Fish consumption, cognitive impairment and dementia: an updated dose-response meta-analysis of observational studies

Justyna Godos; Agnieszka Micek; Walter Currenti; Carlotta Franchi; Andrea Poli; Maurizio Battino; Alberto Dolci; Cristian Ricci; Zoltan Ungvari; Giuseppe Grosso

doi:10.1007/s40520-024-02823-6

Fish consumption, cognitive impairment and dementia: an updated dose-response meta-analysis of observational studies

Aging Clin Exp Res. 2024 Aug 20;36(1):171. doi: 10.1007/s40520-024-02823-6.

Authors

Justyna Godos^{1

2}, Agnieszka Micek³, Walter Currenti¹, Carlotta Franchi^{4

5}, Andrea Poli⁶, Maurizio Battino^{7

8

9}, Alberto Dolci¹⁰, Cristian Ricci¹¹, Zoltan Ungvari^{12

13

14

15

16}, Giuseppe Grosso^{17

18}

Affiliations

¹ Department of Biomedical and Biotechnological Sciences, University of Catania, Catania, Italy.
² Center for Human Nutrition and Mediterranean Foods (NUTREA), University of Catania, Catania, Italy.
³ Statistical Laboratory, Faculty of Health Sciences, Jagiellonian University Medical College, Kraków, 31-501, Poland.
⁴ Laboratory of Pharmacoepidemiology and Human Nutrition, Department of Health Policy, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, 20156, Italy.
⁵ Italian Institute for Planetary Health (IIPH), Milan, 20124, Italy.
⁶ Nutrition Foundation of Italy (NFI), Milan, 20124, Italy.
⁷ Department of Clinical Sciences, Università Politecnica Delle Marche, Ancona, Italy.
⁸ Research Group on Food, Nutritional Biochemistry and Health, Universidad Europea del Atlántico, Isabel Torres 21, Santander, 39011, Spain.
⁹ International Joint Research Laboratory of Intelligent Agriculture and Agri-Products Processing, Jiangsu University, Zhenjiang, Jiangsu, China.
¹⁰ Sustainable Development Department, Bolton Food SpA, Milan, 20124, Italy.
¹¹ Africa Unit for Transdisciplinary Health Research (AUTHeR), North-West University, Potchefstroom, 2531, South Africa.
¹² Vascular Cognitive Impairment, Neurodegeneration and Healthy Brain Aging Program, Department of Neurosurgery, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA.
¹³ Oklahoma Center for Geroscience and Healthy Brain Aging, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA.
¹⁴ International Training Program in Geroscience, Department of Public Health, Doctoral College, Semmelweis University, Budapest, Hungary.
¹⁵ Stephenson Cancer Center, University of Oklahoma, Oklahoma City, OK, USA.
¹⁶ Department of Health Promotion Sciences, College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA.
¹⁷ Department of Biomedical and Biotechnological Sciences, University of Catania, Catania, Italy. [email protected].
¹⁸ Center for Human Nutrition and Mediterranean Foods (NUTREA), University of Catania, Catania, Italy. [email protected].

Abstract

Background: Cognitive impairment is projected to affect a preponderant proportion of the aging population. Lifelong dietary habits have been hypothesized to play a role in preventing cognitive decline. Among the most studied dietary components, fish consumptionhas been extensively studied for its potential effects on the human brain.

Aims: To perform a meta-analysis of observational studies exploring the association between fish intake and cognitive impairment/decline and all types of dementia.

Methods: A systematic search of electronic databases was performed to identify observational studies providing quantitative data on fish consumption and outcomes of interest. Random effects models for meta-analyses using only extreme exposure categories, subgroup analyses, and dose-response analyses were performed to estimate cumulative risk ratios (RRs) and 95% confidence intervals (CIs).

Results: The meta-analysis comprised 35 studies. Individuals reporting the highest vs. the lowest fish consumption were associated with a lower likelihood of cognitive impairment/decline (RR = 0.82, 95% CI: 0.75, 0.90, I² = 61.1%), dementia (RR = 0.82, 95% CI: 0.73, 0.93, I² = 38.7%), and Alzheimer's disease (RR = 0.80, 95% CI: 0.67, 0.96, I² = 20.3%). The dose-response relation revealed a significantly decreased risk of cognitive impairment/decline and all cognitive outcomes across higher levels of fish intake up to 30% for 150 g/d (RR = 0.70, 95% CI: 0.52, 0.95). The results of this relation based on APOE ε4 allele status was mixed based on the outcome investigated.

Conclusions: Current findings suggest fish consumption is associated with a lower risk of cognitive impairment/decline in a dose-response manner, while for dementia and Alzheimer's disease there is a need for further studies to improve the strength of evidence.

Keywords: Alzheimer’s disease; Cognitive status; Dementia; Fish; Meta-analysis.

Publication types

Meta-Analysis
Systematic Review

MeSH terms

Alzheimer Disease
Animals
Cognitive Dysfunction* / epidemiology
Dementia* / epidemiology
Dementia* / prevention & control
Diet
Fishes*
Humans
Observational Studies as Topic*
Seafood