Effect of long-term omega 3 polyunsaturated fatty acid supplementation with or without multidomain intervention on cognitive function in elderly adults with memory complaints (MAPT): a randomised, placebo-controlled trial
- Type de publi. : Article dans une revue
- Date de publi. : 01/05/2017
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Auteurs :
Sandrine AndrieuSophie GuyonnetNicola ColeyChristelle CantetMarc BonnefoySerge BordesLawrence BoriesMarie CufiThierry DantoineFrançois DartiguesFrançois DesclauxAudrey GabelleYannick GasnierAlain PesceKristel SudresJacques TouchonPhilippe RobertOlivier RouaudPhilippe P. LegrandPierre PayouxJean-Paul CaubereMichael WeinerIsabelle CarriePierre OussetBruno VellasBrigitte BrigitteCatherine FaisantFrançois LalaJulien DelrieuHélène VillarsEmeline CombrouzeCarole BadufleAudrey ZuerasChristophe MorinGabor Abellan van KanCharlotte DupuyYves RollandCeline CaillaudBertrand FougèreSherry WillisSylvie BellevilleBrigitte GilbertFrancine FontaineMarc MarcetFleur DelvaAlexandra FoubertSandrine CerdaMarie Noëlle-CuffiCorinne CostesPatrick ManckoundiaValérie QuipourtSophie MarilierEvelyne FranonMarie PaderMarie BassetBruno LapoujadeValérie FaureMichael LiYung TongChristine Malick-LoiseauEvelyne Cazaban-CampistronColette BlatgeCécile Laubarie-MouretIsabelle SaulnierPierre ClémentMarie PicatLaurence Bernard-BourzeixStéphanie WilleboisIléana DesormaisNoëlle CardinaudPierre LivetPascale RebaudetClaire GédéonCatherine BurdetFlavien TerracolStéphanie RothSylvie ChaillouSandrine LouchartNicolas LebrunNadège Barro-BelayguesKarim BennysAurélia RomanoLynda TouatiCecilia MarelliCecile PaysFranck Le DuffClaire GervaisSébastien GonfrierDanièle BegorreChristian CarpuatKhaled KhalesFrançois LefebvreSamira Misbah El IdrissiPierre SkolilPierre SallesCarole DufouilStéphane LehéricyMarie ChupinFrançois ManginAli BouhayiaMichèle AllardFréderic RicolfiDominique DuboisMarie PauleBonceour MartelFrançois CottonAlain BonaféStéphane ChanaletFrançois HugonFabrice BonnevilleChristophe CognardFrançois CholletThierry VoisinSophie PeifferAnne HitzelMichel ZancaJacques MonteilJacques DarcourtLaurent MolinierHélène DerumeauxNadège CostaChristian VincentBertrand PerretClaire VinelPascale Olivier-Abbal
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Organismes :
Institut National de la Santé et de la Recherche Médicale
Université Toulouse III - Paul Sabatier
Centre Hospitalier Universitaire de Toulouse
Université Toulouse III - Paul Sabatier
Institut National de la Santé et de la Recherche Médicale
Centre Hospitalier Universitaire de Toulouse
Institut National de la Santé et de la Recherche Médicale
Université Toulouse III - Paul Sabatier
Centre Hospitalier Universitaire de Toulouse
Institut National de la Santé et de la Recherche Médicale
Université Toulouse III - Paul Sabatier
Centre Hospitalier Universitaire de Toulouse
Centre Hospitalier Lyon Sud [CHU - HCL]
Cardiovasculaire, métabolisme, diabétologie et nutrition
Hopital de Tarbes
CHU Charles Foix [AP-HP]
Hopital de castres
CHU Limoges
CHU Bordeaux
Hopital Lavaur
Département de neurologie [Montpellier]
Cellules Souches, Plasticité Cellulaire, Médecine Régénératrice et Immunothérapies (IRMB)
Hopital de Tarbes
Hôpital Princesse Grace [Monaco]
Centre hospitalier de Montauban
Département de neurologie [Montpellier]
Neuropsychiatrie : recherche épidémiologique et clinique
Cognition Behaviour Technology
Centre Mémoire Ressources et Recherche [Dijon]
Institut National de la Recherche Agronomique
Service de Médecine Nucléaire - Rangueil [CHU Toulouse]
Centre de Recherche Pierre Fabre
University of California [San Francisco]
Centre Hospitalier Universitaire de Toulouse
Centre Hospitalier Universitaire de Toulouse
Institut National de la Santé et de la Recherche Médicale
Université Toulouse III - Paul Sabatier
Centre Hospitalier Universitaire de Toulouse
Institut National de la Santé et de la Recherche Médicale
Université Toulouse III - Paul Sabatier
Service d'Etudes du Comportement des Matériaux de Conditionnement
Interactions, transferts, ruptures artistiques et culturelles
Université Paris Descartes - École de sages-femmes Baudelocque
Gérontopôle
Epidémiologie et analyses en santé publique : risques, maladies chroniques et handicaps
Service de Génétique Médicale [CHU Poitiers]
Epidémiologie et Biostatistique [Bordeaux]
Service de médecine gériatrique (CHU de Dijon - Centre gériatrique de Champmaillot - EHPAD)
Service de médecine gériatrique (CHU de Dijon - Centre gériatrique de Champmaillot - EHPAD)
Service de médecine gériatrique (CHU de Dijon - Centre gériatrique de Champmaillot - EHPAD)
Cabinet médical [Dijon]
Handicap, Activité, Vieillissement, Autonomie, Environnement
Sciences et Société ; Historicité, Éducation et Pratiques
Centre de Mémoire de Ressources et de Recherches [Limoges]
Service de Chirurgie Thoracique et Vasculaire - Médecine vasculaire [CHU Limoges]
Handicap, Activité, Vieillissement, Autonomie, Environnement
Centre d'EPistémologie et d'ERgologie Comparatives
