n-3 Fatty acids, Mediterranean diet and cognitive function in normal aging: A systematic review

Background Intake of n-3 fatty acids and adherence to the Mediterranean diet (MedDiet) have been shown to slow the progression of age-related cognitive decline, but the results are mixed. We summarized and evaluated the effect of n-3 fatty acids and MedDiet on cognitive outcomes in a cognitively healthy aged population. Methods Relevant published studies from January 2000 to May 2015 were identified by searching three electronic databases: Pubmed, Web of Science/MEDLINE, and CINHAL. Observational studies and randomized controlled trials (RCTs) were considered. Results Twenty-four studies were included for the systematic review. n-3 fatty acids were associated with better global cognition and some specific cognitive domains though some results were conflicting. Adherence to the MedDiet was also significantly associated with better cognitive performance and less cognitive decline. Finally, better cognitive performance was observed in men compared to women and mixed results were also found for the influence of APOE4 genotype on the association between n-3 fatty acids or MedDiet and cognition. Conclusions Studies suggest that n-3 fatty acids in the diet and adherence to the MedDiet are beneficial in slowing age-related cognitive decline. However, more high-quality RCTs would be useful to clarify the effect of n-3 fatty acid supplements on cognition.