TABLE 4.
Characteristics of 48 studies included in the systematic review and meta-analysis
| N | First author, y | Design, Cohort name, Country | Follow-up duration (mean) | Age at baseline (mean) | Female (%) | Participants | Cases | Outcome | Categories | Exposure measurement | Study quality |
|---|---|---|---|---|---|---|---|---|---|---|---|
| 1 | Li 2021 | RC; ADNI; Canada, Unites States | 2.8y | 73y | 46% | 11351/867 2 | 3071/2872 | AD | 1 omega-3 2 omega-3, DHA, ALA | FFQ | 6 |
| 2 | Melo van Lent 2021 [27] | PC; AgeCoDe; Germany | 7y | 84y | 64% | 1264 | 233 | AD | 2 omega-3; DHA; EPA; ALA | Blood sample | 7 |
| 3 | Koch 2021 [28] | PNCC; GEMS; Unites States | 4.8y | 78y | 47% | 1252 | 498/334 | Dementia; AD | 2 omega-3; DHA; EPA; ALA | Blood sample | 6.5 |
| 4 | Nozaki 2021 [29] | PC; JPHC; Japan | 15y | 73y | 69% | 1127 | 380/54 | Dementia; MCI | 1 PUFA; omega-3; EPA; DHA | FFQ | 5.5 |
| 5 | Thomas 2020 [30] | PC; 3C; France | 174y | 74y | NA | 1279 | 271 | Dementia | 2 EPA; DHA | Blood sample | 7.5 |
| 6 | Jiang et al. [31] 2020 | PC; SCHS; Singapore | 20y | 45-74y | NA | 16736 | 2397 | CD | 1 PUFA; omega-3; ALA | FFQ | 8 |
| 7 | Gustafson et al. [32] 2020 | PC; WHICAP; Unites States | 4.9y | 76y | 67% | 2612 | 380 | AD | 1 PUFA; omega-3; DHA; EPA | FFQ | 7 |
| 8 | Mao 2019 [33] | PC; CARDIA; Unites States | 25y | 25y | 56% | 3231 | NA | CD | 1 omega-3; DHA; EPA | CARDI questionnaire | 7.5 |
| 9 | Bigornia 2018 [34] | PC; BPRHS; Unites States | 2y | 45-75y | 73% | 1032 | 151 | CD | 1 and 3 ALA; EPA; DHA | FFQ and blood sample | 6.5 |
| 10 | Haution-bitker 2018 [35] | PNCC; GERIOX; France | 11.55m | 80y | 65% | 1402/703 | 44 | CD | 2 and 3 omega-3; EPA; DHA; ALA | Blood sample | 3 |
| 11 | Nooyens 2018 [36] | PC; DS; Netherlands | 5y | 43-70y | 51% | 2612 | NA | CD | 1 PUFA; omega-3; DHA; ALA; EPA | FFQ | 7 |
| 12 | Ammann 2017 [37] | PC; WHIMS-ECHO; Unites States | 9.85y | 70y | 100% | 6706 | 587/671 | Dementia; MCI | 3 omega-3; DHA; EPA | Blood sample | 7.5 |
| 13 | Yamagishi 2017 [38] | PNCC; CIRCS; Japan | 12.5y | 64y | 66% | 7586 | 315 | Dementia | 2 DHA; EPA; ALA | Blood sample (serum) | 7.5 |
| 14 | Vanderest 2016 [39] | PC; MAP; Unites States | 4.9y | 81y | 75% | 915 | NA | CD | 1 omega3; ALA | FFQ | 7 |
| 15 | Otsuka 2014 [40] | PC; NILS-LSA; Japan | 10.2y | 67y | 46% | 430 | 36 | CD | 2 DHA; EPA | Blood sample | 7 |
| 16 | Bowman 2013 [41] | PC; OBAS; Unites States | 3.9y | 86y | 62% | 86 | NA | CD | 2 omega-3 | Blood sample | 6.5 |
| 17 | Titova 2013 [42] | PC; PIVUS; Sweden | 5y | 70y | 48% | 252 | NA | CD | 1 omega-3 | 7-d food protocol | 6.5 |
| 18 | Ammann 2013 [43] | PC; WHISCA; Unites States | 5.95y | 73y | 100% | 2157 | NA | CD | 3 omega-3 | Blood sample | 6 |
| 19 | Okereke 2012 [44] | PC; WHS; Unites States | 44y | 66y | 100% | 6183 | NA | CD | 1 PUFA | FFQ | 5 |
| 20 | Ronnemaa 2012 [45] | PC; ULSAM; Sweden | 354y | 50y | 0% | 2009 | 213/91 | Dementia; AD | 2 DHA; EPA; ALA | Blood sample | 6.5 |
