Randomized trial of marine n-3 polyunsaturated fatty acids for the prevention of cerebral small vessel disease and inflammation in aging (PUFA trial): Rationale, design and baseline results

Gene Bowman, Lisa Silbert, Hiroko Dodge, David Lahna, Kirsten Hagen, Charles F. Murchison, Diane Howieson, Jeffrey Kaye, Joseph Quinn, Lynne Shinto

Research output: Contribution to journalArticle

5 Scopus citations


Vascular risk factors for age-related cognitive decline are significant, and their management may ultimately prove the most successful strategy for reducing risk and sustaining cognitive health. This randomized, double-blinded, placebo-controlled trial with parallel group allocation to either marine n-3 polyunsaturated fatty acids (n-3 PUFA) or soybean oil placebo assesses the effects on the total volume of accumulation in cerebral white matter hyperintensities (WMH), a potentially modifiable neurovascular component of age-related cognitive decline. Total WMH accumulation over 3 years is the primary endpoint. The safety and efficacy of n-3 PUFA is evaluated in older adults with significant WMH and suboptimum plasma n-3 PUFA as inclusion criteria. One hundred and two non-demented older adults were enrolled with a mean age of 81.1 (±4.4) years, WMH of 19.4 (±16.1) cm3, and a plasma n-3 PUFA of 86.64 (±29.21) µg/mL. 61% were female, 28% were apolipoprotein E epsilon 4 carriers, and the mean mini-mental state exam (MMSE) was 27.9 (±1.7). This trial provides an initial evaluation of n-3 PUFA effects on WMH, a reproducible and valid risk biomarker for cognitive decline, as well as on inflammatory biomarkers thought to play a role in WMH accumulation. We present the baseline results and operational experience of enriching a study population on advanced age, blood n-3 PUFA, and magnetic resonance imaging (MRI) derived WMH with biomarker outcomes (WMH, inflammation markers) in a dementia prevention paradigm.

Original languageEnglish (US)
Article number735
Issue number4
StatePublished - Apr 1 2019



  • Cognitive decline
  • Docosahexaenoic acid
  • Eicosapentaenoic acid
  • Elderly
  • Executive function
  • MRI
  • Neuroimaging
  • Vascular cognitive impairment
  • White matter hyperintensities

ASJC Scopus subject areas

  • Food Science
  • Nutrition and Dietetics

Cite this