Brain Atrophy in Cognitively Impaired Elderly: The Importance of Long-chain ω-3 Fatty Acids
and B Vitamin Status in a Randomized Controlled Trial
Fredrik Jernerén, Amany K Elshorbagy, Abderrahim Oulhaj,
Stephen M Smith, Helga Refsum, and A David Smith
From the Oxford Project to Investigate Memory and Ageing (OPTIMA),
Department of Pharmacology,
University of Oxford, Oxford, United Kingdom;
|This study provides clarity to earlier studies that found that B vitamins and/or Omega-3 fatty acids were found to slow brain loss in areas of the brain associated with Alzheimer’s disease.
In a 2010 study, Smith et al.  (in the Oxford Project to Investigate Memory and Ageing study) gave 271 individuals with mild cognitive impairment high-dose B vitamins for 2 years. Pre- and post-MRI studies were done, and they demonstrated that the B vitamin group experienced 30-percent slower rates of brain atrophy, on average, and in some cases patients experienced reductions as high as 53 percent.
In a 2012 study, Bowman et al.  (in the Oregon Brain Aging Study) reviewed blood nutrient levels in 104 dementia-free elders. They found two nutrient biomarker patterns (NBPs) that were associated with more favorable cognitive and MRI measures: one was high plasma levels of the vitamins B, C, D, and E, and the second NBP was high plasma marine omega-3 fatty acids. They also demonstrated that high trans fat blood levels were associated with less favorable cognitive function and less total cerebral brain volumes.
When this article was pre-released, the New York Times ran a banner headline titled:
In a 2013 study, Douaud et al.  provided high-dose B-vitamin treatment to elderly subjects with increased dementia risk for 2 years. They found that B vitamins reduced brain shrinkage and reduced levels of plasma total homocysteine (tHcy). This is important because many cross-sectional and prospective studies have shown that high tHcy levels are associated with cognitive impairment, Alzheimer’s disease (AD), and vascular dementia.
The current study also helps explain why some trials that focused solely on the B vitamins or Omega-3s had mixed results. Apparently having high blood levels of BOTH the B vitamins AND Omega-3 fatty acids provides better results in preventing the deterioration of brain tissue in Alzheimer’s patients.