부산대학교 도서관

Background:Polyunsaturated fatty acids (PUFA) are essential nutrients for normal brain function, constituting nearly 35% of brain lipids. Experimental studies suggest that omega-3 and omega-6 PUFA, present in plant foods and fish, may reduce risk of dementia. Most prior studies assessed self-reported estimates and used one baseline measure of objective PUFA biomarkers, which may lead to poor estimation of long-term risk.Aims:Investigate prospective associations of serial measures of plasma phospholipid omega-3 (ALA [18:3], EPA [20:5], DPA [22:5], DHA [22:6]) and omega-6 (LA [18:2], AA [20:4]) PUFA with risk of total dementia and dementia subtypes (Alzheimer’s Disease [AD] and vascular and mixed dementia [VaD]) in older adults in the Cardiovascular Health Study.Methods:Among 3,307 U.S. adults aged ≥65y and free of stroke, cognitive impairment or dementia at baseline, circulating levels were measured serially at baseline, 6 years and 13 years using standardized methods. Dementia was identified using neuropsychological tests or hospitalization records adjudicated by CHS Cognition Study investigators, and by ICD-9 codes from linked Medicare administrative data. Prospective associations were assessed by multivariate-adjusted Cox models incorporating time-varying fatty acid measures and covariates.Results:During 22,288 person-years of follow-up (1992-2015), 1,164 dementia cases were identified, with 530 AD and 256 VaD cases. After adjustment for demographic, lifestyle and dietary factors, higher circulating levels of AA were associated with lower risk of total dementia and AD (see Table). There were no statistically significant associations between circulating omega-3 PUFA or LA and incident dementia.Conclusion:In older adults, higher circulating AA was inversely associated with risk of total dementia and AD, but not other dementia subtypes. These findings highlight the need to identify mechanisms influencing circulating AA levels that could be effective for the prevention of dementia later in life.