Effects of ω-3, DHA, EPA, Souvenaid in Alzheimer's Disease: A Systematic Review and Meta-analysis

• Published in: Archives of physical medicine and rehabilitation Vol. 106; no. 4; p. e107
• Main Authors: Manzoor, Tanseem, Borges-Sosa, Omar, Srinivas, Samyuktha, Martinez, Ernesto Calderon, Saji, Stephin Zachariah, Ore, Jonathan Victor Salazar, Mareddy, Naga Sai Rasagna, Vanna, Mariela Di, Shanableh, Yasemin Al, Taneja, Rishabh
• Format: Journal Article
• Language: English
• Published: Elsevier Inc 01.04.2025
• Subjects: Alzheimer's disease; Cognitive decline; Dementia, Docosahexaenoic acid; Omega 3; Rehabilitation; Cognitive decline; Omega 3; Dementia, Docosahexaenoic acid; Rehabilitation; Alzheimer's disease
• ISSN: 0003-9993
• DOI: 10.1016/j.apmr.2025.01.277

To investigate the role of n-3 polyunsaturated fatty acid (n-3-PUFA), eicosapentaenoic acid (EPA), docosahexaenoic acid (DHA), and Souvenaid in Alzheimer's disease (AD) management and to examine the effect of these interventions on cognition, ventricular volume, and adverse events. We systematically searched PubMed, Scopus, Web of Science, Cochrane, and Embase for randomized controlled trials, cohorts, and case-control studies involving adult patients with AD receiving dietary supplementation with n-3-PUFA, EPA, DHA, or Souvenaid from 2003 to 2024. The selected studies assessed the impact of ω-3, DHA, EPA, and the nutritional supplement Souvenaid on adult patients with AD. The interventions involved oral supplements or any other method of consumption. Initial title and abstract screening and full-text analysis were undertaken by 2 independent reviewers based on predetermined inclusion and exclusion criteria, and disagreements were resolved by third blinded reviewer. The study adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses flow chart to guide the systematic review article selection process, resulting in a uniform dataset and enhancing the accuracy and reliability of the findings. Risks of bias were assessed using Cochrane Risk of Bias 2.0 tool for randomized controlled trials and Newcastle-Ottawa scale for cohort and case-control studies by 2 independent reviews, with a third blind reviewer resolving disagreements. Our analysis comprised 14 studies including 2766 subjects meeting inclusion criteria. The majority of publications reported positive cognitive outcomes from supplements (58%). Gastrointestinal symptoms predominated as the most-reported adverse events. The Clinical Dementia Rating scale indicated a reduction in cognitive decline progression (standardized mean difference, −0.4127; 95% confidence interval, −0.5926 to −0.2327), with no subgroup differences observed among various dietary supplement interventions. However, no significant differences were evident in other outcomes, including Alzheimer's Disease Cooperative Study–Activities of Daily Living Scale, Mini-Mental State Examination, Alzheimer's Disease Assessment Scale-Cognitive, adverse events, and ventricular volume. Of note, Souvenaid exhibited a significant negative effect (standardized mean difference, −0.3593; 95% confidence interval, −0.5834 to −0.1352) on ventricular volumes. Supplementation with n-3-PUFAs shows promise in slowing cognitive decline in patients with AD, as demonstrated by the Clinical Dementia Rating scale. However, our findings reveal no discernible differences between different n-3-PUFA supplements. These results underscore both the potential benefits and limitations of dietary interventions in managing cognitive decline in patients with AD. none.