A randomized placebo-controlled pilot trial of omega-3 fatty acids and alpha lipoic acid in Alzheimer's disease.
Oxidative stress, inflammation, and increased cholesterol levels are all mechanisms that have been associated with Alzheimer's disease (AD) pathology. Several epidemiologic studies have reported a decreased risk of AD with fish consumption. This pilot study was designed to evaluate the effects of supplementation with omega-3 fatty acids alone (ω-3) or omega-3 plus alpha lipoic acid (ω-3 + LA) compared to placebo on oxidative stress biomarkers in AD. The primary outcome measure was peripheral F2-isoprostane levels (oxidative stress measure). Secondary outcome measures included performance on: Mini-Mental State Examination (MMSE), Activities of Daily Living/Instrumental Activities of Daily Living (ADL/IADL), and Alzheimer Disease Assessment Scale-cognitive subscale (ADAS-cog). Thirty-nine AD subjects were randomized to one of three groups: 1) placebo, 2) ω-3, or 3) ω-3 + LA for a treatment duration of 12 months. Eighty seven percent (34/39) of the subjects completed the 12-month intervention. There was no difference between groups at 12 months in peripheral F2-isoprostane levels (p = 0.83). The ω-3 + LA and ω-3 were not significantly different than the placebo group in ADAS-cog (p = 0.98, p = 0.86) and in ADL (p = 0.15, p = 0.82). Compared to placebo, the ω-3 + LA showed less decline in MMSE (p < 0.01) and IADL (p = 0.01) and the ω-3 group showed less decline in IADL (p < 0.01). The combination of ω-3 + LA slowed cognitive and functional decline in AD over 12 months. Because the results were generated from a small sample size, further evaluation of the combination of omega-3 fatty acids plus alpha-lipoic acid as a potential treatment in AD is warranted.
Department of Neurology, Oregon Health & Science University, Portland, OR, USA.
Lynne
L
Shinto
Joseph
J
Quinn
Thomas
T
Montine
Hiroko H
HH
Dodge
William
W
Woodward
Sara
S
Baldauf-Wagner
Dana
D
Waichunas
Lauren
L
Bumgarner
Dennis
D
Bourdette
Lisa
L
Silbert
Jeffrey
J
Kaye
D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000150:complications / Q000178:diet therapy* / Q000523:psychology; D000704:Analysis of Variance; D003072:Cognition Disorders / Q000178:diet therapy / Q000209:etiology; D004311:Double-Blind Method; D028441:F2-Isoprostanes / Q000378:metabolism; D015525:Fatty Acids, Omega-3 / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008297:Male; D008609:Mental Status Schedule; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D010865:Pilot Projects; D008063:Thioctic Acid / Q000627:therapeutic use*
D028441:F2-Isoprostanes; D015525:Fatty Acids, Omega-3; D008063:Thioctic Acid
Alpha-lipoic acid; Alzheimer's disease; clinical trial; omega-3 fatty acids