O. van de Rest

Effect of fish oil on cognitive performance in older subjects A randomized, controlled trial

Background: High intake of n-3 polyunsaturated fatty acids may protect against age-related cognitive decline. However, results from epidemiologic studies are inconclusive, and results from randomized trials in elderly subjects without dementia are lacking. Objective: To investigate the effect of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) supplementation on cognitive performance. Methods: Double-blind, placebo-controlled trial involving 302 cognitively healthy (Mini-Mental State Examination score > 21) individuals aged 65 years or older. Participants were randomly assigned to 1,800 mg/d EPA–DHA, 400 mg/d EPA–DHA, or placebo capsules for 26 weeks. Cognitive performance was assessed using an extensive neuropsychological test battery that included the cognitive domains of attention, sensorimotor speed, memory, and executive function. Results: The mean age of the participants was 70 years, and 55% were male. Plasma concentrations of EPA–DHA increased by 238% in the high-dose and 51% in the low-dose fish oil group compared with placebo, reflecting excellent compliance. Baseline scores on the cognitive tests were comparable in the three groups. Overall, there were no significant differential changes in any of the cognitive domains for either low-dose or high-dose fish oil supplementation compared with placebo. Conclusions: In this randomized, double-blind, placebo-controlled trial, we observed no overall effect of 26 weeks of eicosapentaenoic acid and docosahexaenoic acid supplementation on cognitive performance.

Results of 2-year vitamin B treatment on cognitive performance; Secondary data from an RCT

Objective: We investigated the effects of 2-year folic acid and vitamin B12 supplementation on cognitive performance in elderly people with elevated homocysteine (Hcy) levels. Methods: This multicenter, double-blind, randomized, placebo-controlled trial included 2,919 elderly participants (65 years and older) with Hcy levels between 12 and 50 µmol/L. Participants received daily either a tablet with 400 µg folic acid and 500 µg vitamin B12 (B-vitamin group) or a placebo tablet. Both tablets contained 15 µg vitamin D3. Data were available for global cognitive functioning assessed by Mini-Mental State Examination (n = 2,556), episodic memory (n = 2,467), attention and working memory (n = 759), information processing speed (n = 731), and executive function (n = 721). Results: Mean age was 74.1 (SD 6.5) years. Hcy concentrations decreased 5.0 (95% confidence interval −5.3 to −4.7) µmol/L in the B-vitamin group and 1.3 (−1.6 to −0.9) µmol/L in the placebo group. Cognitive domain scores did not differ over time between the 2 groups, as determined by analysis of covariance. Mini-Mental State Examination score decreased with 0.1 (−0.2 to 0.0) in the B-vitamin group and 0.3 (−0.4 to −0.2) in the placebo group (p = 0.05), as determined by an independent t test. Conclusions: Two-year folic acid and vitamin B12 supplementation did not beneficially affect performance on 4 cognitive domains in elderly people with elevated Hcy levels. It may slightly slow the rate of decline of global cognition, but the reported small difference may be attributable to chance. Classification of evidence: This study provides Class I evidence that 2-year supplementation with folic acid and vitamin B12 in hyperhomocysteinemic elderly people does not affect cognitive performance.

Effect of Fish Oil Supplementation on Quality of Life in a General Population of Older Dutch Subjects: A Randomized, Double-Blind, Placebo-Controlled Trial

OBJECTIVES: To investigate the effect of eicosapentaenoic acid (EPA) plus docosahexaenoic acid (DHA) supplementation on quality of life (QOL).

Short-term effects of glucose and sucrose on cognitive performance and mood in elderly people

In this study we determined the short-term effects of a glucose drink and a sucrose drink compared to a placebo on cognitive performance and mood in elderly people with subjective, mild memory complaints using a randomized crossover study design. In total, 43 nondiabetic older adults with self-reported memory complaints were included. Drinks consisted of 250 ml with dissolved glucose (50 g), sucrose (100 g), or a mixture of artificial sweeteners (placebo). Multiple neuropsychological tests were performed and were combined by means of z scores into four cognitive domains: episodic memory, working memory, attention and information (processing speed), and executive functioning. Mood was assessed with the short Profile of Mood Status (s-POMS) questionnaire. Blood glucose concentrations were measured at five time points to divide participants into those with a better or poorer blood glucose recovery. Performance on the domain of attention and information processing speed was significantly better after consuming the sucrose drink (domain score of 0.06, SD = 0.91) than after the placebo drink (–0.08, SD = 0.92, p = .04). Sucrose had no effect on the other three domains, and glucose had no effect on any of the domains compared to the placebo. When dividing participants into poorer or better glucose recoverers, the beneficial effect of sucrose on attention and information processing speed was only seen in participants with a poorer recovery. After sucrose consumption, depressive feelings and tension were slightly higher than after the placebo. To conclude, 100 g sucrose, but not 50 g glucose, optimized attention and information processing speed in the short term in this study in elderly people with subjective, mild memory complaints.

