The effect of low-dose omega 3 fatty acids on the treatment of mild to moderate depression in the elderly: a double-blind, randomized, placebo-controlled study.

Due to the rise in the social and economic costs of depression, new antidepressant medication with fewer side effects should be found. Several studies have shown that an association exists between ω-3 polyunsaturated fatty acids (ω-3 PUFAs) and depression. However, this association has not been clear enough in the elderly with mild to moderate depression. Sixty-six inhabitants of Kahrizak Charity Foundation participated in this double-blind, randomized, placebo-controlled study. Each participant was ≥ 65 years of age, had a Mini Mental State Exam of ≥ 22, and had scores ranging from 5 to 11 on the Geriatric Depression Scale-15 (GDS-15). During the 6 months, the drug group was treated daily with one gram of fish oil capsule containing 300 mg of both eicosapentaenoic acid and docosahexaenoic acid. No significant differences were noted between the groups in regard to level of education, use of antidepressant drugs, alcohol, tobacco use, history of chronic diseases, age, body mass index (BMI), high-sensitive C-reactive protein (hs-CRP), total cholesterol, and GDS-15 scores at baseline. After adjusting for cholesterol, BMI, and history of thyroid dysfunctions, a statistically significant difference was seen in GDS-15 scores between both groups. Furthermore, treatment with ω-3 PUFAs was clinically more effective in treating depression in comparison with the placebo. In this study, low-dose ω-3 PUFAs had some efficacy in the treatment of mild to moderate depression in elderly participants.

The effects of low dose n-3 fatty acids on serum lipid profiles and insulin resistance of the elderly: a randomized controlled clinical trial.

INTRODUCTION: N-3 fatty acids have several beneficial effects on dyslipidemia and diabetes, conditions which are prevalent in the elderly. This study assessed the effects of low-dose n-3 fatty acids on serum lipid profile, lipoprotein(a), apolipoprotein B, fasting glucose, insulin, and insulin resistance in a group of elderly Iranians. MATERIALS AND METHODS: A 6-month randomized, double-blind placebo-controlled clinical trial was carried out in 124 elderly residents of Kahrizak Charity Foundation aged >or= 65. The intervention group was supplemented with 1 g/day fish oil capsule (with 180 mg eicosapentaenoic acid, EPA; and 120 mg docosahexaenoic acid, DHA; a total of 300 mg n-3 fatty acids as effective constituents). Fasting blood samples were collected at baseline and after 6 months of the trial. RESULTS: There were no significant effects of fish oil on the studied variables in the intervention group. In the placebo group, serum triglyceride significantly increased and high-density lipoprotein cholesterol significantly decreased (p = 0.01 and p = 0.009, respectively). By repeated measurement analysis after adjustments, the overall decrease in serum triglycerides compared with placebo was significant (p = 0.04). CONCLUSION: Supplementation with low dose n-3 fatty acids for 6 months could significantly protect elderly Iranians from a rise in serum triglycerides.

Increased risk of chronic kidney disease in elderly with metabolic syndrome and high levels of C-reactive protein: Kahrizak Elderly Study.

BACKGROUND: To explore the interrelationship between metabolic syndrome (MS), chronic kidney disease (CKD) and C-reactive protein (CRP) in an elderly Iranian cohort. METHODS: 122 residents of Kahrizak Charity Foundation aged >or= 60 years were enrolled in this survey. MS was defined according to the NCEP-ATPIII criteria. CKD was defined as an estimated glomerular filtration rate < 60 ml/min/1.73 m2. CRP levels >or= 3 mg/dl were determined as a high CRP. RESULTS: The multivariate-adjusted odds ratio (OR) for CKD in MS was 5.81 (95% confidence interval (CI) 1.72-19.58) compared to those without MS. High blood pressure and high triglyceride levels were significantly associated with an increased risk of CKD (OR 4.01, 95% CI 1.55-10.37 and OR 3.27, 95% CI 1.25-8.53, respectively). Subjects with MS and high CRP levels had a 1.71-fold greater risk of having CKD compared to those without MS and low CRP levels (95% CI 1.02-2.84). CONCLUSION: There was a strong and independent relation between MS and risk of CKD in these elderly people. High blood pressure and hypertriglyceridemia increased the risk of CKD. Combination of high CRP and MS was strongly associated with an increased risk of CKD.

Relationship between insulin resistance and subclinical atherosclerosis in individuals with and without type 2 diabetes mellitus.

