PUFA, fish intake and risk of disabling dementia in Japan: the Japan Public Health Centre Disabling Dementia Study
2025
Sarah K Abe | Manami Inoue | Nobufumi Yasuda | Kazumasa Yamagishi | Shoichiro Tsugane | Norie Sawada | for the JPHC Study Group
Abstract Objective: The aim of this study was to assess the association between fish intake, n-3 PUFA, n-6 PUFA and risk of disabling dementia. Design: Prospective cohort. Setting: Municipalities within the Japan Public Health Centre-based Prospective Study. Participants: 43 651 participants: (20 002 men and 23 649 women). Results: Exposure intake of fish, n-3 and n-6 PUFA was evaluated in 1995–1997. We defined disabling dementia cases as participants who were certified to receive disability care under the long-term-care insurance programme (2006–2016) in participating municipalities with a grade of activities of daily living related to dementia ≥ IIa on the dementia rating scale (range 0–IV and M). Cox proportional hazard models were applied to obtain hazard ratios (HR) and 95 % CI according to quartiles of exposures of interest. In the main analysis, we adjusted for age and area, smoking, BMI, alcohol and metabolic equivalent tasks. During 410 350 person-years of follow-up with an average follow-up of 9·4 years, 5278 cases of disabling dementia were diagnosed. Fish intake and most PUFA were not associated with the risk of disabling dementia in men. In women, n-6 PUFA showed a significant decreasing trend in risk the highest HR (95 % CI) compared with the lowest was 0·90 (0·81, 0·99) (P for trend = 0·024) and alpha-linolenic acid (ALA) was 0·91 (0·82, 1·00) (P for trend = 0·043). Conclusions: Our findings suggest no association with fish in general and only n-6 PUFA and ALA may be associated with a decreased risk of disabling dementia especially in women.
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