Effects of a 3-Year Multi-Domain Intervention with or without Omega-3 Supplementation on Cognitive Functions in Older Subjects with Increased CAIDE Dementia Scores
Effects of a 3-Year Multi-Domain Intervention with or without Omega-3 Supplementation on Cognitive Functions in Older Subjects with Increased CAIDE Dementia Scores
复制标题
DOI：
10.3233/jad-180209
复制
发表时间：
2018-01-01
影响因子：
4
通讯作者：
Vellas, Bruno
中科院分区：
文献类型：
--
作者：
Chhetri, Jagadish K.;Barreto, Philipe de Souto;Vellas, Bruno
最近阿尔茨海默病预防试验的结果表明，基于中年心血管风险因素的痴呆评分增加的受试者在一定程度上受益于多领域干预策略。这些干预措施对认知功能的影响仍有待确定。这项研究是MAPT研究的二次分析，1,293名CAIDE评分高的老年受试者（平均年龄75岁）（即，>= 6）根据四个干预组分类：1）多领域干预加安慰剂，2）单独补充ω-3多不饱和脂肪酸（n-3 PUFA），3）两种干预的组合，和4）单独安慰剂。采用线性混合模型重复测量分析，根据干预组与安慰剂组之间自基线起36个月时的各种神经心理学测试评分评估认知变化。与安慰剂组相比，多领域干预联合n-3 PUFA组在36个月时的自由和线索选择性提醒测试（FCRT）（平均值+/-标准误（SE）+/- 0.20 +/- 0.10）和MMSE定向测试（平均值+/- SE = 0.15 +/- 0.06）的延迟总回忆测试中显示出显著改善。与安慰剂组相比，隔离多领域干预组在MMSE定向测试中表现出显著更少的下降（平均值+/- SE = 0.12 +/- 0.06）。在36个月时，与安慰剂组相比，n-3 PUFA干预组的FCSRT自由回忆测试的改善显著较少（平均值+/- SE = -1.01 +/- 0.46）。我们的研究结果表明，用CAIDE痴呆评分筛选的痴呆高危受试者可能受益于MAPT研究中的多领域干预策略，特别是在定向和延迟回忆领域。
Findings from recent Alzheimer's disease prevention trials have shown subjects with increased dementia score based upon mid-life cardiovascular risk factors, to benefit from multi-domain intervention strategies to some extent. The effects of such interventions on cognitive functions remains yet to be well-established. This study is a secondary analysis of the MAPT study, 1,293 older subjects (mean age 75 years) with high CAIDE score (i.e., >= 6) were classified according to the four intervention groups: 1) multi-domain intervention plus placebo, 2) isolated supplementation with Omega-3 polyunsaturated fatty acid (n-3 PUFA), 3) combination of the two interventions, and 4) placebo alone. Linear mixed-model repeated-measures analyses were used to assess the cognitive changes according to various neuropsychological test scores between intervention groups compared to the placebo at 36 months from baseline. Compared to the placebo, group with multidomain intervention in combination withn-3PUFA was found to show significant improvement in the delayed total recall test of the free and cued selective reminding test (FCSRT) (mean +/- standard error(SE) +/- 0.20 +/- 0.10) and MMSE orientation test (mean +/- SE = 0.15 +/- 0.06) at 36 months. Isolated multi-domain intervention group showed significant less decline in the MMSE orientation test (mean +/- SE = 0.12 +/- 0.06) compared to the placebo. There was significant less improvement (mean +/- SE = -1.01 +/- 0.46) in the FCSRT free recall test in the n-3 PUFA intervention group compared to the placebo at 36 months. Our findings show high-risk subjects for dementia screened with CAIDE dementia score might benefit from multi-domain intervention strategies as in the MAPT study, particularly in the orientation and delayed recall domain.