BACKGROUND: Insulin resistance is of utmost importance as an underlying mechanism for increased risk of cardiovascular disease (CVD). We assessed the association between Homeostatic Model Assessment (HOMA-IR) and two surrogate subclinical atherosclerosis markers (SCA) among individuals with and without type 2 diabetes (DM), those who did not have any clinical presentation of the CVD. METHODS: In a cross-sectional study, 208 participants (105 diabetics and 103 non-diabetics) were enrolled from referred patients with diabetes to an academic outpatient clinic and their non-diabetic relatives in-law. Fasting serum levels of insulin, blood glucose and lipid profile, were measured. Anthropometric and blood pressure were measuremented standardly. Body Mass Index (BMI) and Homeostatic Model Assessment-Insulin Resistance (HOMA-IR) index were calculated. Coronary Artery Calcium Score(CACS) was measured using a Multi-Detctor CT scanner. Flow mediated dilation (FMD) was measured using bimode ultrasonography (with linear transducer 13,000 MHZ). Univariate and multivariate logistic regression models were used to evaluate the association between these SCA markers and HOMA index in adjusting models. RESULTS: CACS and HOMA-IR were higher and FMD was lower in diabetic participants than non-diabetic ones (P < 0.01) In a stepwise logistic regression model, CACS and FMD were associated with HOMA-IR (odds ratio = 1.778; 95 % confidence interval (CI): 1.211-2.726 and odds ratio = 1.557; 95 % CI: 1.601-2.275, respectively) in non-diabetics but not among diabetic participants. CONCLUSIONS: CACS and FMD are related to insulin resistance among non-diabetic individuals, but we could not find this relationship among diabetic patients.

Effect of low dose ω-3 poly unsaturated fatty acids on cognitive status among older people: a double-blind randomized placebo-controlled study.

BACKGROUND: Cognitive impairment is a prevalent health problem in older people and its global prevalence tends to increase parallel to the extended life expectancy in world. The beneficial effect of ω-3 PUFAs on cognitive impairment has been demonstrated in some experimental and cohort studies. In this study we aimed to assess the effect of low dose docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA) supplementation on cognitive status in the elderly. METHODS: In a double-blind, randomized placebo-controlled study, 199 individuals aged ≥65 years with normal or mild to moderate cognition impairment were assigned to receive either 180 mg of DHA plus 120 mg of EPA or placebo for 180 days. Cognitive status was assessed using Mini-Mental State Examination (MMSE) and Abbreviated Mental Test (AMT) score. RESULTS: MMSE and AMT scores were not different at the time of allocation [18.84 (5.37), 18.55 (5.12), (P = 0.70) and 4.81 (2.79) and 4.64 (2.77), (P = 0.67) respectively] and over 6 months between the ω-3 PUFA- and placebo- treated groups [18.57 (5.21), 18.39 (5.10), (P = 0.80) and 4.64 (2.77) and 4.48 (2.69) and (P = 0.67)]. The participants were categorized based on MMSE score into normal cognition, mild and moderate cognitive impairment. After multivariate adjustment, there was no significant difference among categorized groups regarding the ω-3 PUFA effect except in normal cognition group, that amount of decline in AMT in ω-3 poly unsaturated fatty acids (PUFAs) was less than placebo group. CONCLUSIONS: It seems that prescription of low dose ω-3 PUFAs for 6 months had no significant beneficial effects on improvement of cognition or prevention of cognitive decline in older people.

Association of cardiac autonomic neuropathy with arterial stiffness in type 2 diabetes mellitus patients.

BACKGROUND: Diabetic patients are at the risk of cardiac autonomic neuropathy (CAN) and arterial stiffness. This study aimed to investigate the association of heart rate variability (HRV) as an index for CAN and pulse wave velocity (PWV) as an index for arterial stiffness. METHODS: Uncomplicated diabetes type-2 patients who had no apparent history of cardiovascular condition underwent HRV and PWV measurements and the results were compared with the control group consisting of non-diabetic peers. Also, the findings were adjusted for the cardiovascular risk factors and other confounding factors. RESULTS: A total of 64 diabetic patients (age= 52.08±8.50 years; males=33 [51.6%]) were compared with 57 controls (age= 48.74±6.18 years; males=25 [43.9%]) in this study. Hypertension, dyslipidemia, and thereby systolic blood pressure and statin use were significantly more frequent in the diabetic group, while the serum levels of cholesterol, HDL-C and LDL-C were significantly higher in the controls. Pulse wave was significantly increased in the diabetic patients (p<0.001). Main HRV parameters were significantly lower in diabetics than in controls. After adjustment for the confounders, PWV and HRV remained significantly different between the groups (p=0.01 and p=0.004, respectively). Multiple logistic regression of the association between pulse wave velocity and HRV index was independently significant both in diabetics and controls. CONCLUSIONS: There exists a significant relationship between heart rate variability and arterial stiffness as a measure for atherosclerosis in diabetic patients, although the role of the confounding factors is noteworthy.