Serial circulating omega 3 polyunsaturated fatty acids and healthy ageing among older adults in the Cardiovascular Health Study: prospective cohort study

Abstract

Objective: To determine the longitudinal association between serial biomarker measures of circulating omega 3 polyunsaturated fatty acid (n3-PUFA) levels and healthy ageing.

Design: Prospective cohort study.

Setting: Four communities in the United States (Cardiovascular Health Study) from 1992 to 2015.

Participants: 2622 adults with a mean (SD) age of 74.4 (4.8) and with successful healthy ageing at baseline in 1992-93.

Exposure: Cumulative levels of plasma phospholipid n3-PUFAs were measured using gas chromatography in 1992-93, 1998-99, and 2005-06, expressed as percentage of total fatty acids, including α-linolenic acid from plants and eicosapentaenoic acid, docosapentaenoic acid, and docosahexaenoic acid from seafoood.

Main outcome measure: Healthy ageing defined as survival without chronic diseases (ie, cardiovascular disease, cancer, lung disease, and severe chronic kidney disease), the absence of cognitive and physical dysfunction, or death from other causes not part of the healthy ageing outcome after age 65. Events were centrally adjudicated or determined from medical records and diagnostic tests.

Results: Higher levels of long chain n3-PUFAs were associated with an 18% lower risk (95% confidence interval 7% to 28%) of unhealthy ageing per interquintile range after multivariable adjustments with time-varying exposure and covariates. Individually, higher eicosapentaenoic acid and docosapentaenoic acid (but not docosahexaenoic acid) levels were associated with a lower risk: 15% (6% to 23%) and 16% (6% to 25%), respectively. α-linolenic acid from plants was not noticeably associated with unhealthy ageing (hazard ratio 0.92, 95% confidence interval 0.83 to 1.02).

Conclusions: In older adults, a higher cumulative level of serially measured circulating n3-PUFAs from seafood (eicosapentaenoic acid, docosapentaenoic acid, and docosahexaenoic acid), eicosapentaenoic acid, and docosapentaenoic acid (but not docosahexaenoic acid from seafood or α-linolenic acid from plants) was associated with a higher likelihood of healthy ageing. These findings support guidelines for increased dietary consumption of n3-PUFAs in older adults.

Fig 1

Omega 3 polyunsaturated fatty acids and the risk of unhealthy ageing in the Cardiovascular Health Study after 22 years of maximum follow-up among 2622 older adults

Fig 2

Hazard ratios (95% confidence intervals) of 2330 unhealthy ageing events per interquintile range (IQR) of omega 3 polyunsaturated fatty acids (n3-PUFAs) after 22 years of maximum follow-up among 2622 older adults. The IQR is equivalent to the difference between the midpoint of the 1st and 5th quintiles, estimated to be 0.12%, 0.64%, 0.40%, 2.40% and 2.90% for the n3-PUFAs, respectively

Fig 3

Multivariable-adjusted relationship of plasma phospholipid omega 3 polyunsaturated fatty acid (n3-PUFA) levels with risk of unsuccessful healthy ageing, evaluated using restricted cubic splines