Skip to main content Accessibility help
×
Home

Association between fish consumption and risk of dementia: a new study from China and a systematic literature review and meta-analysis

  • Aishat T Bakre (a1), Ruoling Chen (a1), Ranjit Khutan (a1), Li Wei (a2), Tina Smith (a1), Gordon Qin (a3), Isaac M Danat (a1), Weiju Zhou (a1), Peter Schofield (a4), Angela Clifford (a1), Jiaji Wang (a5), Arpana Verma (a6), Cuilin Zhang (a7) and Jindong Ni (a8)...

Abstract

Objective

To assess the association of fish consumption with risk of dementia and its dose–response relationship, and investigate variations in the association among low-, middle- and high-income countries.

Design

A new community-based cross-sectional study and a systematic literature review.

Settings

Urban and rural communities in China; population-based studies systematically searched from worldwide literature.

Subjects

Chinese adults aged ≥60 years in six provinces (n 6981) took part in a household health survey of dementia prevalence and risk factors. In addition, 33 964 participants from eleven published and eligible studies were included in the systematic review and meta-analysis.

Results

In the new study in China, 326 participants were diagnosed with dementia (4·7 %); those who consumed any amount of fish in the past two years v. those who consumed no fish had reduced risk of dementia (adjusted OR=0·73, 95 % CI 0·64, 0·99), but the dose–response relationship was not statistically significant. The meta-analysis of available data from the literature and the new study showed relative risk (RR) of dementia of 0·80 (95 % CI 0·74, 0·87) for people with fish consumption; the impact was similar among countries with different levels of income. Pooled dose–response data revealed RR (95 % CI) of 0·84 (0·72, 0·98), 0·78 (0·68, 0·90) and 0·77 (0·61, 0·98) in people with low, middle and high consumption of fish, respectively. Corresponding figures for Alzheimer’s disease were 0·88 (0·74, 1·04), 0·79 (0·65, 0·96) and 0·67 (0·58, 0·78), respectively.

Conclusions

Greater consumption of fish is associated with a lower risk of dementia. Increasing fish consumption may help prevent dementia worldwide regardless of income level.

  • View HTML
    • Send article to Kindle

      To send this article to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle. Find out more about sending to your Kindle.

      Note you can select to send to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

      Find out more about the Kindle Personal Document Service.

      Association between fish consumption and risk of dementia: a new study from China and a systematic literature review and meta-analysis
      Available formats
      ×

      Send article to Dropbox

      To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Dropbox.

      Association between fish consumption and risk of dementia: a new study from China and a systematic literature review and meta-analysis
      Available formats
      ×

      Send article to Google Drive

      To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Google Drive.

      Association between fish consumption and risk of dementia: a new study from China and a systematic literature review and meta-analysis
      Available formats
      ×

