Background Maintaining healthy ageing (HA) is a crucial priority in older adults worldwide, given global population ageing, increased number of years living with disability, and the need for new treatments. Omega-3 polyunsaturated fatty acids (n3-PUFA) from seafood and plants exert favourable physiologic effects that could benefit HA. However, relationships between n3-PUFA and HA are not well-established, especially using serial biomarkers which provide highly objective measures.
Methods We investigated the longitudinal association between serial circulating n3-PUFAs and maintenance of HA in the Cardiovascular Health Study, evaluating 2342 older U.S. adults with mean age 75 years and successful HA to-date at baseline in 1992–93. Individual plasma phospholipid n3-PUFAs (expressed as% of total fatty acids) including alpha-linoleic acid (ALA), eicosapentaenoic acid (EPA), docosapentaenoic acid (DPA), and docosahexaenoic acid (DHA) were quantified using gas chromatography in 1992–93, 1998–99, and 2005–06. HA was defined as survival free of cardiovascular disease, cancer, lung disease, and severe chronic kidney disease, with no difficulties with activities of daily living and intact cognitive function (Mini-Mental State Examination ≥80th percentile); dying with a lifetime meeting this criteria was also considered as HA. Events were centrally adjudicated or determined from medical records and diagnostic tests. Multivariable-Cox proportional hazards models with time-varying covariates evaluated the association between time-varying, cumulative average n3-PUFAs and unsuccessful HA.
Results During 22 years of follow-up, 267 (11%) participants experienced successful HA. After multivariable-adjustments, the interquintile range of total n3-PUFAs and seafood-derived n3-PUFAs was associated with lower risk of unsuccessful HA by 17% (0.74%–0.93 95% CI, p= 0.002) and 16% (0.75%–0.94 95% CI, p= 0.002), respectively. Individually, EPA, DPA and DHA each associated with lower risk of unsuccessful HA by 12% (0.80%–0.97 95% CI, p= 0.009), 14% (0.77%–0.97 95% CI, p= 0.010) and 15% (0.76%–0.96 95% CI, p= 0.009), respectively. Plant-derived ALA levels were not significantly associated with HA. Sensitivity analyses including freedom from atrial fibrillation, milder chronic kidney disease, and diabetes within the HA definition did not appreciably alter results.
Conclusion Among older adults with mean age 75 years and HA to-date, a higher cumulative level of circulating seafood-derived n3-PUFAs (combined and individually), but not plant-derived ALA, was associated with maintainence of HA. These novel findings support guidelines for increased fish intake among older adults; and need for further investigations into plausible biological mechanisms and interventions for effects of n3-PUFAs on maintenance of HA.
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