Abstract
Alzheimer's disease (AD) is the leading cause of dementia and the most common neurodegenerative disease in the elderly. Furthermore, AD has provided the most positive indication to support the fact that inflammation contributes to neurodegenerative disease. The exact etiology of AD is unknown, but environmental and genetic factors are thought to contribute, such as advancing age, family history, presence of chronic diseases such as cardiovascular disease (CVD) and diabetes, and poor diet and lifestyle. It is hypothesised that early prevention or management of inflammation could delay the onset or reduce the symptoms of AD. Normal physiological changes to the brain with ageing include depletion of long chain omega-3 fatty acids and brains of AD patients have lower docosahexaenoic acid (DHA) levels. DHA supplementation can reduce markers of inflammation. This review specifically focusses on the evidence in humans from epidemiological, dietary intervention, and supplementation studies, which supports the role of long chain omega-3 fatty acids in the prevention or delay of cognitive decline in AD in its early stages. Longer term trials with long chain omega-3 supplementation in early stage AD are warranted. We also highlight the importance of overall quality and composition of the diet to protect against AD and dementia.
Highlights
Alzheimer’s disease (AD) was first described in 1906 by German psychiatrist Alois Alzheimer, who observed abnormal clumps and tangled bundles of protein in the brain of a patient who experienced memory loss, language difficulties, and abnormal behaviour [1]
This review has highlighted the lack of consistent evidence for the potential of nutraceuticals and pharmacotherapies to delay the progression of AD
Evidence for a single nutrient therapy is inconsistent. It appears that the overall quality and composition of the diet contribute to protection against AD and dementia
Summary
Alzheimer’s disease (AD) was first described in 1906 by German psychiatrist Alois Alzheimer, who observed abnormal clumps and tangled bundles of protein in the brain of a patient who experienced memory loss, language difficulties, and abnormal behaviour [1]. The risk of developing AD increases exponentially with age and is the leading cause of dementia and the most common neurodegenerative disease in the elderly; prevalence rates in 65–74 year olds are estimated to be 3%, rising to 19% for 75–85 year olds, and nearly 50% in those aged over 85 [2]. Given that the dementia epidemic will continue to rise worldwide alongside diabetes and cardiovascular disease, the economic burden of care will become untenable. The recent National Institutes of Health State-ofthe-Science conference on Alzheimer’s prevention reported that “firm conclusions cannot be drawn about the association of any modifiable risk factor with cognitive decline or AD,” there was a clear message that the evidence was insufficient, trials were focused on older participants with late stage disease, and further research was urgently needed in early onset disease where the impact is likely to be greater [1]. This review focusses on the evidence supporting the role of long chain omega-3 fatty acids in the prevention or delay of progression of AD in its early stages
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