2f:I[703058,["/_next/static/immutable/chunks/3bhq_5eh1d760.js","/_next/static/immutable/chunks/1855-ogyi8eh4.js","/_next/static/immutable/chunks/2pfsjpn6k6zlg.js","/_next/static/immutable/chunks/26c7v3_3uwnwu.js","/_next/static/immutable/chunks/25a3ozcrvi1ff.js","/_next/static/immutable/chunks/2r4wx50nvjh_4.js","/_next/static/immutable/chunks/23fsw06hsi5b1.js","/_next/static/immutable/chunks/06_yt270h41rg.js","/_next/static/immutable/chunks/3ezsiz-7shkna.js","/_next/static/immutable/chunks/20x2y96ldu5wx.js","/_next/static/immutable/chunks/2lxntcm3pd1_h.js","/_next/static/immutable/chunks/00dgco8irq3jw.js","/_next/static/immutable/chunks/00nwe-kq0rboc.js","/_next/static/immutable/chunks/2051ffx3xzio9.js"],"PaperListPageClient"] 30:T826,Protein-energy wasting, chronic inflammation, and functional decline are prevalent among patients undergoing haemodialysis (HD) and are associated with adverse outcomes and reduced quality of life. Although a substantial body of literature exists on nutritional management in HD, evidence has evolved considerably in recent years. Nutritional care in HD remains inconsistent and is limited by restrictive dietary paradigms and organizational barriers. To map evidence published between 2015 and 2025 on nutritional management in adult patients undergoing HD, focusing on personalized strategies, barriers to effective nutritional care, and patient-centred, function-oriented implementation. A scoping review was conducted following Joanna Briggs Institute methodology and reported according to PRISMA Extension for Scoping Reviews. PubMed/MEDLINE, Scopus, Web of Science, and Europe PMC were searched for English-language studies published between January 2015 and August 2025. A total of 30 studies were included. The literature describes diverse personalized nutritional approaches, including oral and intradialytic supplementation, plant-forward dietary patterns, microbiota-oriented strategies, and targeted nutrient supplementation. Reported outcomes included nutritional biomarkers, inflammation, body composition, functional measures, and patient-reported experience. Key barriers to effective nutritional care were poor dietary adherence, psychosocial burden, limited health literacy, inconsistent professional guidance, and organizational constraints. Morphofunctional assessment tools provided added value beyond biochemical parameters, and the studies highlighted specific considerations for nutritional risk assessment in older adults undergoing HD. This scoping review highlights a shift towards more personalized and function-oriented nutritional care in HD, while underscoring persistent barriers and substantial evidence heterogeneity. The findings support future research and the development of more integrated, patient-centred, and sustainable nutritional care models.31:Tb3a,ABSTRACT Background Protein-energy wasting, chronic inflammation, and functional decline are prevalent among patients undergoing haemodialysis (HD) and are associated with adverse outcomes and reduced quality of life. Although a substantial body of literature exists on nutritional management in HD, evidence has evolved considerably in recent years. Nutritional care in HD remains inconsistent and is limited by restrictive dietary paradigms and organizational barriers. Objective To map evidence published between 2015 and 2025 on nutritional management in adult patients undergoing HD, focusing on personalized strategies, barriers to effective nutritional care, and patient-centred, function-oriented implementation. Methods A scoping review was conducted following Joanna Briggs Institute methodology and reported according to PRISMA Extension for Scoping Reviews. PubMed/MEDLINE, Scopus, Web of Science, and Europe PMC were searched for English-language studies published between January 2015 and August 2025. Results A total of 30 studies were included. The literature describes diverse personalized nutritional approaches, including oral and intradialytic supplementation, plant-forward dietary patterns, microbiota-oriented strategies, and targeted nutrient supplementation. Reported outcomes included nutritional