Copyright

Corresponding author

*Corresponding authors: Email r.chen@wlv.ac.uk and wjiaji@163.com

References

Hide All
1. Prince, M, Wimo, A, Guerchet, M et al. (2015) The Global Impact of Dementia: An Analysis of Prevalence, Incidence, Cost and Trends. http://www.alz.co.uk/research/world-report-2015 (accessed August 2016).
2. He, K, Song, Y, Daviglus, ML et al. (2004) Accumulated evidence on fish consumption and coronary heart disease mortality: a meta-analysis of cohort studies. Circulation 109, 27052711.
3. Larsson, SC & Orsini, N (2011) Fish consumption and the risk of stroke: a dose–response meta-analysis. Stroke 42, 36213623.
4. Yang, H, Xun, P & He, K (2013) Fish and fish oil intake in relation to risk of asthma: a systematic review and meta-analysis. PLoS One 8, e80048.
5. Li, F, Liu, X & Zhang, D (2016) Fish consumption and risk of depression: a meta-analysis. J Epidemiol Community Health 70, 299304.
6. Prince, M, Albanese, E, Guerchet, M et al. (2014) Nutrition and Dementia: A Review of Available Research. http://www.alz.co.uk/sites/default/files/pdfs/nutrition-and-dementia.pdf (accessed August 2016).
7. Eilander, A, Hundscheid, D, Osendarp, S et al. (2007) Effects of n-3 long chain polyunsaturated fatty acid supplementation on visual and cognitive development throughout childhood: a review of human studies. Prostaglandins Leukot Essent Fatty Acids 76, 189203.
8. Salem, N Jr, Litman, B, Kim, H et al. (2001) Mechanisms of action of docosahexaenoic acid in the nervous system. Lipids 36, 945959.
9. Lopez, L, Kritz-Silverstein, D & Barrett-Connor, E (2011) High dietary and plasma levels of the omega-3 fatty acid docosahexaenoic acid are associated with decreased dementia risk: the Rancho Bernardo study. J Nutr Health Aging 15, 2531.
10. Morris, MC, Evans, DA, Tangney, CC et al. (2005) Fish consumption and cognitive decline with age in a large community study. Arch Neurol 62, 18491853.
11. van Gelder, BM, Tijhuis, M, Kalmijn, S et al. (2007) Fish consumption, n-3 fatty acids, and subsequent 5-y cognitive decline in elderly men: the Zutphen Elderly Study. Am J Clin Nutr 85, 11421147.
12. Barberger-Gateau, P, Letenneur, L, Deschamps, V et al. (2002) Fish, meat, and risk of dementia: cohort study. BMJ 325, 932933.
13. Morris, MC, Evans, DA, Bienias, JL et al. (2003) Consumption of fish and n-3 fatty acids and risk of incident Alzheimer disease. Arch Neurol 60, 940946.
14. van de Rest, O, Spiro, A 3rd, Krall-Kaye, E et al. (2009) Intakes of (n-3) fatty acids and fatty fish are not associated with cognitive performance and 6-year cognitive change in men participating in the Veterans Affairs Normative Aging Study. J Nutr 139, 23292336.
15. Engelhart, MJ, Geerlings, MI, Ruitenberg, A et al. (2002) Diet and risk of dementia: does fat matter? The Rotterdam Study. Neurology 59, 19151921.
16. Zhang, Y, Chen, J, Qiu, J et al. (2016) Intakes of fish and polyunsaturated fatty acids and mild-to-severe cognitive impairment risks: a dose–response meta-analysis of 21 cohort studies. Am J Clin Nutr 103, 330340.
17. Wu, S, Ding, Y, Wu, F et al. (2015) Omega-3 fatty acids intake and risks of dementia and Alzheimer’s disease: a meta-analysis. Neurosci Biobehav Rev 48, 19.
18. Cao, L, Tan, L, Wang, H et al. (2015) Dietary patterns and risk of dementia: a systematic review and meta-analysis of cohort studies. Mol Neurobiol 53, 61446154.
19. Chen, R (2012) Association of environmental tobacco smoke with dementia and Alzheimer’s disease among never smokers. Alzheimers Dement 8, 590595.
20. Chen, R, Hu, Z, Chen, RL et al. (2013) Determinants for undetected dementia and late-life depression. Br J Psychiatry 203, 203208.
21. Chen, R, Zhang, D, Chen, Y et al. (2012) Passive smoking and risk of cognitive impairment in women who never smoke. Arch Intern Med 172, 271273.
22. Copeland, J, Prince, M, Wilson, K et al. (2002) The geriatric mental state examination in the 21st century. Int J Geriatr Psychiatry 17, 729732.
23. Prince, M, Acosta, D, Chiu, H et al. (2003) Dementia diagnosis in developing countries: a cross-cultural validation study. Lancet 361, 909917.
24. Chen, R, Wei, L, Hu, Z et al. (2005) Depression in older people in rural China. Arch Intern Med 165, 20192025.
25. Prince, MJ, De Rodriguez, JL, Noriega, L et al. (2008) The 10/66 Dementia Research Group’s fully operationalised DSM-IV dementia computerized diagnostic algorithm, compared with the 10/66 dementia algorithm and a clinician diagnosis: a population validation study. BMC Public Health 8, 219.