Centre de droit privé fondamental
Institut Cochin
Département de neurologie [Montpellier]
Centre de Recherche de l'Institut du Cerveau et de la Moelle épinière
Service de Neurologie
Laboratoire d'Informatique Médicale
The Smithsonian Museum Conservation Institute
Chercheur indépendant
Centre Léon Bérard [Lyon]
Neuroépidémiologie
Institut du Cerveau et de la Moëlle Epinière = Brain and Spine Institute
Institut du Cerveau et de la Moëlle Epinière = Brain and Spine Institute
Institut de Neurosciences cognitives et intégratives d'Aquitaine
Service de neuroradiologie, imagerie des urgences [CHU de Dijon]
Urgence et post-urgence psychiatrique
Hôpital Pasteur [Nice]
Centre Hospitalier Universitaire de Toulouse
Institut des Neurosciences de Montpellier
Centre Hospitalier Universitaire de Toulouse
Centre de recherche sur l'Inflammation
Service de Médecine Nucléaire - Pierre-Paul Riquet [CHU Toulouse]
Hôpital Gui de Chauliac [CHU Montpellier]
Transporteurs et Imagerie, Radiothérapie en Oncologie et Mécanismes biologiques des Altérations du Tissu Osseux
Département d'Information Médicale [CHU Toulouse]
Département d'Information Médicale [CHU Toulouse]
Centre de Physiopathologie Toulouse Purpan
Institut des Maladies Métaboliques et Cardiovasculaires
- Publié dans The Lancet Neurology le 27/10/2020
Résumé : BACKGROUND:No large trials have been done to investigate the efficacy of an intervention combining a specific compound and several lifestyle interventions compared with placebo for the prevention of cognitive decline. We tested the effect of omega 3 polyunsaturated fatty acid supplementation and a multidomain intervention (physical activity, cognitive training, and nutritional advice), alone or in combination, compared with placebo, on cognitive decline.METHODS:The Multidomain Alzheimer Preventive Trial was a 3-year, multicentre, randomised, placebo-controlled superiority trial with four parallel groups at 13 memory centres in France and Monaco. Participants were non-demented, aged 70 years or older, and community-dwelling, and had either relayed a spontaneous memory complaint to their physician, limitations in one instrumental activity of daily living, or slow gait speed. They were randomly assigned (1:1:1:1) to either the multidomain intervention (43 group sessions integrating cognitive training, physical activity, and nutrition, and three preventive consultations) plus omega 3 polyunsaturated fatty acids (ie, two capsules a day providing a total daily dose of 800 mg docosahexaenoic acid and 225 mg eicosapentaenoic acid), the multidomain intervention plus placebo, omega 3 polyunsaturated fatty acids alone, or placebo alone. A computer-generated randomisation procedure was used to stratify patients by centre. All participants and study staff were blinded to polyunsaturated fatty acid or placebo assignment, but were unblinded to the multidomain intervention component. Assessment of cognitive outcomes was done by independent neuropsychologists blinded to group assignment. The primary outcome was change from baseline to 36 months on a composite Z score combining four cognitive tests (free and total recall of the Free and Cued Selective Reminding test, ten Mini-Mental State Examination orientation items, Digit Symbol Substitution Test, and Category Naming Test) in the modified intention-to-treat population. The trial was registered with ClinicalTrials.gov (NCT00672685).FINDINGS:1680 participants were enrolled and randomly allocated between May 30, 2008, and Feb 24, 2011. In the modified intention-to-treat population (n=1525), there were no significant differences in 3-year cognitive decline between any of the three intervention groups and the placebo group. Between-group differences compared with placebo were 0·093 (95% CI 0·001 to 0·184; adjusted p=0·142) for the combined intervention group, 0·079 (-0·012 to 0·170; 0·179) for the multidomain intervention plus placebo group, and 0·011 (-0·081 to 0·103; 0·812) for the omega 3 polyunsaturated fatty acids group. 146 (36%) participants in the multidomain plus polyunsaturated fatty acids group, 142 (34%) in the multidomain plus placebo group, 134 (33%) in the polyunsaturated fatty acids group, and 133 (32%) in the placebo group had at least one serious emerging adverse event. Four treatment-related deaths were recorded (two in the multidomain plus placebo group and two in the placebo group). The interventions did not raise any safety concerns and there were no differences between groups in serious or other adverse events.INTERPRETATION:The multidomain intervention and polyunsaturated fatty acids, either alone or in combination, had no significant effects on cognitive decline over 3 years in elderly people with memory complaints. An effective multidomain intervention strategy to prevent or delay cognitive impairment and the target population remain to be determined, particularly in real-world settings.
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