An analysis of omega-3 clinical trials and a call for personalized supplementation for dementia prevention

INTRODUCTION

Targeted interventions are needed to delay or prevent the onset of neurodegenerative diseases. Poor dietary habits are associated with cognitive decline, highlighting the benefits of a healthy diet with fish and polyunsaturated fatty acids (PUFAs). Intake of omega-3 PUFAs docosahexaenoic acid (DHA), α-linolenic acid (ALA) and eicosapentaenoic acid (EPA) is linked with healthy aging, cardiovascular benefits, and reduced risk of Alzheimer's disease. Although omega-3 has health benefits, its intake is often inadequate and insufficient in modern diets. Although fish oil supplements offer an alternative source, inconsistent results from clinical trials raise questions about the factors determining their success.

AREAS COVERED

In this this review, the authors discuss the aforementioned determining factors and highlight strategies that could enhance the effectiveness of omega-3 PUFAs interventions for dementia and cognitive decline. Moreover, the authors provide suggestions for potential future research.

EXPERT OPINION

Factors such as diet, lifestyle, and genetic predisposition can all influence the effectiveness of omega-3 supplementation. When implementing clinical trials, it is crucial to consider these factors and recognize their potential impact on the interpretation of results. It is important to study each variable independently and the interactions between them.

Self-reported glaucoma prevalence and related factors, contribution to reported visual impairment, and functional burden in a cross-sectional study in Colombia

PURPOSE

Describe the self-reported prevalence of glaucoma in Colombian older adults, emphasizing the most important risk factors and associated daily-life functional alterations.

METHODS

This a secondary analysis of the Health, Wellness, and Aging survey conducted in the year 2015. Diagnosis of glaucoma was obtained from self-report. Functional variables were assessed through activities of daily living questionnaires. A descriptive analysis followed by bivariate and multivariate regression models adjusting for confounding variables was conducted.

RESULTS

Self-reported prevalence of glaucoma was 5.67%, with higher rate in women, OR 1.22 (1.13-1.40) p = .003, older age OR 1.02 (1.01-1.02) p < .001, and with higher education OR 1.38 (1.28-1.50) p < .001. Glaucoma was independently associated with diabetes OR 1.37 (1.18-1.61) p  < .001 and hypertension 1.26 (1.08-1.46) p = .003. It also showed statistically significant correlations with poor SRH OR 1.15 (1.02-1.32) p < .001, self-reported visual impairment 1.73 (1.50-2.01) p < .001, and impairment in money management OR 1.59 (1.16-2.08) p  = .002, grocery shopping OR 1.57 (1.26-1.96) p < .001 and preparing meals OR 1.31 (1.06-1.63) p  = .013 and having had falls during the last year OR 1.14 (1.01-1.31) p = 0.041.

CONCLUSION

Our findings suggest the self-reported prevalence of glaucoma in older adults in Colombia to be higher than reported data. Glaucoma and visual impairment in older adults represent a public health concern, since glaucoma was associated with adverse outcomes like functional loss and risk of falling, affecting the quality of life and their participation in society.

Síntomas depresivos y prevalencia de fragilidad en adultos mayores colombianos. Análisis secundario de la encuesta SABE Colombia 2015