26. Rodriguez, JJL, Ferri, CP, Acosta, D et al. (2008) Prevalence of dementia in Latin America, India, and China: a population-based cross-sectional survey. Lancet 372, 464474.
27. Moher, D, Liberati, A, Tetzlaff, J et al. (2009) Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. Ann Intern Med 151, 264269.
28. Kalmijn, S, Launer, LJ, Ott, A et al. (1997) Dietary fat intake and the risk of incident dementia in the Rotterdam Study. Ann Neurol 42, 776782.
29. Devore, EE, Grodstein, F, van Rooij, FJ et al. (2009) Dietary intake of fish and omega-3 fatty acids in relation to long-term dementia risk. Am J Clin Nutr 90, 170176.
30. Wells, G, Shea, B, O’Connell, D et al. (2014) The Newcastle–Ottawa Scale (NOS) for Assessing the Quality of Non-Randomized Studies in Meta-Analysis. http://www.ohri.ca/programs/clinical_epidemiology/oxford.asp (accessed August 2016).
31. Downes, MJ, Brennan, ML, Williams, HC et al. (2016) Development of a critical appraisal tool to assess the quality of cross-sectional studies (AXIS). BMJ Open 6, e011458.
32. Egger, M, Davey Smith, G, Schneider, M et al. (1997) Bias in meta-analysis detected by a simple, graphical test. BMJ 315, 629634.
33. Albanese, E, Dangour, AD, Uauy, R et al. (2009) Dietary fish and meat intake and dementia in Latin America, China, and India: a 10/66 Dementia Research Group population-based study. Am J Clin Nutr 90, 392400.
34. Conquer, JA, Tierney, MC, Zecevic, J et al. (2000) Fatty acid analysis of blood plasma of patients with Alzheimer’s disease, other types of dementia, and cognitive impairment. Lipids 35, 13051312.
35. Tully, A, Roche, H, Doyle, R et al. (2003) Low serum cholesteryl ester-docosahexaenoic acid levels in Alzheimer’s disease: a case–control study. Br J Nutr 89, 483489.
36. Kim, M, Nam, JH, Oh, DH et al. (2010) Erythrocyte α-linolenic acid is associated with the risk for mild dementia in Korean elderly. Nutr Res 30, 756761.
37. Barberger-Gateau, P, Raffaitin, C, Letenneur, L et al. (2007) Dietary patterns and risk of dementia: the Three-City cohort study. Neurology 69, 19211930.
38. Huang, TL, Zandi, PP, Tucker, KL et al. (2005) Benefits of fatty fish on dementia risk are stronger for those without APOE e4. Neurology 65, 14091414.
39. Schaefer, EJ, Bongard, V, Beiser, AS et al. (2006) Plasma phosphatidylcholine docosahexaenoic acid content and risk of dementia and Alzheimer disease: the Framingham Heart Study. Arch Neurol 63, 15451550.
40. Uauy, R & Dangour, AD (2006) Nutrition in brain development and aging: role of essential fatty acids. Nutr Rev 64, 5 Pt 2, S24S33.
41. Connor, WE & Connor, SL (2007) The importance of fish and docosahexaenoic acid in Alzheimer disease. Am J Clin Nutr 85, 929930.
42. Newman, AB, Fitzpatrick, AL, Lopez, O et al. (2005) Dementia and Alzheimer’s disease incidence in relationship to cardiovascular disease in the Cardiovascular Health Study cohort. J Am Geriatr Soc 53, 11011107.
43. Hill, AB (1965) The environment and disease: association or causation? Proc R Soc Med 58, 295300.
44. He, J, Vupputuri, S, Allen, K et al. (1999) Passive smoking and the risk of coronary heart disease – a meta-analysis of epidemiologic studies. N Engl J Med 340, 920926.
45. Taylor, R, Najafi, F & Dobson, A (2007) Meta-analysis of studies of passive smoking and lung cancer: effects of study type and continent. Int J Epidemiol 36, 10481059.
46. Cohen, JT, Bellinger, DC, Connor, WE et al. (2005) A quantitative analysis of prenatal intake of n-3 polyunsaturated fatty acids and cognitive development. Am J Prev Med 29, 366374.
47. Ryan, AS, Astwood, JD, Gautier, S et al. (2010) Effects of long-chain polyunsaturated fatty acid supplementation on neurodevelopment in childhood: a review of human studies. Prostaglandins Leukot Essent Fatty Acids 82, 305314.
48. Dangour, AD, Allen, E, Elbourne, D et al. (2009) Fish consumption and cognitive function among older people in the UK: baseline data from the OPAL study. J Nutr Health Aging 13, 198202.
49. Innis, SM (2007) Dietary (n-3) fatty acids and brain development. J Nutr 137, 855859.
50. Calder, PC (2006) N-3 polyunsaturated fatty acids, inflammation, and inflammatory diseases. Am J Clin Nutr 83, Suppl. 6, 1505S1519S.
