DHA (Docosahexaenoic Acid), an Omega 3 Fatty Acid, in Slowing the Progression of Alzheimer's Disease (DHA)
Primary Purpose
Alzheimer's Disease
Status
Completed
Phase
Phase 3
Locations
United States
Study Type
Interventional
Intervention
DHA (Docosahexaenoic Acid)
Placebo
Sponsored by
About this trial
This is an interventional treatment trial for Alzheimer's Disease focused on measuring fish oil, omega-3 fatty acids, EPA
Eligibility Criteria
Inclusion Criteria:
- Male or female
- 50 years of age or older
- Residing in the community at baseline (includes assisted living facilities, but excludes long-term care nursing facilities)
- MMSE (Mini-Mental State Examination) at screen of 14-26 (inclusive)
- No medical contraindications to study participation
- Fluent in English or Spanish
- Corrected vision and hearing sufficient for compliance with testing procedures
- Supervision available for study medication
- Caregiver/study partner to accompany participant to all visits
- Study partner must have direct contact with the participant more than 2 days/week
- Able to ingest oral medication
- Daily DHA consumption less than or equal to 200 mg/day in prior two months estimated by an abbreviated DHA food frequency questionnaire
- Neuroimaging consistent with the diagnosis of AD at some time after the onset of the memory decline
- Clinical laboratory values must be within normal limits or, if abnormal, must be judged to be clinically insignificant by the investigator
- Stable use of cholinesterase inhibitors and memantine is permitted if doses are stable for 4 months prior to enrollment
Exclusion Criteria:
- Non-AD dementia
- Residence in a long-term care facility at baseline
- History of clinically significant stroke
- Modified Hachinski Ischemia score ≥ 4
- Current evidence or history in past two years of epilepsy, seizure, focal brain lesion, head injury with loss of consciousness or DSM-IV (Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition) criteria for any major psychiatric disorder including psychosis, major depression, bipolar disorder, alcohol or substance abuse
- Sensory impairment which would prevent subject from participating in or cooperating with the protocol
- Use of another investigational agent within two months
- Evidence of any significant clinical disorder or laboratory finding that renders the participant unsuitable for receiving an investigational new drug including clinically significant or unstable hematologic, hepatic, cardiovascular (including history of ventricular fibrillation or ventricular tachycardia), pulmonary, gastrointestinal, endocrine, metabolic, renal, or other systemic disease or laboratory abnormality
- Active neoplastic disease (skin tumors other than melanoma may be included; participants with stable prostate cancer may be included at the discretion of the Project Director)
Sites / Locations
- University of Alabama, Birmingham
- Banner Alzheimer's Institute
- Sun Health Research Institute/Arizona Consortium
- University of California Irvine
- UCSD Shiley-Marcos Alzheimer's Research Center
- University of Southern California Psychiatry and Behavioral Sciences
- UCLA Neurology
- Palo Alto Institute for Research & Education
- UC-Davis Alzheimer's Disease Center
- Pacific Research Network
- Yale University School of Medicine
- Georgetown University Medical Center, Dept. of Neurology
- Howard University College of Medicine
- Mayo Clinic, Jacksonville
- Wien Center
- University of South Florida Suncoast Alzheimer's and Gerontology Center
- Byrd Alzheimer's Institute
- Emory University Dept. of Psychiatry
- Northwestern University Cognitive Neurology and Alzheimer Disease Center
- Rush Alzheimer's Disease Center
- Indiana University
- University of Kansas Medical Center
- University of Kentucky, Lexington, Sanders-Brown Center on Aging/Neurology
- Johns Hopkins University Division of Cognitive Neuroscience
- Brigham and Women's Hospital
- Boston University Alzheimer's Disease Clinical and Research Program
- University of Michigan Dept. of Neurology
- Saint Mary's Health Care
- Mayo Clinic Rochester, Alzheimer's Disease Research Center
- Saint Louis University, Department of Psychiatry
- Washington University ADRC-Memory and Aging Project
- Dartmouth-Hitchcock Medical Center
- Albany Medical College
- Dent Neurological Institute
- Mount Sinai School of Medicine
- New York University Medical Center
- Columbia University
- University of Rochester Medical Center
- Wake Forest University Health Services
- Case Western Reserve University Memory and Aging Center
- The Ohio State University
- Oregon Health and Science University Neurology
- University of Pittsburgh
- Rhode Island Hospital Neurology
- Medical University of South Carolina
- Meharry Medical College
- University of Texas Southwestern-Memory Research Unit
- Baylor University Department of Neurology
- The Memory Clinic
- University of Washington/Seattle Institute for Biomedical & Clinical Research
- University of Wisconsin Department of Medicine
Arms of the Study
Arm 1
Arm 2
Arm Type
Experimental
Placebo Comparator
Arm Label
1.
