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Omega-3 Polyunsaturated Fatty Acids and Cognitive Decline in Adults with Non-Dementia or Mild Cognitive Impairment: An Overview of Systematic Reviews

Barros MI, Brandão T, Irving SC, Alves P, Gomes F, Correia M

Nutrients, 2025

26,881 participants · 16 citations

Abstract

Background/objectives: As global aging accelerates, prevalence of mild cognitive impairment (MCI) continues to rise, challenging healthcare systems and diminishing older adults' quality of life. There is great interest in better understanding the neuroprotective/anti-inflammatory properties of omega-3 polyunsaturated fatty acids but the results from many published studies in humans come to different conclusions. This review aims to clarify the efficacy of n-3 fatty acids as a preventive or therapeutic strategy for cognitive health and to inform future clinical recommendations within aging populations.

Methods: Following PRISMA guidelines and a registered PROSPERO protocol, we reviewed systematic reviews (SRs) from 2014 to 2024 assessing exclusive n-3 fatty acid supplementation and cognitive outcomes via MMSE. Data were extracted on intervention details and cognitive scores. Meta-analyses used fixed and random-effects models, with Hedges' estimating overall impact. Quality was assessed using AMSTAR-2, and statistical analyses were performed (SPSS 28).

Results: A total of nine SRs incorporating 14 RCTs were included, representing 26,881 participants aged 40 years or older. The pooled random-effects meta-analysis showed a statistically significant but modest improvement in MMSE scores (effect size: 0.16; 95% CI: 0.01-0.32). Heterogeneity was moderate (I2 = 42.8%), and no publication bias was detected. Further analyses revealed no significant associations between treatment…

How strong is the evidence?

Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 26,881 participants or records.

How the five levels of evidence work. The level is assigned automatically from the abstract and can be wrong, so check the paper.

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