Association of long-term adherence to the mind diet with cognitive function and cognitive decline in American women

ObjectivesThere is increasing attention for dietary patterns as a potential strategy to prevent cognitive decline. We examined the association between adherence to a recently developed Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND) diet with cognitive function and cognitive decline, taking into account the interaction between the apolipoprotein E ε4 genotype and the MIND diet.DesignPopulation-based prospective cohort study.ParticipantsA total of 16,058 older women aged 70 and over from the Nurses’ Health Study.MeasurementsDietary intake was assessed five times between 1984 and 1998 with a 116-item Food Frequency Questionnaire. The MIND score includes ten brain-healthy foods and five unhealthy foods. Cognition was assessed four times by telephone from 1995 to 2001 (baseline) with the Telephone Interview for Cognitive Status (TICS) and by calculating composite scores of verbal memory and global cognition. Linear regression modelling and linear mixed modelling were used to examine the associations of adherence to the MIND diet with average cognitive function and cognitive change over six years, respectively.ResultsGreater long-term adherence to the MIND diet was associated with a better verbal memory score (multivariable-adjusted mean differences between extreme MIND quintiles=0.04 (95%CI 0.01-0.07), p-trend=0.006), but not with cognitive decline over 6 years in global cognition, verbal memory or TICS.ConclusionLong-term adherence to the MIND diet was moderately associated with better verbal memory in later life. Future studies should address this association within populations at greater risk of cognitive decline.

The Impact of Omega-3 Fatty Acids on Quality of Life

Improving quality of life (QoL) is becoming an increasingly important outcome in research into the elderly population and for studies in health promotion; generic outcomes are, next to disorder-specific outcomes, also very important. Current evidence indicates that low dietary intake and a low status of omega-3 fatty acids may be associated with mental health problems, which are among the leading causes of impaired QoL in old age. Some studies have also been performed that directly investigated the relationship between omega-3 fatty acids and QoL. In the current chapter these studies will be summarized and discussed. However, because the total number of studies is very limited (only two observational studies and only three intervention studies), no firm conclusions can yet be drawn. More research is warranted, for which some suggestions are provided in this chapter.

The efficacy of omega-3 fatty acids on cognitive performance and mental well-being in elderly people: a double-blind placebo-controlled trial

body Background and objectives: A timely linkage to care (LtC) after HIV diagnosis may benefit individual health and may reduce onward transmission of HIV. We determined the time from HIV diagnosis to LtC among persons with HIV (PWH) entering HIV care and enrolled in the ICONA cohort in 2010-2018. We also analysed determinants for a late LtC (>28 or >60 days) in the last three years (2016-2018) of enrolment. Methods: We analysed time to LtC (defined as the time from HIV diagnosis to first CD4 or viremia determination or cART initiation, whichever came first) among persons enrolled in the ICONA cohort in 2010-2018. Limited to the last three years of enrolment, we performed a logistic regression analysis to investigate the association between late LtC (>28 or >60 days) and individual characteristics including gender, age (by 10 years of increase), being Italian, mode of HIV-transmission, education, job situation and AIDS diagnosis within 30 days from HIV diagnosis. In a sub analysis, AIDS cases diagnosed within 30 days from HIV diagnosis were not considered. Results: 9143 patients were considered in the analysis (81% males and 67% Italians) of whom 48% were men-who-have-sexwithmen (MSM), 38% heterosexual contacts and 6.4% intravenous drug user (IDU); 7.2% had an AIDS diagnosis within 30 days from first positive HIV-test. Overall, median days to LtC was 16 days (IQR: 4-77), and it decreased significantly from 32 days (IQR: 6-276) in 2010-2011 to 11 days in the last three years (IQR: 3-28; p<0001, Figure 1). This was particularly evident with an increasing number of CD4 at first determination. Among 2855 PWH enrolled 2016 onwards, factors significantly associated with time to LtC>28 days, were being IDU (OR=3.35 vs heterosexual) or lack of an AIDS diagnosis within 30 days from HIV diagnosis (OR=14.3) with a decreasing risk (-7%) for each 10-years of age of increase (Table 1). Similar results were observed when AIDS cases were not considered in the analysis. Finally, when considering a longer time LtC (>60 days), and excluding AIDS cases, significant determinants were: being female (OR=1.42), being IDU and be unemployed or with an occasional job (OR=1.56). Conclusions: Among PWH entering in care in 2010-2018 progressive significant reduction in time to LtC was observed. Limiting the analysis to the last three years (2016-2018) major determinants of having a longer time to LtC were being a IDU or not having had an AIDS diagnosis. In some analysis female gender and unemployment were also associated with longer time to LtC. [The project was partially funded by the Minister of Health (ref 4023/P.G.1). *List of the associations involved in the project (in alphabetic order): Anlaids, Arcigay, Caritas, CICA, Circolo Mario Mieli, CNCA, Fondazione Villa Maraini, LILA, Nadir, NPS Italia, PLUS]. Powered by TCPDF (www.tcpdf.org) 1 / 1 20 10 20 11 20 12 20 13 20 14 20 15 20 16 20 17 20 18 0 10 20 30 40 50 150 250 350