biomarkers, inflammation, body composition, functional measures, and patient-reported experience. Key barriers to effective nutritional care were poor dietary adherence, psychosocial burden, limited health literacy, inconsistent professional guidance, and organizational constraints. Morphofunctional assessment tools provided added value beyond biochemical parameters, and the studies highlighted specific considerations for nutritional risk assessment in older adults undergoing HD. Conclusions This scoping review highlights a shift towards more personalized and function-oriented nutritional care in HD, while underscoring persistent barriers and substantial evidence heterogeneity. The findings support future research and the development of more integrated, patient-centred, and sustainable nutritional care models. 32:T614,While omega-3 fatty acid supplementation is widely used for cognitive protection, its efficacy remains controversial, and its impact on core Alzheimer's disease (AD) pathologies in humans is not well-established. This longitudinal study utilized data from the Alzheimer's Disease Neuroimaging Initiative (ADNI). We employed linear mixed-effects models to assess the association between omega-3 supplementation and longitudinal cognitive decline, and mediation analyses to examine whether this relationship was mediated by core AD pathologies (Aβ-PET, tau-PET, T1-MRI, FDG-PET). Omega-3 supplementation was associated with significantly accelerated cognitive decline, as evidenced by a faster decrease in MMSE scores (β = -0.266, p < 0.001) and a faster increase in both ADAS-Cog13 (β = 0.823, p < 0.001) and CDR-SB scores (β = 0.205, p < 0.001). This association was not mediated by Aβ deposition, tau pathology, or gray matter atrophy. Instead, longitudinal FDG hypometabolism within AD-vulnerable regions served as a significant mediating pathway, accounting for 30.8%, 40.8%, and 19.0% of the total effect on the decline in MMSE, ADAS-Cog13, and CDR-SB, respectively. Omega-3 supplementation may be associated with accelerated cognitive decline in older adults, potentially through adverse effects on cerebral synaptic function rather than classical AD proteinopathies. These findings challenge the prevailing view of omega-3 as uniformly beneficial and highlight the need for a cautious reassessment of its widespread use for cognitive protection.25:[[["$","script","0",{"type":"application/ld+json","dangerouslySetInnerHTML":{"__html":"{\"@context\":\"https://schema.org\",\"@type\":\"CollectionPage\",\"name\":\"Omega-3 Fatty Acid Supplementation: modality Research & Clinical Takeaways\",\"description\":\"Explore peer-reviewed papers on Omega-3 Fatty Acid Supplementation (modality). Clinician-written summaries and actionable practice insights. 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Key thresholds include: screen all dialysis patients at least every 3 months; start ONS when spontaneous intake cannot meet needs after counseling (target ~250–300 kcal/day); initiate IDPN when oral + ONS intake still falls short but spontaneous intake exceeds 50% of requirements; prescribe IDPN for 3.5–4 hour sessions with a stepped volume increase. Fish oil supplementation (4 capsules/day) in the PISCES trial reduced serious cardiovascular events by ~40% (HR 0.57, 95% CI 0.47–0.70) in hemodialysis patients.","limitations":"- All statements are expert consensus, not derived from high-quality RCTs; most IDPN trials are small, heterogeneous, and lack standardized endpoints.\n- The entire expert group received honoraria and travel support from Fresenius Kabi, the manufacturer of IDPN products, creating a significant conflict of interest.\n- Guidance covers only ONS and IDPN; enteral nutrition and total PN are addressed only briefly.","practice_takeaway":"Screen every dialysis patient for protein-energy wasting at least quarterly using MIS or SGA, and escalate support stepwise: counseling → ONS → IDPN (or enteral nutrition) based on intake adequacy and PEW severity. When starting IDPN, use a gradual step-up infusion approach and monitor glucose, triglycerides, electrolytes, and volume status closely at each session, especially in the first two weeks."