2.
Arm Description
DHA
Placebo
Outcomes
Primary Outcome Measures
Rate of Change on the ADAS-Cog 11.
ADAS-cog 11 = Alzheimer's Disease Assessment Scale, cognitive sub-scale in points per year. This is a psychometric measure sensitive to change in mild to moderate AD. The range of this instrument is 0 to 70 with higher numbers indicating greater impairment.
Rate of Change on CDR-SOB
CDR-SOB = Clinical Dementia Rating, Sum of Boxes. This is a global rating of dementia severity based on the clinician's interpretation of the history and examination. The range of this instrument is 0 to 18 with higher numbers indicating greater impairment.
Secondary Outcome Measures
ADCS-ADL
ADCS-ADL = Alzheimer's Disease Cooperative Study Activities of Daily Living Score. This is a structured questionnaire about activities of daily living, administered to the subject's caregiver/study partner. The range of this instrument is 0 to 6 with lower numbers indicating greater impairment.
Neuropsychiatric Inventory (NPI)
The Neuropsychiatric Inventory quantifies behavioral changes in dementia, including depression, anxiety, psychosis, agitation, sleep change, appetite change, and others. This is a structured questionnaire administered to the subject's caregiver/study partner. The range of this instrument is 0 to 120 with higher numbers indicating greater impairment.
Full Information
NCT ID
NCT00440050
First Posted
February 22, 2007
Last Updated
September 15, 2014
Sponsor
Alzheimer's Disease Cooperative Study (ADCS)
Collaborators
National Institute on Aging (NIA), DSM Nutritional Products, Inc.
1. Study Identification
Unique Protocol Identification Number
NCT00440050
Brief Title
DHA (Docosahexaenoic Acid), an Omega 3 Fatty Acid, in Slowing the Progression of Alzheimer's Disease
Acronym
DHA
Official Title
A Randomized Double-Blind Placebo-Controlled Trial Of The Effects Of Docosahexaenoic Acid (DHA) In Slowing The Progression Of Alzheimer's Disease
Study Type
Interventional
2. Study Status
Record Verification Date
September 2014
Overall Recruitment Status
Completed
Study Start Date
February 2007 (undefined)
Primary Completion Date
May 2009 (Actual)
Study Completion Date
May 2009 (Actual)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Alzheimer's Disease Cooperative Study (ADCS)
Collaborators
National Institute on Aging (NIA), DSM Nutritional Products, Inc.
4. Oversight
Data Monitoring Committee
Yes
5. Study Description
Brief Summary
The purpose of this study is to determine whether chronic DHA (Docosahexaenoic Acid) supplementation slows the progression of cognitive and functional decline in mild to moderate Alzheimer's disease (AD).
Detailed Description
Preliminary studies have shown a reduced risk of Alzheimer's disease (AD) in people consuming increased amounts of fish in their diets. Many of the health benefits of fish are attributed to the abundance of omega 3 fatty acids. Docosahexaenoic Acid (DHA) is the most abundant omega 3 fatty acid in the brain. Data from several animal models supports the hypothesis that DHA may be an effective treatment for AD by means of anti-amyloid, antioxidant, and neuroprotectant mechanisms.
In this study, 400 individuals with mild to moderate AD will participate at approximately 53 study sites throughout the US for 18 months. Participants will be randomized so that 60% will receive approximately 2 grams of DHA, divided into 4 capsules, 2 capsules taken twice a day, while 40% receive an identical placebo.
