Division of Epidemiology, Human Genetics and Environmental Science, The University of Texas Health Science Center at Houston School of Public Health, Houston, TX, USA.
The George Institute for Global Health and the Faculty of Medicine, University of New South Wales, Sydney, Australia.
J Alzheimers Dis. 2023;95(3):965-979. doi: 10.3233/JAD-230083.
Comprising nearly 35% of brain lipids, polyunsaturated fatty acids (PUFA) are essential for optimal brain function. However, the role of PUFA on cognitive health outcomes later in life is largely unknown.
We investigated prospective associations of plasma phospholipid omega-3 (ALA [18 : 3], EPA [20 : 5], DPA [22 : 5], DHA [22 : 6]) and omega-6 (LA [18 : 2], AA [20 : 4]) PUFA with cognitive decline, risk of cognitive impairment and dementia among adults aged≥65 years in the Cardiovascular Health Study.
Circulating fatty acid concentrations were measured serially at baseline (1992/1993), 6 years, and 13 years later. Cognitive decline and impairment were assessed using the 100-point Modified Mini-Mental State Examination (3MSE) up to 7 times. Clinical dementia was identified using adjudicated neuropsychological tests, and ICD-9 codes.
Among 3,564 older adults free of stroke and dementia at baseline, cognitive function declined annually by approximately -0.5 3MSE points; 507 participants developed cognitive impairment and 499 dementia over up to 23 years of follow-up. In multivariable models, higher circulating arachidonic acid (AA) concentrations were associated with slower cognitive decline and lower dementia risk, with associations growing stronger with greater length of follow-up (hazard ratio [HR,95% CI] of dementia per interquintile range, 0.74 [0.56-0.97] at 5 years, and 0.53 [0.37-0.77] at 15 years). Circulating docosapentaenoic (DPA) concentrations were associated with slower cognitive decline and lower risk of cognitive impairment (extreme-quintile HR, 0.72 [95% CI: 0.55, 0.95]). Findings were generally null or inconsistent for other omega-3 or omega-6 PUFA.
Circulating AA and DPA, but not other PUFA, are associated with slower rate of cognitive decline and lower risk of dementia or cognitive impairment later in life.
多不饱和脂肪酸（PUFA）约占大脑脂质的 35%，对大脑功能的最佳状态至关重要。然而，PUFA 对晚年认知健康结果的作用在很大程度上尚不清楚。
我们研究了血浆磷脂中 ω-3（ALA[18：3]、EPA[20：5]、DPA[22：5]、DHA[22：6]）和 ω-6（LA[18：2]、AA[20：4]）PUFA 与≥65 岁心血管健康研究成年人认知能力下降、认知障碍风险和痴呆的前瞻性关联。
基线（1992/1993 年）、6 年和 13 年后连续测量循环脂肪酸浓度。使用改良的迷你精神状态检查（3MSE）的 100 分评估认知能力下降和损害，最多进行 7 次评估。使用经审定的神经心理测试和 ICD-9 代码来确定临床痴呆。
在 3564 名基线时无卒中且无痴呆的老年人中，认知功能每年下降约 0.5 个 3MSE 点；507 名参与者在 23 年的随访中发展为认知障碍，499 名发展为痴呆。在多变量模型中，较高的循环花生四烯酸（AA）浓度与认知衰退较慢和痴呆风险较低相关，且随着随访时间的延长，相关性更强（痴呆每五分位间隔的风险比[HR，95%CI]，5 年时为 0.74[0.56-0.97]，15 年时为 0.53[0.37-0.77]）。循环二十二碳五烯酸（DPA）浓度与认知衰退较慢和认知障碍风险较低相关（最极端五分位数 HR，0.72[95%CI：0.55，0.95]）。对于其他 ω-3 或 ω-6 PUFA，结果通常为无效或不一致。
循环 AA 和 DPA，但不是其他 PUFA，与晚年认知衰退速度较慢和痴呆或认知障碍风险较低相关。
