The effects of docosahexaenoic acid supplementation on cognition and well-being in mild cognitive impairment: A 12-month randomised controlled trial

OBJECTIVES

Several recent clinical trials have shown that docosahexaenoic acid (DHA) supplements have a significant effect on cognition in cognitively impaired older adults. This randomised controlled trial aimed to investigate the cognitive effects of a DHA fish oil supplement in older adults with mild cognitive impairment, and to examine the moderating effect of the apolipoprotein E (APOE) ɛ4 allele on cognition and well-being.

METHODS/DESIGN

Seventy-two older adults between the ages of 60 and 90 from New Zealand were given a DHA supplement equivalent to 1491 mg DHA + 351 mg eicosapentaenoic acid per day or a placebo for a period of 12 months. Outcome measures included cognition, wellbeing and self-rated quality of life as well as height, weight, blood pressure and APOE genotyping.

RESULTS

The final analysis (n = 60) found no evidence of a treatment effect on cognitive measures, although did find a treatment effect on systolic blood pressure (p = 0.03, ƞ²  = 0.08), and a treatment interaction for APOE ɛ4 carriers on depression (p = 0.04, ƞ²  = 0.07) and anxiety (p = 0.02, ƞ²  = 0.09) scores in favour of the DHA supplement.

CONCLUSIONS

Despite no effect on cognition, the positive result in APOE ɛ4 carriers on depression and anxiety scores and on systolic blood pressure justifies further DHA trials. It may be a prudent step going forward for more studies to replicate the design elements (dose, duration and cognitive measures) of previous DHA trials to help understand why not all older adults appear to benefit from taking a fish oil supplement.

Fish oil supplement use in New Zealand: A cross-sectional survey

OBJECTIVE

The aims of the survey were to determine: (i) the percentage of fish oil supplement users in a sample population; (ii) why people take fish oil supplements; (iii) where fish oil supplements are stored as well as the average daily dosage; (iv) what dietary and lifestyle behaviours are associated with fish oil supplement use.

DESIGN

An online cross-sectional survey.

SETTING

New Zealand.

RESPONDENTS

A total of 334 New Zealand residents over the age of 18.

RESULTS

Fish oil supplements were taken by 21.9% of respondents. Reasons for taking fish oil supplements were - 72.6% for 'general well-being', 54.8% to 'improve brain function', 31.5% for 'pain/inflammation', 12.3% to 'lower cholesterol levels' and 11% for 'a dietary insufficiency'. Approximately 26% of fish oil users reported taking a dose of fish oil supplements that would meet the recommended daily intake of 400-600 mg combined docosahexaenoic acid and eicosapentaenoic acid, and only 6.8% of fish oil users reported storing their fish oil supplements in the refrigerator. After controlling for other characteristics including age, gender, ethnicity and body mass index, fish oil supplementation use was most likely among respondents who already eat oily fish and least likely in respondents who regularly eat nuts and seeds.

CONCLUSIONS

Fish oil supplements are a commonly used supplement in New Zealand, yet questions remain about the role of these supplements in improving health outcomes. Safety issues related to manufacturing and storage conditions indicate that there is an urgency in answering these questions.

DHA supplementation improved both memory and reaction time in healthy young adults: a randomized controlled trial

BACKGROUND

Docosahexaenoic acid (DHA) is important for brain function, and its status is dependent on dietary intakes. Therefore, individuals who consume diets low in omega-3 (n-3) polyunsaturated fatty acids may cognitively benefit from DHA supplementation. Sex and apolipoprotein E genotype (APOE) affect cognition and may modulate the response to DHA supplementation.

OBJECTIVES

We investigated whether a DHA supplement improves cognitive performance in healthy young adults and whether sex and APOE modulate the response.

DESIGN

Healthy adults (n = 176; age range: 18-45 y; nonsmoking and with a low intake of DHA) completed a 6-mo randomized, placebo-controlled, double-blind intervention in which they consumed 1.16 g DHA/d or a placebo. Cognitive performance was assessed by using a computerized cognitive test battery. For all tests, z scores were calculated and clustered into cognitive domains as follows: episodic and working memory, attention, reaction time (RT) of episodic and working memory, and attention and processing speed. ANCOVA was conducted with sex and APOE as independent variables.

