During the 8th International Conference on Clinical Trials for Alzheimer’s Disease (CTAD) held in Barcelona, Spain, data from the MAPT study of older adults with memory lapses was presented. This study suggested that the combination of a multi-domain nutritional and stimulation intervention plus an omega-3 fatty acid supplementation slows cognitive decline in older adults, and particularly in individuals with mild cognitive impairment (MCI).
The MAPT trial, Omega-3 Fatty Acids and/or Multi-domain Intervention in the Prevention of Age-related Cognitive Decline, was conceived to evaluate the combination of a supplement (docosahexaenoic acid or DHA, an omega-3 fatty acid that is a primary structural component of the human brain and elsewhere) and multi-domain training — nutritional advise, exercise, and cognitive and social stimulation — as opposed to other approaches. Importantly, DHA has been suggested to possess anti-inflammatory proprieties and to be associated with a lower risk of Alzheimer’s disease (AD).
Bruno Vellas, MD, PhD, of the University of Toulouse in France, and colleagues randomized 1,680 patients, ages 70 and up with subjective memory complaints, into four groups: DHA (800 mg/day) alone, DHA (800 mg/day) plus multi-domain training, placebo plus multi-domain training, and placebo alone.
The multi-domain training was preformed in 12, two-hour sessions of groups of six to eight participants over a two-month period. Training then switched to hourlong sessions every month. The study’s primary endpoint was a change of memory function at three years, as assessed by the Free and Cued Selective Reminding test, a test used to identify mild cognitive impairment. Moreover, the research team looked at the patients’ ApoE4 status, as well as other genetic markers that are thought to increase the risk of developing Alzheimer’s disease.
The authors found that patients with low baseline DHA considerably benefited from the multi-domain intervention plus DHA supplement. Using imaging studies, researchers observed that those receiving the multi-domain intervention plus DHA showed significant improvements in brain metabolism, findings that became even more relevant in individuals positive for ApoE4 and in patients with evidence of amyloid deposition in the brain.
As the researchers reported, a significant effect was found in the multi-domain intervention groups, with or without DHA supplementation, leading to significantly better outcomes than DHA supplementation alone or placebo. But the largest effect was seen in the group that had the combination of DHA and multi-domain counseling.
The participants will continue to be monitored for two additional years to evaluate if the benefit of the multi-domain intervention is maintained in a long-term. The research team also intends to develop kits to quantify DHA levels, to better identify individuals that may benefit from supplementation. Additionally, a follow-up study focused in individuals identified as being at high risk of disease progression is planned.
The innovative MAPT study is the first in a large series of European multi-domain intervention trials.
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