Potential participants will go to their study site for a screening visit, where eligibility is determined, and if accepted, for a baseline visit where cognitive status, behavioral status, functional status, and global severity of dementia will be assessed. Vital signs and biomarker labs will also be obtained. Subsequent visits will occur every three months for medication checks and, every 6 months, further assessments, physical exams, and labs.
Some participants will also take part in MRI (magnetic resonance imaging) and/or CSF (cerebrospinal fluid) sub-studies. For the MRI sub-study, scans will be done prior to beginning the study medication, and again after 18 months. Likewise, for the CSF sub-study, a lumbar puncture will be done prior to beginning the study medication, and again after 18 months.
Enrollment is restricted to individuals who consume no more than 200 mg of DHA per day, which is almost 300% of the average daily intake in an American diet. Individuals who take fish oil or omega 3 fatty acid supplements are also not eligible. Each visit will include completion of a very brief food frequency questionnaire to monitor dietary DHA levels.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Alzheimer's Disease
Keywords
fish oil, omega-3 fatty acids, EPA
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 3
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
402 (Actual)
8. Arms, Groups, and Interventions
Arm Title
1.
Arm Type
Experimental
Arm Description
DHA
Arm Title
2.
Arm Type
Placebo Comparator
Arm Description
Placebo
Intervention Type
Drug
Intervention Name(s)
DHA (Docosahexaenoic Acid)
Other Intervention Name(s)
Neuromins
Intervention Description
950 mg soft-gel capsules which contain approximately 510 mg DHA, 2 capsules twice a day for 18 months
Intervention Type
Drug
Intervention Name(s)
Placebo
Intervention Description
2 placebo capsules twice a day for 18 months
Primary Outcome Measure Information:
Title
Rate of Change on the ADAS-Cog 11.
Description
ADAS-cog 11 = Alzheimer's Disease Assessment Scale, cognitive sub-scale in points per year. This is a psychometric measure sensitive to change in mild to moderate AD. The range of this instrument is 0 to 70 with higher numbers indicating greater impairment.
Time Frame
Baseline, 6, 12, 18 months
Title
Rate of Change on CDR-SOB
Description
CDR-SOB = Clinical Dementia Rating, Sum of Boxes. This is a global rating of dementia severity based on the clinician's interpretation of the history and examination. The range of this instrument is 0 to 18 with higher numbers indicating greater impairment.
Time Frame
18 months
Secondary Outcome Measure Information:
Title
ADCS-ADL
Description
ADCS-ADL = Alzheimer's Disease Cooperative Study Activities of Daily Living Score. This is a structured questionnaire about activities of daily living, administered to the subject's caregiver/study partner. The range of this instrument is 0 to 6 with lower numbers indicating greater impairment.
Time Frame
18 months
Title
Neuropsychiatric Inventory (NPI)
Description
The Neuropsychiatric Inventory quantifies behavioral changes in dementia, including depression, anxiety, psychosis, agitation, sleep change, appetite change, and others. This is a structured questionnaire administered to the subject's caregiver/study partner. The range of this instrument is 0 to 120 with higher numbers indicating greater impairment.
