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Abstract：
This study aimed to evaluate the efficacy of omega-3 fatty acid supplementation interventions in improving depression in patients with dementia. To achieve this objective, randomized controlled trials (RCTs) were identified from primary electronic databases, focusing on the relationship between omega-3 fatty acids and depression in patients with dementia. The primary outcome was the impact of omega-3 fatty acids on post-intervention depression in patients with dementia, with subgroup analyses conducted based on the type of intervention (docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA) combination), duration of intervention (3 months, 6 months, 12 months, ≥24 months), cognitive function (ranging from mild cognitive impairment (MCI) to severe dementia), and daily dosage (high, medium, low, applicable to both DHA and EPA). The study has been duly registered with PROSPERO (registration ID: CRD42023408744). A meta-analysis of five studies (n = 517) included in nine systematic reviews showed that omega-3 supplementation had a non-significant trend toward affecting depressive symptoms in patients with dementia (standardized mean difference (SMD): 0.147; 95% confidence interval (CI): -0.324 to 0.049; p = 0.141). Subgroup analyses revealed that DHA supplementation significantly reduced depressive symptoms (SMD: -0.247; p = 0.039). There was no significant effect for high (SMD: -0.169; 95% CI: -0.454 to 0.116; p = 0.246) or medium (SMD: -0.061; 95% CI: -0.228 to 0.105; p = 0.470) doses of EPA. However, low doses of EPA were significantly effective (SMD: -0.953; 95% CI: -1.534 to -0.373; p = 0.001), with notable improvements in patients with MCI (SMD: -0.934; p < 0.001). The study concludes that omega-3 fatty acids, particularly through DHA supplementation, may alleviate depressive symptoms in patients with MCI. Given the limited sample size, further long-term RCTs are recommended to better understand the efficacy and optimal management of omega-3 supplementation in this population using different dosages.
摘要：
本研究旨在评估补充omega-3脂肪酸干预措施在改善痴呆患者抑郁方面的疗效。为了实现这一目标,随机对照试验（RCT）从主要电子数据库中确定，重点研究欧米茄-3脂肪酸与痴呆患者抑郁之间的关系。主要结局是Omega-3脂肪酸对痴呆患者干预后抑郁的影响。根据干预类型（二十二碳六烯酸（DHA）和二十碳五烯酸（EPA）组合）进行亚组分析，干预持续时间(3个月，6个月,12个月,≥24个月)，认知功能（从轻度认知障碍（MCI）到重度痴呆），和每日剂量(高，中等,低,适用于DHA和EPA)。该研究已在PROSPERO正式注册（注册ID：CRD42023408744）。对9项系统评价中包含的5项研究（n=517）的荟萃分析显示，补充omega-3对痴呆患者的抑郁症状的影响趋势不显着（标准化平均差（SMD）：0.147；95％置信区间（CI）：-0.324至0.049；p=0.141）。亚组分析显示，补充DHA可显着降低抑郁症状（SMD：-0.247；p=0.039）。高剂量（SMD：-0.169；95％CI：-0.454至0.116；p=0.246）或中等剂量（SMD：-0.061；95％CI：-0.228至0.105；p=0.470）EPA没有显着影响。然而,低剂量的EPA显着有效（SMD：-0.953;95％CI：-1.534至-0.373;p=0.001），MCI患者有显著改善（SMD：-0.934；p<0.001）。研究得出的结论是欧米茄-3脂肪酸，特别是通过补充DHA，可减轻MCI患者的抑郁症状。鉴于样本量有限，我们建议进一步开展长期随机对照试验,以更好地了解在该人群中使用不同剂量补充omega-3的疗效和最佳管理.
