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.
OBJECTIVES: 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. STUDY DESIGN: 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. MAIN OUTCOME MEASURES: 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. RESULTS: 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. CONCLUSIONS: 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.
目的: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。
研究设计: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。
主要观察指标: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。
结果: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。
结论: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。
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