1.
The effects of multi-nutrient formulas containing a combination of n-3 PUFA and B vitamins on cognition in the older adult: a systematic review and meta-analysis.
Fairbairn, P, Dyall, SC, Tsofliou, F
The British journal of nutrition. 2023;129(3):428-441
-
-
-
Free full text
-
Plain language summary
Due to the insidious onset, cognitive impairment often goes unnoticed for several years, with clinical diagnosis being made late into the disease progression. Cognition is critical for functional independence as people age, and intact cognition is vital for humans to communicate effectively. The aims of this study were to (i) investigate whether supplementation with a combination of omega-3 polyunsaturated fatty acids (n-3 PUFA) and B vitamins alone or as part of a multi-nutrient formula can prevent cognitive decline in older adults, and (ii) determine whether the effects of a single nutrient intervention with either n-3 PUFA or B vitamins could be modified by the status of the other nutrient. This study is a systematic review and meta-analysis of fourteen studies of which eleven were randomised controlled trials and the rest were post hoc analysis of randomised controlled trials. Results show a benefit of supplementing with nutrient formulas that contain both n-3 PUFA and B vitamins on global cognition and episodic memory with small to moderate effect sizes. In fact, they can help preserve cognition in the older adults. Authors conclude that more experimental work providing a combination of nutrients including both n-3 PUFA and B vitamins, in healthy older adults or those showing early signs of cognitive decline, is clearly warranted to better explore how nutrition can impact the trajectory of cognition in older adults.
Abstract
There is now evidence to suggest that there may be an interaction between B vitamins and n-3 PUFA, with suggestions that increasing intake of both nutrients simultaneously may benefit cognition in older adults. The aim of this systematic review was to investigate whether supplementation with a combination of n-3 PUFA and B vitamins can prevent cognitive decline in older adults. Randomised controlled trials conducted in older adults that measured cognitive function were retrieved. The included trials provided a combination of n-3 PUFA and B vitamins alone, or in combination with other nutrients. Trials that provided n-3 PUFA alone and also measured B vitamin status or provided B vitamin supplementation alone and measured n-3 PUFA status were also included. The databases searched were The Cochrane Library, EMBASE, CINAHL, Scopus and MEDLINE. A total of 14 papers were included in the analysis (n 4913; age: 60-70 years; follow-up 24 weeks to 4 years). The meta-analysis results found a significant benefit of nutrient formulas, which included both n-3 PUFA and B vitamins alongside other nutrients, v. placebo on global cognition assessed using composite scores from a neuropsychological test battery (G = 0·23, P = 0·002), global cognition using single measures of cognition (G = 0·28, P = 0·004) and episodic memory (G = 0·32, P = 0·001). The results indicate that providing a combination of n-3 PUFA and B vitamins as part of a multi-nutrient formula benefits cognition in older adults v. a placebo, and the potential for an interaction between these key nutrients should be considered in future experimental work.
2.
Effects of a high-DHA multi-nutrient supplement and exercise on mobility and cognition in older women (MOBILE): a randomised semi-blinded placebo-controlled study.
Fairbairn, P, Tsofliou, F, Johnson, A, Dyall, SC
The British journal of nutrition. 2020;:1-10
Abstract
There is a complex interplay between mobility and cognition in older adults. We have previously shown that a high-DHA multi-nutrient supplement improves habitual walking speed, verbal memory and psychomotor response latency in older women. Exercise also improves mobility and cognition in older adults, and n-3 fatty acids and exercise share a range of overlapping biological effects. This study examined for the first time the effects of the high-DHA multi-nutrient supplement and aerobic exercise on mobility and cognition in older women. Women (mean age 67 (sd 8) years) were assigned to the following groups: multi-nutrient (1 g DHA, 160 mg EPA, 240 mg Ginkgo biloba, 60 mg phosphatidylserine, 20 mg d-α tocopherol, 1 mg folic acid and 20 µg vitamin B12 per d, n 13), multi-nutrient and exercise (spin class twice per week, n 14), exercise and placebo (n 12) or placebo (n 12). The multi-nutrient was given for 24 weeks and exercise for 12 weeks. No treatment effects were observed for the primary outcome, habitual walking speed. Improvements in verbal memory and executive function were seen for all treatments groups v. placebo (all, P < 0·05). Significant improvements in self-reported emotional well-being were seen with multi-nutrient and exercise groups v. placebo (P = 0·03). The results suggest that the high-DHA multi-nutrient supplement produces similar improvements in cognitive function to aerobic exercise, offering the intriguing prospect that supplementation may be able to mitigate some of the effects of low physical activity on cognitive function in the elderly.
3.
Combining a high DHA multi-nutrient supplement with aerobic exercise: Protocol for a randomised controlled study assessing mobility and cognitive function in older women.
Fairbairn, P, Tsofliou, F, Johnson, A, Dyall, SC
Prostaglandins, leukotrienes, and essential fatty acids. 2019;:21-30
Abstract
There is a complex interplay between cognition and gait in older people, with declines in gait speed coexisting with, or preceding cognitive decline. Omega-3 fatty acids, B vitamins, vitamin E, phosphatidylserine, and Ginkgo Biloba show promise in preserving mobility and cognitive function in older adults. Exercise benefits mobility and there is evidence suggesting positive interactions between exercise and omega-3 fatty acids on physical and cognitive function in older adults. Non-frail or pre-frail females aged ≥60 years are included in a randomized placebo controlled study. Intervention groups are: high DHA multi-nutrient supplement and exercise, placebo supplement and exercise, high DHA multi-nutrient supplement, and placebo supplement. Dietary supplementation is 24 weeks. The exercise intervention, two cycle ergometer classes per week, is for the final 12 weeks. The primary outcome is habitual walking speed, secondary outcomes include gait variables under single and dual task, five times sit to stand, verbal and spatial memory, executive function, interference control and health related quality of life. Blood fatty acids, serum homocysteine, dietary intake, physical activity, and verbal intelligence are measured to assess compliance and control for confounding factors. The study is registered at www.clinicaltrials.gov (NCT03228550).