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A randomised controlled trial investigating the effect of n-3 long-chain polyunsaturated fatty acid supplementation on cognitive and retinal function in cognitively healthy older people: the Older People And n-3 Long-chain polyunsaturated fatty acids (OPAL) study protocol [ISRCTN72331636]

Alan D Dangour1*, Felicity Clemens2, Diana Elbourne2, Nicky Fasey3, Astrid E Fletcher4, Pollyanna Hardy25, Graham E Holder6, Felicia A Huppert7, Rosemary Knight3, Louise Letley3, Marcus Richards8, Ann Truesdale2, Madge Vickers9 and Ricardo Uauy1

Author Affiliations

1 Nutrition and Public Health Intervention Research Unit, Department of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK

2 Medical Statistics Unit, Department of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK

3 Medical Research Council General Practice Research Framework, London, UK

4 Non-Communicable Disease Epidemiology Unit, Department of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK

5 Clinical Epidemiology and Biostatistics Unit, Royal Children's Hospital, Melbourne, Australia

6 Department of Electrophysiology, Moorfields Eye Hospital, London, UK

7 Department of Psychiatry, University of Cambridge, Cambridge, UK

8 Department of Epidemiology and Public Health, University College London, London, UK

9 Centre for Research in Primary and Community Care, University of Hertfordshire, Hatfield, UK

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Nutrition Journal 2006, 5:20  doi:10.1186/1475-2891-5-20

Published: 31 August 2006

Abstract

The number of individuals with age-related cognitive impairment is rising dramatically in the UK and globally. There is considerable interest in the general hypothesis that improving the diet of older people may slow the progression of cognitive decline. To date, there has been little attention given to the possible protective role of n-3 long-chain polyunsaturated fatty acids (n-3 LCPs) most commonly found in oily fish, in age-related loss of cognitive function. The main research hypothesis of this study is that an increased dietary intake of n-3 LCPs will have a positive effect on cognitive performance in older people in the UK.

To test this hypothesis, a double-blind randomised placebo-controlled trial will be carried out among adults aged 70–79 years in which the intervention arm will receive daily capsules containing n-3 LCP (0.5 g/day docosahexaenoic acid and 0.2 g/day eicosapentaenoic acid) while the placebo arm will receive daily capsules containing olive oil. The main outcome variable assessed at 24 months will be cognitive performance and a second major outcome variable will be retinal function. Retinal function tests are included as the retina is a specifically differentiated neural tissue and therefore represents an accessible window into the functioning of the brain.

The overall purpose of this public-health research is to help define a simple and effective dietary intervention aimed at maintaining cognitive and retinal function in later life. This will be the first trial of its kind aiming to slow the decline of cognitive and retinal function in older people by increasing daily dietary intake of n-3 LCPs. The link between cognitive ability, visual function and quality of life among older people suggests that this novel line of research may have considerable public health importance.