Objetivo: Analizar la relación entre los síntomas depresivos y la prevalencia de fragilidad medida como fenotipo de fragilidad. Material y métodos: Este es un estudio secundario de la encuesta SABE Colombia 2015. Se utilizaron las puntuaciones de la escala Yesavage como variable independiente, la prevalencia de fragilidad calculada con el fenotipo de fragilidad de Fried. Realizamos un análisis descriptivo y bivariado de la muestra, seguido de un análisis multivariado ajustando por variables de confusión. Resultados: Analizamos información de un total de 19,004 participantes mayores de 60 años, participantes sin deterioro cognitivo de la encuesta, a quienes se les administró la escala Yesavage. La media de edad fue 69.25 años, el 56% de los participantes eran mujeres, la prevalencia de fragilidad fue del 12% y se encontró síntomas depresivos en 57,4% de la muestra. En el análisis multivariado encontramos asociaciones estadísticamente significativas entre las puntuaciones más altas de la escala Yesavage y la presencia de fragilidad (Yesavage 5-10) OR 1.20 (0.98-1.46) p valor 0.066 y (Yesavage >10) 2.05 (1.46-2.89) <0.001 después de ajustar por edad, sexo, comorbilidades, funcionalidad, escolaridad y estado marital Conclusiones: Nuestro estudio muestra asociaciones estadísticamente significativas entre la presencia de síntomas depresivos medidos con la escala Yesavage y la prevalencia de fragilidad según el índice de Fried. Aunque existe escasa evidencia en cuanto a la asociación de estas dos entidades en Latinoamérica, nuestros resultados son consistentes con estudios previos en la región.

Polypharmacy is associated with functional decline in Alzheimer's disease and Lewy body dementia

BACKGROUND

In dementia, a number of factors may influence functional decline in addition to cognition. In this study, we aimed to study the potential association of the number of prescribed medications with functional decline trajectories over a five-year follow-up in people diagnosed with mild Alzheimer's disease (AD) or Lewy Body dementia (LBD).

METHODS

This is a longitudinal analysis of a Norwegian cohort study entitled "The Dementia Study of Western Norway". We included 196 patients newly diagnosed with AD (n=111) and LBD (n=85), followed annually for 5 years. We conducted linear mixed-effects models to analyse the association of the number of medications with functional decline measured by the Rapid Disability Rating Scale - 2.

RESULTS

The mean prescribed medications at baseline was 4.18∓2.60, for AD 3.92∓2.51 and LBD 4.52∓2.70. The number of medications increased during the follow-up; at year five the mean for AD was 7.28∓4.42 and for LBD 8.11∓5.16. Using more medications was associated with faster functional decline in AD (Est 0.04, SE 0.01, p-value 0.003) and LBD (Est 0.08, SE 0.03, p-value 0.008) after adjusting for age, sex, comorbidity, neuropsychiatric symptoms, and cognition. For each medication added during the follow-up, functional trajectories worsened by 1% for AD and 2% for LBD. The number of medications was not associated with cognitive decline.

CONCLUSION

We found that higher number of medications was related to a faster functional decline, both in AD and LBD. With disease progression, there was an increase in the number of medications. Prescription in dementia should be carefully assessed, possibly improving the functional prognosis.

Prostate cancer screening and socioeconomic disparities in Mexican older adults

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Edentulism and its relationship with self-rated health: secondary analysis of the SABE Ecuador 2009 Study

Edentulism is related to a number of conditions in older adults, impacting their overall health status and thus their quality of life and relationship with the environment. At the same time, self-rated health has been shown to be an accurate marker of overall health status. However there is little information on how edentulism relates to self-rated health in older adults of Hispanic origin. The aim of this study was to evaluate the impact of edentulism on self-rated health in older adults. We analyzed data from SABE Ecuador 2009, a cross-sectional study that included a probabilistic representative sample of 5, 235 community-dwelling older adults aged 60 years or older. The dependent variable was self-rated health and the independent variable was edentulism, with age, sex and comorbidities as confounding variables. In order to test the independent association of edentulism with self-rated health, a logistic regression model was fitted. Out of the whole sample, 77. 13% of older adults reported having fair/poor self-rated health. We found an independent association between edentulism and self-rated health with incremental risk according to number of missingteeth, ranging from OR 1. 35 (CI 95% 0. 75 - 2. 43) p 0. 32 for less than 4 missing teeth to OR 1. 88(1. 06 - 3. 32) p 0. 029for more than half of teeth missing. Even though oral health has long been considered separately from the rest of the body and mind, it is clear from our results that oral health is a very important component of global health status in the elderly.