RESULTS

RTs of episodic and working memory improved with DHA compared with placebo [mean difference (95% CI): -0.18 SD (-0.33, -0.03 SD) (P = 0.02) and -0.36 SD (-0.58, -0.14 SD) (P = 0.002), respectively]. Sex × treatment interactions occurred for episodic memory (P = 0.006) and the RT of working memory (P = 0.03). Compared with the placebo, DHA improved episodic memory in women [0.28 SD (0.08, 0.48 SD); P = 0.006] and RTs of working memory in men [-0.60 SD (-0.95, -0.25 SD); P = 0.001]. APOE did not affect cognitive function, but there were some indications of APOE × sex × treatment interactions.

CONCLUSIONS

DHA supplementation improved memory and the RT of memory in healthy, young adults whose habitual diets were low in DHA. The response was modulated by sex. This trial was registered at the New Zealand Clinical Trials Registry (http://www.anzctr.org.au/default.aspx) as ACTRN12610000212055.

Memory Deficits in Parkinson’s Disease

The purpose of this study was to investigate deficits in recognition, recall, and prospective memory among Parkinson's disease (PD) patients, and to ascertain whether task difficulty and disease severity moderate these deficits. Comparisons were made between 41 nondemented PD participants, divided into early-stage and advanced-stage groups, and 41 matched controls. PD participants exhibited deficits in recognition, recall, and prospective memory. The advanced-stage PD group produced greater deficits than the early-stage PD group in all tasks, suggesting that these deficits increase in step with overall disease severity. The results of the task difficulty manipulation provide a partial explanation for the inconsistencies in the literature concerning the existence of recognition memory deficits in PD.

Face recognition and aging: Effects of target age and memory load

In the present study, we investigated age-related decline in face recognition memory and whether this decline is moderated by the age of the target faces and by the number of faces that the participant must learn (memory load). Thirty-two participants in each of three age groups (18-39 years, 60-75 years, and 76-96 years) completed a face recognition task. Signal detection analyses confirmed that face recognition accuracy declined with age. However, this finding was qualified by an interaction between participant age and target age, which revealed that the age-related decline in face recognition accuracy occurred only for young target faces. Increased memory load was associated with comparable performance decrements across all age groups. However, memory load appears not to be the cause of these decrements. Instead, they appear to be a product of recognition load (the number of stimuli presented in the recognition phase).

The placebo effect: dissolving the expectancy versus conditioning debate

The authors review the literature on the 2 main models of the placebo effect: expectancy theory and classical conditioning. A path is suggested to dissolving the theoretical impasse that has long plagued this issue. The key is to make a clear distinction between 2 questions: What factors shape placebo effects? and What learning mediates the placebo effect? The reviewed literature suggests that classical conditioning procedures are one shaping factor but that verbal information can also shape placebo effects. The literature also suggests that conditioning procedures and other sources of information sometimes shape conscious expectancies and that these expectancies mediate some placebo effects; however, in other cases conditioning procedures appear to shape placebo effects that are not mediated by conscious cognition.

Driving-related fear: a review

This article reviews the research on driving-related fear (DRF). Until recently, research has concentrated almost exclusively on the effect of motor vehicle accidents (MVAs) on subsequent levels of DRF. However, recent findings have suggested that MVAs are not solely responsible for this fear reaction, and that non-MVA driving fear can be just as strong. Studies of the broader driving-fearful population have encountered difficulty with diagnostic conceptualisation of DRF, although some have investigated a possible typology of DRF. Driving skill has been a neglected issue in the DRF research, and may prove to be a useful part of assessment and remediation of this potentially debilitating problem. Issues of definitional inconsistency are highlighted, and suggestions are made for several directions that future research might profitably take.

