Abstract
Background
Epidemiological and animal studies have suggested that dietary fish or fish oil rich in omega‐3 fatty acids (__ω__3), docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA), may have effects in psychiatric and behavioral symptoms in Alzheimer's disease (AD). An association with APOE__ω__4 carriers and neuropsychiatric symptoms in AD has also been suggested.
Objective
To determine effects of dietary __ω__3 supplementation to AD patients with mild to moderate disease on psychiatric and behavioral symptoms, daily functions and a possible relation to __APOE__genotype.
Methods
Randomized, double‐blind, placebo‐controlled clinical trial where 204 AD patients (74 ± 9 years) with acetylcholine esterase inhibitor treatment and a MMSE >15 points were randomized to daily intake of 1.7 g DHA and 0.6 g EPA (__ω__3 group) or placebo for 6 months. Then, all received the __ω__3 supplementation for 6 more months. Neuropsychiatric symptoms were measured with Neuropsychiatric Inventory (NPI) and Montgomery Åsberg Depression Scale (MADRS). Caregivers burden and activities of daily living (Disability Assessment for Dementia, DAD) were also assessed.
Results
One hundred and seventy‐four patients fulfilled the trial. 72% were __APOEω__4 carriers. No significant overall treatment effects on neuropsychiatric symptoms, on activities of daily living or on caregiver's burden were found. However, significant positive treatment effects on the scores in the NPI agitation domain in __APOEω__4 carriers (p = 0.006) and in MADRS scores in non‐__APOEω__4 carriers (p = 0.005) were found.
Conclusions
Supplementation with __ω__3 in patients with mild to moderate AD did not result in marked effects on neuropsychiatric symptoms except for possible positive effects on depressive symptoms (assessed by MADRS) in non‐__APOEω__4 carriers and agitation symptoms (assessed by NPI) in __APOEω__4 carriers. ClinicalTrials.gov identifier: NCT00211159 Copyright © 2007 John Wiley & Sons, Ltd.