This study examined the cross-sectional relation of red blood cell (RBC) fatty acid levels to subclinical imaging and cognitive markers of dementia risk in a middle-aged to elderly community-based cohort (N = 1,575; 854 women). RBC docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA) levels in dementia-free Framingham Study participants were related to performance on cognitive tests and to volumetric brain MRI, with serial adjustments for age, sex, and education, additionally for APOE 4 and plasma homocysteine, and also for physical activity and body mass index, or for traditional vascular risk factors. Participants with RBC DHA levels in the lowest quartile had lower total brain and greater white matter hyperintensity volumes when compared to others (P = 0.009 and P = 0.049, respectively) with persistence of the association with total brain volume in multivariable analyses. Participants in the lowest quartile of DHA and ω-3 index (RBC DHA+EPA) levels also had lower scores on tests of visual memory (P = 0.008), executive function (P = 0.004), and abstract thinking (P = 0.004). Therefore, lower RBC DHA levels are associated with smaller brain volumes and a “vascular” pattern of cognitive impairment in a dementia-free elderly population. Neurology. 2012 Feb 28;78(9):658-64. PMID: 22371413