Brief exposure to a 50 Hz, 100 microT magnetic field: effects on reaction time, accuracy, and recognition memory

The present study investigated both the direct and delayed effects of a 50 Hz, 100 microT magnetic field on human performance. Eighty subjects completed a visual duration discrimination task, half being exposed to the field and the other half sham exposed. The delayed effects of this field were also examined in a recognition memory task that followed immediately upon completion of the discrimination task, Unlike our earlier studies, we were unable to find any effects of the field on reaction time and accuracy in the visual discrimination task. However, the field had a delayed effect on memory, producing a decrement in recognition accuracy. We conclude that after many years of experimentation, finding a set of magnetic field parameters and human performance measures that reliably yield magnetic field effects is proving elusive. Yet the large number of significant findings suggests that further research is warranted.

Recognition memory impairment in Parkinson's disease: power and meta-analyses

Contrary findings notwithstanding, the prevailing notion is that recognition memory is little affected by Parkinson's disease (PD). Both a power analysis and a meta-analysis were conducted to help clarify the degree of recognition memory deficit associated with PD. The power analysis confirmed that, in general, memory studies of PD participants have been underpowered. This analysis indicated the need to pool study results in a subsequent meta-analysis, the main finding of which was that recognition memory deficits do occur with PD. The largest deficit occurs in PD participants with dementia. Nevertheless, deficits also occur in PD participants without dementia on medication, but nondopaminergic central nervous system abnormalities are more likely to underlie this deficit than PD medication itself. Future development of a theory of cognitive dysfunction in PD should take into account these recognition memory deficits, which may increase with disease progression.

Acute effects of 50 Hz, 100 microT magnetic field exposure on visual duration discrimination at two different times of the day

A two-alternative, forced-choice visual duration discrimination task was used to examine the effect of an intermittent, 50 Hz, 100 microT magnetic field on accuracy at two different times of the day. A total of 59 female and 40 male subjects with an age range of 18 to 46 years were studied under both field-exposed and sham-exposed conditions. The subject's task was to decide which of two sequentially presented light flashes had the longer duration, percentage correct being the measure of performance. The data were gathered under double-blind conditions with sham and real exposure counterbalanced. Exposure to the magnetic field produced a small improvement in accuracy but only at the most difficult level of the task, with female subjects showing a larger improvement than males. The time of day at which the study was run had no effect on performance. Despite the relatively large number of subjects used and a relaxed alpha level (P = .3), the statistical power of the test to detect the observed effect was still only 0.71.

Recognition memory impairment in Parkinson's disease: power and meta-analyses

Contrary findings notwithstanding, the prevailing notion is that recognition memory is little affected by Parkinson's disease (PD). Both a power analysis and a meta-analysis were conducted to help clarify the degree of recognition memory deficit associated with PD. The power analysis confirmed that, in general, memory studies of PD participants have been underpowered. This analysis indicated the need to pool study results in a subsequent meta-analysis, the main finding of which was that recognition memory deficits do occur with PD. The largest deficit occurs in PD participants with dementia. Nevertheless, deficits also occur in PD participants without dementia on medication, but nondopaminergic central nervous system abnormalities are more likely to underlie this deficit than PD medication itself. Future development of a theory of cognitive dysfunction in PD should take into account these recognition memory deficits, which may increase with disease progression.

EXPERIMENTALLY INDUCED LEARNED HELPLESSNESS: HOW FAR DOES IT GENERALIZE?

The study assessed whether experimentally induced learned helplessness on a cognitive training task generalized to a situationally dissimilar social interaction test task. Subjects were randomly assigned to non-contingent feedback, contingent feedback and control groups. The non-contingent feedback group demonstrated increased levels of affect (Anxiety. Depression and Hostility) following the training phase, indicating a successful helplessness induction. However, no significant differences were observed between the groups on the subsequent test task, showing that helplessness failed to generalize. A time delay between the test and training phase did not affect the performance of the non-contingent group, although there was an unexpected main effect with all subjects who experienced the delay showing facilitated performance. Results are discussed in terms of the reformulated learned helplessness model and extensions to it.