Time Frame
18 months
10. Eligibility
Sex
All
Minimum Age & Unit of Time
50 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Male or female
50 years of age or older
Residing in the community at baseline (includes assisted living facilities, but excludes long-term care nursing facilities)
MMSE (Mini-Mental State Examination) at screen of 14-26 (inclusive)
No medical contraindications to study participation
Fluent in English or Spanish
Corrected vision and hearing sufficient for compliance with testing procedures
Supervision available for study medication
Caregiver/study partner to accompany participant to all visits
Study partner must have direct contact with the participant more than 2 days/week
Able to ingest oral medication
Daily DHA consumption less than or equal to 200 mg/day in prior two months estimated by an abbreviated DHA food frequency questionnaire
Neuroimaging consistent with the diagnosis of AD at some time after the onset of the memory decline
Clinical laboratory values must be within normal limits or, if abnormal, must be judged to be clinically insignificant by the investigator
Stable use of cholinesterase inhibitors and memantine is permitted if doses are stable for 4 months prior to enrollment
Exclusion Criteria:
Non-AD dementia
Residence in a long-term care facility at baseline
History of clinically significant stroke
Modified Hachinski Ischemia score ≥ 4
Current evidence or history in past two years of epilepsy, seizure, focal brain lesion, head injury with loss of consciousness or DSM-IV (Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition) criteria for any major psychiatric disorder including psychosis, major depression, bipolar disorder, alcohol or substance abuse
Sensory impairment which would prevent subject from participating in or cooperating with the protocol
Use of another investigational agent within two months
Evidence of any significant clinical disorder or laboratory finding that renders the participant unsuitable for receiving an investigational new drug including clinically significant or unstable hematologic, hepatic, cardiovascular (including history of ventricular fibrillation or ventricular tachycardia), pulmonary, gastrointestinal, endocrine, metabolic, renal, or other systemic disease or laboratory abnormality
Active neoplastic disease (skin tumors other than melanoma may be included; participants with stable prostate cancer may be included at the discretion of the Project Director)
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Joseph Quinn, MD
Organizational Affiliation
Oregon Health and Science University
Official's Role
Principal Investigator
Facility Information:
Facility Name
University of Alabama, Birmingham
City
Birmingham
State/Province
Alabama
ZIP/Postal Code
35294
Country
United States
Facility Name
Banner Alzheimer's Institute
City
Phoenix
State/Province
Arizona
ZIP/Postal Code
85006
Country
United States
Facility Name
Sun Health Research Institute/Arizona Consortium
City
Sun City
State/Province
Arizona
ZIP/Postal Code
85351
Country
United States
Facility Name
University of California Irvine
City
Irvine
State/Province
California
ZIP/Postal Code
92697
Country
United States
Facility Name
UCSD Shiley-Marcos Alzheimer's Research Center
City
La Jolla
State/Province
California
ZIP/Postal Code
92037
Country
United States
Facility Name
University of Southern California Psychiatry and Behavioral Sciences
City
Los Angeles
State/Province
California
ZIP/Postal Code
90033
Country
United States
Facility Name
UCLA Neurology
City
Los Angeles
State/Province
California
ZIP/Postal Code
90095
Country
United States
Facility Name
Palo Alto Institute for Research & Education
City
Palo Alto
State/Province
California
ZIP/Postal Code
94304
Country
United States
Facility Name
UC-Davis Alzheimer's Disease Center
City
Sacramento
State/Province
California
ZIP/Postal Code
95817
Country
United States
Facility Name
Pacific Research Network
City
San Diego
State/Province
California
ZIP/Postal Code
92103
Country
United States
Facility Name
Yale University School of Medicine
City
New Haven
State/Province
Connecticut
ZIP/Postal Code
06510
Country
United States
Facility Name
Georgetown University Medical Center, Dept. of Neurology
City
Washington
State/Province
District of Columbia
ZIP/Postal Code
20057
Country
United States
Facility Name
Howard University College of Medicine
City
Washington
State/Province
District of Columbia
ZIP/Postal Code
20060
Country
United States
Facility Name
Mayo Clinic, Jacksonville
City
Jacksonville
State/Province
Florida
ZIP/Postal Code
32224
Country
United States
Facility Name
Wien Center
City
Miami Beach
State/Province
Florida
ZIP/Postal Code
33140
Country
United States
Facility Name
University of South Florida Suncoast Alzheimer's and Gerontology Center
City
Tampa
State/Province
Florida
ZIP/Postal Code
33617
Country
United States
Facility Name
Byrd Alzheimer's Institute
City
Tampa
State/Province
Florida
ZIP/Postal Code
33647
Country
United States