| 21 | Lopez 2011 [46] | PC; RBS; Unites States | 3y | 80y | 44% | 2421/2662 | 42/30 | Dementia; AD | 1 and 2 DHA | FFQ | 6 |
| 22 | Kesse-guyot 2011 [47] | PC; SUVIMAX 2; France | 13y | 51y | 46% | 3294 | NA | CD | 1 omega-3; DHA; EPA | Repeated 24-h dietary records | 6 |
| 23 | Gao 2011 [48] | PC; SLAS; Singapore | 1.55y | 66y | 66% | 1475 | NA | CD | 1 omega-3 | A self-reported single question | 5.5 |
| 24 | Samieri 2011 [49] | PC; 3C; France | 74y | 74y | 61% | 1228 | NA | CD | 2 DHA; EPA | Blood sample | 7.5 |
| 25 | Vercambre 2010 [50] | PC; WACS; Unites States | 5.44y | 72y | 100% | 2551 | NA | CD | 1 PUFA | Willett FFQ | 5 |
| 26 | Vercambre 2009 [51] | PC; E3N; France | 134y | 78y | 100% | 4809 | 598 | CD | 1 PUFA; omega-3; ALA | FFQ | 5.5 |
| 27 | Devore 2009 [52] | PC; RS; Netherlands | 9.6y | 68y | 59% | 5395 | 465 | Dementia; | 1 omega-3; DHA; EPA | SFFQ | 7.5 |
| 28 | Devore 2009(2) [53] | PC; NHS; Unites States | 4.2y | 74y | 100% | 1486 | NA | CD | 1 PUFA | Willett FFQ | 6 |
| 29 | Kroger 2009 [54] | PC; CSHA; Canada | 4.95y | 81y | 66% | 663 | 149/105 | Dementia; AD | 3 omega-3; DHA; EPA | Blood sample | 7 |
| 30 | Vanderest 2009 [55] | PC; NAS; Unites States | 6y | 68y | 0% | 1025 | NA | CD | 1 omega-3; | Willett FFQ | 4 |
| 31 | Samieri 2008 [56] | PC; 3C; France | 4y4 | 74y | 62% | 1214 | 65 | Dementia | 2 PUFA; omega-3; DHA; EPA;ALA | Blood sample | 6.5 |
| 32 | Eskelinen 2008 [57] | PC; CAIDE; Finland | 21y | 50y | 62% | 1449 | 82 | MCI | 1 PUFA | FFQ | 6.5 |
| 33 | Velho 2008 [58] | PC; NA; Portugal | 8.5m | 70y | 71% | 187 | NA | CD | 1 omega-3 | 3- d food dietary record | 5 |
| 34 | Whalley 2008 [59] | PC; SCRE; Scotland, United Kingdom | 44y | 64y | 60% | 120 | NA | CD | 3 omega-3; DHA; EPA | Blood sample | 5 |
| 35 | Barberger-Gateau 2007 [60] | PC; 3C; France | 3.5y | ≥65y | NA | 8085 | 281/183 | Dementia; AD | 1 omega-3 | FFQ | 7 |
| 36 | Beydoun et al. [14] 2007 | PC; ARIC; Unites States | 6y | 50-65y | 55% | 78141/22512 | 486/140 | CD | 1,2 omega-3; ALA | Blood sample | 5.5 |
| 37 | Vangelder 2007 [61] | PC; ZES ;Netherlands | 5y | 70-89y | 51% | 210 | NA | CD | 1 omega-3 | Cross-check dietary history method | 6 |
| 38 | Dullemeijer 2007 [62] | PC;FACIT; Netherlands | 3y | 50-70y | 0% | 404 | NA | CD | 2 PUFA; omega-3; DHA; EPA; ALA | Blood sample | 6.5 |
| 39 | Solfrizzi 2006(2) [63] | PC; ILSA; Italy | 2.65y | 65-84y | 28% | 278 | 18 | MCI | 1 PUFA | FFQ | 5.5 |
| 40 | Schaefer 2006 [64] | PC; FHS; Unites States | 9.1y | 76y | 45% | 4881/8992 | 79 | AD | 1 and 2 DHA | FFQ | 7 |
| 41 | Laitinen 2006 [65] | PC; CAIDE; Finland | 21y | 50y | 64% | 1341 | 117/76 | Dementia; AD | 1 PUFA | FFQ | 8.5 |
| 42 | Solfrizzi 2006 [66] | PC; ILSA; Italy | 8.55y | 73y | 62% | 278 | NA | CD | 1PUFA | FFQ | 7 |
| 43 | Morris 2005 [67] | PC; CHAP; Unites States | 64y | 74y | 45% | 3718 | NA | CD | 1 omega-3; DHA; EPA; ALA | FFQ | 6.5 |