Effects of glucose and sucrose on mood: a systematic review of interventional studies

Context Glucose is the main energy source for the brain, and as such, manipulation of glucose supply may affect brain function. It has been suggested that a change in blood glucose may influence mood. Objective The aim of this review was to investigate the potential effects of glucose and sucrose, compared with placebo, on mood. Data Sources The electronic databases PubMed and Scopus were searched. Reference lists of selected articles were checked manually. Data Extraction Randomized controlled trials or crossover trials comparing the effects of glucose or sucrose on mood that were published up to May 2017 were eligible. Potentially eligible articles were selected independently by 2 reviewers. Results In total, 19 studies were found. Thirteen studies investigated the effects of glucose consumption compared with placebo on mood. Seven of these 13 studies found no effect of glucose on mood. The other 6 studies found small and partial effects that may also be due to other factors like palatability and expectation. Seven of the 19 studies investigated the effects of sucrose ingestion versus placebo on mood. None of these studies found a positive effect on mood, and 1 study observed an adverse effect. One of the studies investigated the effects of both glucose and sucrose. Conclusions The results from this review show limited effects of glucose ingestion on mood and no effect of sucrose on mood.

Associations between maternal long-chain polyunsaturated fatty acid concentrations and child cognition at 7 years of age: The MEFAB birth cohort

INTRODUCTION Concentrations of the fish fatty acids EPA and DHA are low among Dutch women of reproductive age. As the human brain incorporates high concentrations of these fatty acids in utero, particularly during third trimester of gestation, these low EPA and DHA concentrations may have adverse consequences for fetal brain development and functioning. METHODS Analyses were conducted using longitudinal observational data of 292 mother-child pairs participating in the MEFAB cohort. Maternal AA, DHA, and EPA were determined in plasma phospholipids - obtained in three trimesters - by gas-liquid chromatography. Cognitive function was assessed at 7 years of age, using the Kaufman Assessment Battery for Children, resulting in three main outcome parameters: sequential processing (short-term memory), simultaneous processing (problem-solving skills), and the mental processing composite score. Spline regression and linear regression analyses were used to analyse the data, while adjusting for potential relevant covariates. RESULTS Only 2% of the children performed more than one SD below the mental processing composite norm score. Children with lower test scores (<25%) were more likely to have a younger mother with a higher pre-gestational BMI, less likely to be breastfed, and more likely to be born with a lower birth weight, compared to children with higher test scores (≥25%). Fully-adjusted linear regression models did not show associations of maternal AA, DHA, or EPA status during any of the pregnancy trimesters with childhood sequential and simultaneous processing. CONCLUSION Maternal fatty acid status during pregnancy was not associated with cognitive performance in Dutch children at age 7.

Vitamin D and the Association with Cognitive Performance, Cognitive Decline, and Dementia

Several reviews show that insufficient serum 25-hydroxyvitamin D (25(OH)D) levels are observed all over the world. Aging has been shown to be one of the factors related to the development of vitamin D deficiency. Moreover, it is generally known that aging is a key risk factor for cognitive decline and dementia. During the last decade, interest in the role of vitamin D in cognitive performance has increased, resulting in the publication of various scientific studies investigating this potential link. This chapter provides an overview of the evidence obtained from population-based studies investigating associations of serum 25(OH)D with measures of global cognitive performance and domain-specific cognitive performance, as well as morphological measures obtained by magnetic resonance imaging (MRI). We conclude with an overview of the few trials of the effect of vitamin D supplementation on cognitive performance.