Highlights
- •We examined the association between erythrocyte EPA+DHA and risk for incident dementia in 6706 women in the USA.
- •We found a significant, 8% decreased risk over 10 years for probable dementia associated with a 1-SD increase in EPA+DHA.
- •This large study confirms previous research suggesting that higher EPA+DHA levels may be protective against dementia.
Abstract
Objective
To assess whether red blood cell (RBC) docosahexaenoic acid and eicosapentaenoic acid
(DHA+EPA) levels have a protective association with the risk of dementia in older
women.
Methods
RBC DHA+EPA levels were assessed at baseline, and cognitive status was evaluated annually
in a cohort of 6706 women aged ≥65 years who participated in the Women's Health Initiative
Memory Study (WHIMS). Cox regression was used to quantify the association between
RBC DHA+EPA and the risk of probable dementia, independent of major dementia risk
factors.
Results
During a median follow-up period of 9.8 years, 587 incident cases of probable dementia
were identified. After adjusting for demographic, clinical, and behavioral risk factors,
a one standard deviation increase in DHA+EPA levels was associated with a significantly
lower risk of dementia (HR = 0.92, 95% CI: 0.84, 1.00; p < 0.05). This effect estimate
did not meaningfully change after further adjustment for baseline cognitive function
and APOE genotype. For women with high DHA+EPA exposure (1 SD above mean) compared to low exposure (1 SD below mean), the adjusted 15-year absolute risk difference for dementia was 2.1%
(95% CI: 0.2%, 4.0%). In secondary analyses, we also observed a protective association
with longitudinal change in Modified Mini-Mental State (3MS) Exam scores, but no significant
association with incident MCI, PD/MCI, or baseline 3MS scores.
Discussion
Higher levels of DHA+EPA may help protect against the development of dementia. Results
from prospective randomized controlled trials of DHA+EPA supplementation are needed
to help clarify whether this association is causal.
Abbreviations:
3MS (Modified Mini-Mental State), CEE (Conjugated equine estrogens), CEE+P ((CEE) + Progestin), CI (Confidence interval), DHA (docosahexaenoic acid), EPA (eicosapentaenoic acid), FA (fatty acid), HT (hormone therapy), HR (hazard ratio), MCI (mild cognitive impairment), PD (Probably dementia), RBC (red blood cell), SD (standard deviation), WHIMS (Women's Health Initiative Memory Study), WHIMS-ECHO ((WHIMS) Epidemiology of Cognitive Health Outcomes)Keywords
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Article info
Publication history
Published online: June 14, 2017
Accepted:
June 13,
2017
Received in revised form:
June 12,
2017
Received:
March 22,
2017
Identification
Copyright
© 2017 Elsevier Ltd. All rights reserved.