| 44 | Morris 2003 [68] | PC; CHAP; Unites States | 3.9y | 65-94y | 62% | 815 | 131 | AD | 1 omega-3; DHA; EPA; ALA | FFQ | 6 |
| 45 | Heude 2003 [69] | PC; EVA; France | 4y | 63-74y | 61% | 246 | 27 | CD | 3 PUFA; omega-3; DHA; EPA | Blood sample | 5 |
| 46 | Laurin 2003 [70] | PC; CSHA; Canada | 5y | 77y | 58% | 174 | 11 | Dementia | 2 PUFA; omega-3; DHA; EPA | Blood sample | 7.5 |
| 47 | Engelhart 2002 [71] | PC; RS;Netherlands | 6.0y | 68y | 66% | 5395 | 197/146 /29 | Dementia; AD; VD | 1 PUFA; omega-3 | FFQ | 6.5 |
| 48 | Kalmijn 1997 [72] | PC; ZES; Netherlands | 3y | 69-89y | 59% | 342 | 51 | CD | 1PUFA; omega-3; DHA; EPA | Cross-check dietary history method | 4.5 |
Abbreviations: AD, Alzheimer’s disease; ADNI, Alzheimer’s Disease Neuroimaging Initiative; AgeCoDe, German Study on Aging, Cognition, and Dementia; BPRHS, Boston Puerto Rican Health Study; CAIDE, Cardiovascular risk factors, Aging and Dementia study; CARDIA, Coronary Artery Risk Development in Young Adults; CD, cognitive decline; CIRCS, Circulatory Risk in Communities Study; CHAP, Chicago Health and Aging Project; CHCS, Cardiovascular Health Cognition Study; CHNS, China Health and Nutrition Survey; CLHLS, Chinese Longitudinal Health Longevity Study; CSHA, Canadian Study of Health and Aging; DS, Doetinchem Study; EVA, Etude du Vieillissement Artériel Study; E3N, Etude Epideámiologique de Femmes de la Mutuelle Geáneárale de l’Education Nationale study; FACIT, Folic Acid and Carotid Intima-media Thickness Trial; FHS, Framingham Heart Study; GEMS, Ginkgo Evaluation of Memory Study; ILSA, Italian Longitudinal Study on Aging; JPHC, Japan Public Health Center-based Prospective Study; MAP, Rush Memory and Aging Project; MCI, mild cognitive impairment; NA, not available; NAS, Normative Aging Study; NILS-LSA, National Institute for Longevity Sciences-Longitudinal Study for Aging; NHS, Nurses’ Health Study; OBAS, Oregon Brain Aging Study; Omega-3, omega-3 polyunsaturated fatty acid; PC, prospective cohort; PIVUS, Prospective Investigation of the Vasculature in Uppsala Seniors Cohort; PNCC, Prospective nested case-control study; PUFA, polyunsaturated fatty acid; RBS, Rancho Bernardo Study; RC, retrospective cohort; RS, Rotterdam Study; SCHS, Singapore Chinese Health Study; SCRE, Scottish Council for Research in Education; SLAS, Singapore Longitudinal Aging Study; SUVIMAX, Supplementation with Antioxidant Vitamins and Minerals; ULSAM, Uppsala Longitudinal Study of Adult Men cohort; VD, vascular dementia; WACS, Women’s Antioxidant Cardiovascular Study; WHICAP, Washington Heights-Hamilton Heights-Inwood Columbia Aging Project; WHISCA, Women's Health Initiative Study of Cognitive Aging; WHIMS-ECHO, Woman's Health Initiative Memory Study - Epidemiology of Cognitive Health Outcomes; WHS, Women's Health Study; ZES, Zutphen Elderly Study; 3C, Three-City Study.
dietary
plasma/serum
erythrocyte
max age
median age