51. Chandra, RK (2001) Effect of vitamin and trace-element supplementation on cognitive function in elderly subjects. Nutrition 17, 709712.
52. Mohanty, BP, Ganguly, S, Mahanty, A et al. (2016) DHA and EPA content and fatty acid profile of 39 food fishes from India. Biomed Res Int 2016, 4027437.
53. Connor, WE (2000) Importance of n-3 fatty acids in health and disease. Am J Clin Nutr 71, Suppl. 1, 171S175S.
54. Nestel, PJ (2000) Fish oil and cardiovascular disease: lipids and arterial function. Am J Clin Nutr 71, Suppl. 1, 228S231S.
55. Grosso, G, Micek, A, Marventano, S et al. (2016) Dietary n-3 PUFA, fish consumption and depression: a systematic review and meta-analysis of observational studies. J Affect Disord 205, 269281.
56. Gould, JF, Smithers, LG & Makrides, M (2013) The effect of maternal omega-3 (n-3) LCPUFA supplementation during pregnancy on early childhood cognitive and visual development: a systematic review and meta-analysis of randomized controlled trials. Am J Clin Nutr 97, 531544.
57. Huang, TL (2010) Omega-3 fatty acids, cognitive decline, and Alzheimer’s disease: a critical review and evaluation of the literature. J Alzheimers Dis 21, 673690.
58. Luchtman, DW & Song, C (2013) Cognitive enhancement by omega-3 fatty acids from childhood to old age: findings from animal and clinical studies. Neuropharmacology 64, 550565.
59. Qin, B, Plassman, BL, Edwards, LJ et al. (2014) Fish intake is associated with slower cognitive decline in Chinese older adults. J Nutr 144, 15791585.
60. Horrocks, LA & Farooqui, AA (2004) Docosahexaenoic acid in the diet: its importance in maintenance and restoration of neural membrane function. Prostaglandins Leukot Essent Fatty Acids 70, 361372.
61. Hashimoto, M, Tanabe, Y, Fujii, Y et al. (2005) Chronic administration of docosahexaenoic acid ameliorates the impairment of spatial cognition learning ability in amyloid β-infused rats. J Nutr 135, 549555.
62. Xiao, Y & Li, X (1999) Polyunsaturated fatty acids modify mouse hippocampal neuronal excitability during excitotoxic or convulsant stimulation. Brain Res 846, 112121.
63. Okada, M, Amamoto, T, Tomonaga, M et al. (1996) The chronic administration of docosahexaenoic acid reduces the spatial cognitive deficit following transient forebrain ischemia in rats. Neuroscience 71, 1725.
64. Tsukada, H, Kakiuchi, T, Fukumoto, D et al. (2000) Docosahexaenoic acid (DHA) improves the age-related impairment of the coupling mechanism between neuronal activation and functional cerebral blood flow response: a PET study in conscious monkeys. Brain Res 862, 180186.
65. Gamoh, S, Hashimoto, M, Sugioka, K et al. (1999) Chronic administration of docosahexaenoic acid improves reference memory-related learning ability in young rats. Neuroscience 93, 237241.
66. Kotani, S, Sakaguchi, E, Warashina, S et al. (2006) Dietary supplementation of arachidonic and docosahexaenoic acids improves cognitive dysfunction. Neurosci Res 56, 159164.
67. Chiu, C, Su, K, Cheng, T et al. (2008) The effects of omega-3 fatty acids monotherapy in Alzheimer’s disease and mild cognitive impairment: a preliminary randomized double-blind placebo-controlled study. Prog Neuropsychopharmacol Biol Psychiatry 32, 15381544.
68. Lee, LK, Shahar, S, Chin, A et al. (2013) Docosahexaenoic acid-concentrated fish oil supplementation in subjects with mild cognitive impairment (MCI): a 12-month randomised, double-blind, placebo-controlled trial. Psychopharmacology (Berl) 225, 605612.
69. Chen, R, Ma, Y, Wilson, K et al. (2012) A multicentre community‐based study of dementia cases and subcases in older people in China – the GMS‐AGECAT prevalence and socio‐economic correlates. Int J Geriatr Psychiatry 27, 692702.
70. Food and Agriculture Organization of the United Nations (2016) The State of World Fisheries and Aquaculture: Contributing to Food Security and Nutrition for All: In Brief. http://www.fao.org/3/a-i5798e.pdf (accessed September 2016).
71. Larrieu, S, Letenneur, L, Helmer, C et al. (2004) Nutritional factors and risk of incident dementia in the PAQUID longitudinal cohort. J Nutr Health Aging 8, 150154.
72. Grant, WB (2003) Diet and risk of dementia: does fat matter? The Rotterdam Study. Neurology 60, 20202021.

Keywords

Type Description Title
WORD
Supplementary materials

Bakre et al. supplementary material 1
Bakre et al. supplementary material

 Word (75 KB)
75 KB

Metrics

Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed