epub 2020 Jun 26.
To investigate the effect of omega-3 (ω-3) polyunsaturated fatty acid supplementation and a multidomain intervention (MI) (physical activity counselling, cognitive training and nutritional advice) among community-dwelling older adults on levels of intrinsic capacity (IC), a construct recently proposed by the World Health Organization.
Secondary analysis from the factorial-design 3-year Multidomain Alzheimer Preventive Trial (MAPT) with 1445 subjects (64.2 % female, mean age 75.3 years, SD = 4.4) randomized to one group of MI plus ω-3 (800 mg docosahexaenoic acid and 225 mg eicosapentaenoic acid/day); MI plus placebo; ω-3 supplementation alone; or placebo alone. Data collection was held between 2008 and 2014.
IC domains were examined with the Geriatric Depression Scale (psychological); Short Physical Performance Battery (mobility); Z-score combining four tests (cognitive function); and handgrip strength (vitality). All domains were combined into a composite IC Z-score.
After 3 years, IC Z-score decreased among all groups when time was considered continuous (MI plus ω-3: -0.16, 95 %CI: -0.22 to -0.10; MI alone: -0.13, 95 %CI: -0.19 to -0.07; ω-3 alone: -0.19, 95 %CI: -0.25 to -0.10; placebo: -0.20, 95 %CI: -0.26 to -0.14; all p < 0.0001). There were no significant differences between groups. In a sensitivity analysis with categorical time, significant within-group declines were first identified at 24 months for all groups.
This trial designed to improve cognitive function was unable to find effects of the intervention on the composite IC Z-score. Further investigations are needed, especially trials providing stronger interventions (such as exercise training and a controlled diet) and also embracing the sensorial domain of IC.
研究ω-3 多不饱和脂肪酸补充剂和多领域干预（MI）（身体活动咨询、认知训练和营养建议）对社区居住的老年人内在能力（IC）水平的影响，IC 是世界卫生组织最近提出的一个概念。
这是一项为期 3 年的多领域阿尔茨海默病预防试验（MAPT）的二次分析，共有 1445 名受试者（64.2%为女性，平均年龄 75.3 岁，标准差=4.4）被随机分为以下 4 组：MI 加 ω-3（800mg 二十二碳六烯酸和 225mg 二十碳五烯酸/天）；MI 加安慰剂；ω-3 单独补充；或安慰剂单独补充。数据收集于 2008 年至 2014 年进行。
使用老年抑郁量表（心理）、简短身体表现测试（移动）、四项测试综合 Z 分数（认知功能）和握力（活力）检查 IC 各领域。所有领域都结合成一个综合 IC Z 分数。
在考虑时间为连续变量的情况下，所有组在 3 年后的 IC Z 评分均下降（MI 加 ω-3：-0.16，95%CI：-0.22 至-0.10；MI 单独：-0.13，95%CI：-0.19 至-0.07；ω-3 单独：-0.19，95%CI：-0.25 至-0.10；安慰剂：-0.20，95%CI：-0.26 至-0.14；所有 p<0.0001）。各组之间无显著差异。在按类别时间进行的敏感性分析中，所有组在 24 个月时首先出现组内显著下降。
本试验旨在改善认知功能，但未能发现干预对综合 IC Z 评分的影响。需要进一步的研究，特别是提供更强干预（如运动训练和控制饮食）的试验，同时也应包含 IC 的感觉域。
