Archief Roodbont

Among many proposed interventions to lower risk for or severity of dementia is supplementation with -3 fatty acids, such as eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), which are commonly found in oily fish.

U.K. investigators enrolled 867 patients (age range, 70–79) from general practices; none had diabetes, and all had normal cognition (Mini-Mental State Examination scores 24). Participants were randomized to daily supplementation with EPA (200 mg) plus DHA (500 mg) or to olive oil placebo. The EPA and DHA dosages were based on U.K. dietary recommendations for fish consumption. The withdrawal and death rates were similar in the two groups — roughly 14% total.

At 24 months' follow-up, no differences were found between the two groups in a validated assessment of cognitive function based on verbal memory or in secondary outcomes related to global cognitive function, memory, or executive function. Adverse events were minor and similar in both groups, with a small incremental risk for flatulence, loose stools, and belching in the treated group.

Comment: This randomized controlled trial is reportedly the longest and largest to evaluate -3 fatty acid supplementation for prevention of dementia. The negative results are consistent with the conclusions of a recent Institute of Medicine report that showed no clear support for any interventions that are purported to prevent dementia.

— Thomas L. Schwenk, MD

Published in Journal Watch General Medicine May 11, 2010