Facility Name
Emory University Dept. of Psychiatry
City
Atlanta
State/Province
Georgia
ZIP/Postal Code
30322
Country
United States
Facility Name
Northwestern University Cognitive Neurology and Alzheimer Disease Center
City
Chicago
State/Province
Illinois
ZIP/Postal Code
60611
Country
United States
Facility Name
Rush Alzheimer's Disease Center
City
Chicago
State/Province
Illinois
ZIP/Postal Code
60612
Country
United States
Facility Name
Indiana University
City
Indianapolis
State/Province
Indiana
ZIP/Postal Code
46202
Country
United States
Facility Name
University of Kansas Medical Center
City
Kansas City
State/Province
Kansas
ZIP/Postal Code
66160
Country
United States
Facility Name
University of Kentucky, Lexington, Sanders-Brown Center on Aging/Neurology
City
Lexington
State/Province
Kentucky
ZIP/Postal Code
40536
Country
United States
Facility Name
Johns Hopkins University Division of Cognitive Neuroscience
City
Baltimore
State/Province
Maryland
ZIP/Postal Code
20205
Country
United States
Facility Name
Brigham and Women's Hospital
City
Boston
State/Province
Massachusetts
ZIP/Postal Code
02115
Country
United States
Facility Name
Boston University Alzheimer's Disease Clinical and Research Program
City
Boston
State/Province
Massachusetts
ZIP/Postal Code
02118
Country
United States
Facility Name
University of Michigan Dept. of Neurology
City
Ann Arbor
State/Province
Michigan
ZIP/Postal Code
48105
Country
United States
Facility Name
Saint Mary's Health Care
City
Grand Rapids
State/Province
Michigan
ZIP/Postal Code
49503
Country
United States
Facility Name
Mayo Clinic Rochester, Alzheimer's Disease Research Center
City
Rochester
State/Province
Minnesota
ZIP/Postal Code
55905
Country
United States
Facility Name
Saint Louis University, Department of Psychiatry
City
St. Louis
State/Province
Missouri
ZIP/Postal Code
63104
Country
United States
Facility Name
Washington University ADRC-Memory and Aging Project
City
St. Louis
State/Province
Missouri
ZIP/Postal Code
63108
Country
United States
Facility Name
Dartmouth-Hitchcock Medical Center
City
Lebanon
State/Province
New Hampshire
ZIP/Postal Code
03756
Country
United States
Facility Name
Albany Medical College
City
Albany
State/Province
New York
ZIP/Postal Code
12208
Country
United States
Facility Name
Dent Neurological Institute
City
Amherst
State/Province
New York
ZIP/Postal Code
14226
Country
United States
Facility Name
Mount Sinai School of Medicine
City
Bronx
State/Province
New York
ZIP/Postal Code
10468
Country
United States
Facility Name
New York University Medical Center
City
New York
State/Province
New York
ZIP/Postal Code
10016
Country
United States
Facility Name
Columbia University
City
New York
State/Province
New York
ZIP/Postal Code
10032
Country
United States
Facility Name
University of Rochester Medical Center
City
Rochester
State/Province
New York
ZIP/Postal Code
14620
Country
United States
Facility Name
Wake Forest University Health Services
City
Winston-Salem
State/Province
North Carolina
ZIP/Postal Code
27157
Country
United States
Facility Name
Case Western Reserve University Memory and Aging Center
City
Cleveland
State/Province
Ohio
ZIP/Postal Code
44120
Country
United States
Facility Name
The Ohio State University
City
Columbus
State/Province
Ohio
ZIP/Postal Code
43210
Country
United States
Facility Name
Oregon Health and Science University Neurology
City
Portland
State/Province
Oregon
ZIP/Postal Code
97239
Country
United States
Facility Name
University of Pittsburgh
City
Pittsburgh
State/Province
Pennsylvania
ZIP/Postal Code
15213
Country
United States
Facility Name
Rhode Island Hospital Neurology
City
Providence
State/Province
Rhode Island
ZIP/Postal Code
02903
Country
United States
Facility Name
Medical University of South Carolina
City
North Charleston
State/Province
South Carolina
ZIP/Postal Code
29406
Country
United States
Facility Name
Meharry Medical College
City
Nashville
State/Province
Tennessee
ZIP/Postal Code
37208
Country
United States
Facility Name
University of Texas Southwestern-Memory Research Unit
City
Dallas
State/Province
Texas
ZIP/Postal Code
75390
Country
United States
Facility Name
Baylor University Department of Neurology
City
Houston
State/Province
Texas
ZIP/Postal Code
77030
Country
United States
Facility Name
The Memory Clinic
City
Bennington
State/Province
Vermont
ZIP/Postal Code
05201
Country
United States
Facility Name
University of Washington/Seattle Institute for Biomedical & Clinical Research
City
Seattle
State/Province
Washington
ZIP/Postal Code
98108
Country
United States
Facility Name
University of Wisconsin Department of Medicine
City
Madison
State/Province
Wisconsin
ZIP/Postal Code
53705
Country
United States
12. IPD Sharing Statement
Citations:
PubMed Identifier
15041028
Citation
Horrocks LA, Farooqui AA. Docosahexaenoic acid in the diet: its importance in maintenance and restoration of neural membrane function. Prostaglandins Leukot Essent Fatty Acids. 2004 Apr;70(4):361-72. doi: 10.1016/j.plefa.2003.12.011.
