A combination of exercise, nutrition, and cognitive counseling along with omega-3 fatty acid supplementation slowed cognitive decline in older adults with memory impairment, researchers found. The Multidomain Alzheimer’s Preventive Trial (MAPT) set out to assess the impact of a multidomain program of nutritional counseling, exercise, and cognitive and social stimulation — with or without supplementation of an omega-3 fatty acid, docosahexaenoic acid (DHA) — on preserving cognitive function in older patients. Patients were counselled on three areas: nutrition, exercise, and cognition. Patients were given nutritional advice, instructed to do 150 minutes of moderate exercise each week by walking 30 minutes a day, and cognitive training focused on improved memory. The primary endpoint was the change in cognitive function at 3 years as measured by a composite cognitive battery involving episodic memory, spatial orientation, executive function, and verbal fluency.
Vellas and colleagues found a significant effect for the multidomain groups, with or without DHA supplementation, leading to significantly better outcomes than DHA supplementation alone or placebo, they reported. Vellas added that the largest effect was seen in the group that had the combination of DHA and multidomain counseling. In prespecified analyses, those with worse cognitive function benefited more from the combination of DHA and counseling, as did those with lower levels of DHA at baseline. And patients who were ApoE4 positive garnered the most benefit from the combination, Vellas reported.