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DHA in mild memory decline

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In this clinical trial Yorko-Mauro et al. found out that DHA a t a dose of 0.9 g per day may help in improving memory functions. Not all parameters were chenged though.

In this clinical trial Yorko-Mauro et al. found out that DHA a t a dose of 0.9 g per day may help in improving memory functions. Not all parameters were chenged though.

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  • 1. Beneficial effects of docosahexaenoic acid on cognition in age-related cognitive decline Yurko-Mauro et al. Alzheimers Dement 2010;6:456-464 Page 1 Yurko-Mauro et al. Alzheimers Dement 2010;6:456-464 www.pronutritionist.net
  • 2. Pronutritionist’sbackground • Docosahexanoic acid (DHA) is the major omega-3 fatty acid found in neurons • Epidemiological studies suggest that fish intake might reduce the risk of Alzheimer´s disease (AD) (Kalmijn et al. 1997, Barberger-Gateau et al. 2007) • In addition, DHA intake is inversely correlated with the risk of AD (Morris et al. 2003) • However, studies have failed to demonstrate DHAs efficacy in the treatment of AD (Quinn et al. 2010) • Beneficial effects of DHA supplementation might depend on the stage of disease  people with mild memory complaints may benefit the most Page 2 Yurko-Mauro et al. Alzheimers Dement 2010;6:456-464 www.pronutritionist.net
  • 3. Methods • a randomized, double-blind, placebo-controlled study • n = 485 – age ≥ 55 years – healthy adults with age-related cognitive decline: • Mini-Mental State Examination (MMSE) score > 26 • Logical Memory (Wechsler Memory Scale III) baseline score > 1 standard deviation below younger adults • 900 mg/d of DHA orally or matching placebo • duration 24 weeks • the primary outcome: – CANTAB Paired Associate Learning (PAL), a visuospatial learning and episodic memory test – Measures visuospatiallearning and episodicmemoryerrors made during the test (lower the score the better) Page 3 Yurko-Mauro et al. Alzheimers Dement 2010;6:456-464 www.pronutritionist.net
  • 4. Results (1/3) • DHA supplementation produced a significant 2-fold reduction in the number of visuospatial learning and episodic memory errors on the CANTAB PAL 6 pattern test at 24 weeks – There were no significant differences between groups on the PAL and other CANTAB tests at week 12 • Plasma DHA levels doubled and correlated with improved memory scores in the DHA group • In addition, DHA supplementation was associated with improved immediate and delayed Verbal Recognition Memory scores 4 Yurko-Mauro et al. Alzheimers Dement 2010;6:456-464 www.pronutritionist.net
  • 5. Results: PAL scores at baseline and after 24 weeks (errors made in test) 14 13.4 13 Number of errors 12 12.1 DHA 11 Placebo 10 9.7 9 8.8 8 baseline score week 24 score 5 Yurko-Mauro et al. Alzheimers Dement 2010;6:456-464 www.pronutritionist.net
  • 6. Results (3/3) • “A 3.4 year net improvement in learning and memory function with DHA” was achieved • Self-assessment tests of memory and daily living skills showed no differential effects with DHA. • DHA supplementation did not produce changes in – working memory (SWM) – executive function (SOC) • DHA was well tolerated with no reported treatment- related serious adverse events 6 Yurko-Mauro et al. Alzheimers Dement 2010;6:456-464 www.pronutritionist.net
  • 7. Pronutritionist’s discussion (1/2) • This is the first clinical trial (RCT) to report that DHA (900 mg/d) improve learning and memory function in age-related cognitive decline • It is unclear if the effects of supplementation last beyond 24 weeks (or if they become even more pronounced) • EPA was virtually lacking in the used supplement. • The supplement also included vitamin C + E and rosemary extract. These ingredients are confounding factors in this trial (authors do not discuss this) • In another recent larger study DHA/EPA supplementation (18 months) did not result in improvement in memory learning among patients with Alzheimer’s disease (Quinn et al. 2010). In this study different test pattern (MMSE/CDER) was used to evaluate cognition. Maybe it’s too late after onset of AD? 7 Yurko-Mauro et al. Alzheimers Dement 2010;6:456-464 www.pronutritionist.net
  • 8. Pronutritionist’s discussion (2/2) • It is unclear how much the choice of test patterns (MMSE vs .PAL etc.) affects the outcomes of omega-3 trials in cognitive impairment. Authors claim that PAL is more sensitive than MMSE or CDR or ADAS-cog in mild cognitive impairment • Even if the authors speculate that DHA supplementation would delay memory impairment by 3,4 years, the clinical relevance of the findings is unclear. After all, participants did not report themselves that their memory improved , nor did MMSE points change • More studies verifying the results of this intriguing trial are needed 8 Yurko-Mauro et al. Alzheimers Dement 2010;6:456-464 www.pronutritionist.net