Results Reference
background
PubMed Identifier
14745067
Citation
Kalmijn S, van Boxtel MP, Ocke M, Verschuren WM, Kromhout D, Launer LJ. Dietary intake of fatty acids and fish in relation to cognitive performance at middle age. Neurology. 2004 Jan 27;62(2):275-80. doi: 10.1212/01.wnl.0000103860.75218.a5.
Results Reference
background
PubMed Identifier
12873849
Citation
Morris MC, Evans DA, Bienias JL, Tangney CC, Bennett DA, Wilson RS, Aggarwal N, Schneider J. Consumption of fish and n-3 fatty acids and risk of incident Alzheimer disease. Arch Neurol. 2003 Jul;60(7):940-6. doi: 10.1001/archneur.60.7.940.
Results Reference
background
PubMed Identifier
11935973
Citation
Suzuki H, Morikawa Y, Takahashi H. Effect of DHA oil supplementation on intelligence and visual acuity in the elderly. World Rev Nutr Diet. 2001;88:68-71. doi: 10.1159/000059767. No abstract available.
Results Reference
background
PubMed Identifier
15339646
Citation
Calon F, Lim GP, Yang F, Morihara T, Teter B, Ubeda O, Rostaing P, Triller A, Salem N Jr, Ashe KH, Frautschy SA, Cole GM. Docosahexaenoic acid protects from dendritic pathology in an Alzheimer's disease mouse model. Neuron. 2004 Sep 2;43(5):633-45. doi: 10.1016/j.neuron.2004.08.013.
Results Reference
background
PubMed Identifier
15788759
Citation
Lim GP, Calon F, Morihara T, Yang F, Teter B, Ubeda O, Salem N Jr, Frautschy SA, Cole GM. A diet enriched with the omega-3 fatty acid docosahexaenoic acid reduces amyloid burden in an aged Alzheimer mouse model. J Neurosci. 2005 Mar 23;25(12):3032-40. doi: 10.1523/JNEUROSCI.4225-04.2005.
Results Reference
background
PubMed Identifier
27358067
Citation
Yassine HN, Rawat V, Mack WJ, Quinn JF, Yurko-Mauro K, Bailey-Hall E, Aisen PS, Chui HC, Schneider LS. The effect of APOE genotype on the delivery of DHA to cerebrospinal fluid in Alzheimer's disease. Alzheimers Res Ther. 2016 Jun 30;8:25. doi: 10.1186/s13195-016-0194-x.
Results Reference
derived
PubMed Identifier
21045096
Citation
Quinn JF, Raman R, Thomas RG, Yurko-Mauro K, Nelson EB, Van Dyck C, Galvin JE, Emond J, Jack CR Jr, Weiner M, Shinto L, Aisen PS. Docosahexaenoic acid supplementation and cognitive decline in Alzheimer disease: a randomized trial. JAMA. 2010 Nov 3;304(17):1903-11. doi: 10.1001/jama.2010.1510.
Results Reference
derived
Learn more about this trial
DHA (Docosahexaenoic Acid), an Omega 3 Fatty Acid, in Slowing the Progression of Alzheimer's Disease
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