Effect of Long-Term Omega 3 Polyunsaturated Fatty Acid Supplementation with or without Multidomain Lifestyle Intervention on Muscle Strength in Older Adults: Secondary Analysis of the Multidomain Alzheimer Preventive Trial (MAPT)

Abstract

Background: The benefits of long-term omega 3 polyunsaturated fatty acid (ω3-PUFA) supplementation on muscle strength in older adults remains to be investigated. Objectives: We assessed the effect of ω3-PUFA supplementation and a multidomain (physical activity, cognitive training, and nutritional advice), alone or in combination, compared with placebo, on muscle strength. We also hypothesized that ω3-PUFA supplementation resulted in additional benefit in participants with a low docosahexaenoic acid (DHA)/eicosapentaenoic acid (EPA) erythrocyte level at baseline and high adherence to the multidomain intervention sessions. Design: We performed secondary analyses of the Multidomain Alzheimer Preventive Trial (MAPT), a 3-year, multicenter, randomized, placebo-controlled trial with four parallel groups. Participants were non-demented, aged 70 years or older. They were recruited in 13 memory clinics in France and Monaco between 30 May 2008 and 24 February 2011. Participants were randomly assigned to either ω3-PUFA alone (two capsules a day providing a total daily dose of 800 mg DHA and 225 mg EPA), ω3-PUFA plus the multidomain intervention (43 group sessions integrating advice for physical activity (PA), and nutrition, cognitive training, and three preventive consultations), the multidomain intervention plus placebo, or placebo alone. Our primary outcome was the change from baseline to 36 months of the muscle strength assessed with the repeated chair stand test and handgrip strength. Results: A total of 1680 participants (75.34 years ± 4.42) were randomized. In the modified intention-to-treat population (n = 1679), no significant differences at 3-year follow-up were observed in the repeated chair stand test score between any of the three intervention groups and the placebo group. The between-group differences compared with placebo were −0.05388 (−0.6800 to 0.5723; Standard Error, SE = 0.3192; p = 0.8660) for the ω3-PUFA group, −0.3936 (−1.0217 to 0.2345; SE = 0.3180; p = 0.2192) for the multidomain intervention plus placebo group, and −0.6017 (−1.2255 to 0.02222; SE = 0.2092; p = 0.3202) for the combined intervention group. No significant effect was also found for the handgrip strength. Sensitivity analyses performed among participants with low (DHA+EPA) erythrocyte level at baseline (first quartile vs. others) or highly adherent participants (≥75% of the multidomain intervention sessions) revealed similar results. Conclusion: Low dose ω3-PUFA supplementation, either alone or in combination with a multidomain lifestyle intervention comprising physical activity counselling, had no significant effects on muscle strength over 3 years in elderly people.

The Effects of a 6-Month High Dose Omega-3 and Omega-6 Polyunsaturated Fatty Acids and Antioxidant Vitamins Supplementation on Cognitive Function and Functional Capacity in Older Adults with Mild Cognitive Impairment

“…However, we should note that the reduction observed in TUG (1.7 s, 8%) was not statistically significant, in contrast with a previous study that found a smaller but significant reduction in TUG time (0.5 s, 7%) [30]. Moreover, the same study along with others did not find any effect of supplementation on handgrip strength, similar to the present study [28,29]. In contrast, Smith et al reported that 6 months supplementation with 1.86 g/d EPA and 1.50 g/d DHA in healthy older adults led to significant beneficial effects on handgrip strength, and upper-and lower-body 1-RM muscle strength [27].…”

“…In the last decade, there have been numerous studies demonstrating a positive impact of EPA and DHA supplementation on skeletal muscle strength and mass, even though this was not confirmed in other studies [25][26][27][28][29]. However, only few studies have examined the effect of omega-3 fatty acid supplementation on the physical performance of elderly people [27][28][29][30][31]. Nevertheless, based on these limited data of various doses and supplementation duration, there is conflicting evidence as to whether omega-3 alone or in combination with omega-6 supplementation could confer a beneficial effect on muscle function in older adults as a monotherapy and without an exercise component.…”

“…Moreover, it is well recognized that muscle weakness and poor functional ability are strong predictors of clinically relevant adverse outcomes in older adults including falls, dementia, nursing home admission and mortality [21][22][23][24]. In the last decade, there have been numerous studies demonstrating a positive impact of EPA and DHA supplementation on skeletal muscle strength and mass, even though this was not confirmed in other studies [25][26][27][28][29]. However, only few studies have examined the effect of omega-3 fatty acid supplementation on the physical performance of elderly people [27][28][29][30][31].…”

Expert Opinion on Benefits of Long-Chain Omega-3 Fatty Acids (DHA and EPA) in Aging and Clinical Nutrition

“…However, 12 weeks supplementation with 440 mg/d DHA and 660 mg/d EPA had no effect on muscle mass or handgrip strength in community-dwelling older people (mean age 74.6 ± 8.0 years) [117]. In another study, 800 mg/d DHA and 225 mg/d EPA in combination with physical exercise, cognitive training and nutritional counseling had no effect on different measures of muscle strength in older people [118]. Based on the evidence from these trials, doses of 3000 mg/d of DHA plus EPA or more (with preferably more than 800 mg/d EPA) may be required for positive effects on physical performance in older adults [114,116] as lower doses have not had an effect [117,118].…”

What works and what does not work in Alzheimer’s disease? From interventions on risk factors to anti‐amyloid trials

“…There are other multidomain interventional studies in individuals with cognitive impairment or AD that have been completed (Nousia et al, 2018;Rolland, Barreto, Maltais, Guyonnet, Cantet, Andrieu, & Vellas, 2019;Vellas et al, 2014)…”