}},{"doi":"10.1016/j.jtos.2026.06.003","pmid":"42270038","title":"Dysregulated lipid metabolism in dry eye disease: Pathophysiological mechanisms and emerging treatments","journal_title":"The Ocular Surface","journal_issn":"1542-0124","published_at":"2026-06-10T00:00:00.000Z","url":"https://doi.org/10.1016/j.jtos.2026.06.003","source_score":4,"is_retracted":false,"is_open_access":false,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-06-17T13:29:50.616Z","updated_at":"2026-06-17T13:29:50.616Z","tags":[{"paper_doi":"10.1016/j.jtos.2026.06.003","tag_type":"age_group","value":"mixed","value_numeric":null},{"paper_doi":"10.1016/j.jtos.2026.06.003","tag_type":"category","value":"Ophthalmology","value_numeric":null},{"paper_doi":"10.1016/j.jtos.2026.06.003","tag_type":"condition","value":"Dry Eye Disease","value_numeric":null},{"paper_doi":"10.1016/j.jtos.2026.06.003","tag_type":"condition","value":"Meibomian Gland Dysfunction","value_numeric":null},{"paper_doi":"10.1016/j.jtos.2026.06.003","tag_type":"impact_flag","value":"limited_evidence","value_numeric":null},{"paper_doi":"10.1016/j.jtos.2026.06.003","tag_type":"level_of_evidence","value":"5","value_numeric":null},{"paper_doi":"10.1016/j.jtos.2026.06.003","tag_type":"modality","value":"Ferroptosis Inhibitor","value_numeric":null},{"paper_doi":"10.1016/j.jtos.2026.06.003","tag_type":"modality","value":"Lipid Metabolism Modulator","value_numeric":null},{"paper_doi":"10.1016/j.jtos.2026.06.003","tag_type":"modality","value":"Omega-3 Fatty Acid Supplementation","value_numeric":null},{"paper_doi":"10.1016/j.jtos.2026.06.003","tag_type":"study_design","value":"Narrative Review","value_numeric":null},{"paper_doi":"10.1016/j.jtos.2026.06.003","tag_type":"warning","value":"Emerging therapies (ferroptosis inhibitors, metabolic enzyme modulators) are discussed conceptually; clinical evidence is limited or absent.","value_numeric":null},{"paper_doi":"10.1016/j.jtos.2026.06.003","tag_type":"warning","value":"No sample size applicable — this is a review article with no primary patient cohort.","value_numeric":null},{"paper_doi":"10.1016/j.jtos.2026.06.003","tag_type":"warning","value":"Publication date is June 10, 2026 — very recently published; findings have not yet been externally replicated or cited.","value_numeric":null},{"paper_doi":"10.1016/j.jtos.2026.06.003","tag_type":"warning","value":"The 'Ocular Lipid Unit' (OLU) framework appears to be a conceptual construct introduced in this review; its clinical utility has not been independently validated.","value_numeric":null}],"summaries":{"what_studied":"This review synthesizes evidence on dysregulated lipid metabolism in dry eye disease (DED), examining pathophysiological mechanisms across the meibomian glands, lacrimal glands, cornea, conjunctiva, and tear film — conceptualized as an integrated 'Ocular Lipid Unit' (OLU).","key_result":"Key mechanisms identified include impaired mitochondrial fatty acid oxidation, dysregulated very-long-chain fatty acid (VLCFA) synthesis reducing meibum fluidity, an n-6/n-3 PUFA imbalance driving chronic inflammation, and lipid peroxidation/ferroptosis — all worsened by aging and diabetes. Lipidomics evidence suggests lipid physical properties (viscoelasticity, molecular ordering) are more clinically relevant than absolute lipid quantity.","limitations":"This is a narrative review without a registered systematic protocol or meta-analysis, which limits protection against selection bias. No primary data or clinical trial results are reported. Emerging therapies discussed (e.g., ferroptosis inhibitors, metabolic enzyme targets) lack large-scale clinical validation.","practice_takeaway":"Consider DED as a metabolic disorder of the ocular surface, not just an inflammatory one — therapeutic strategies targeting lipid homeostasis (e.g., n-3 PUFA supplementation, physical therapies for meibomian gland dysfunction) may offer benefit beyond anti-inflammatory approaches. Precision medicine targeting specific lipid defects across the OLU represents a promising future direction."}},{"doi":"10.1093/ckj/sfag117","pmid":"42094027","title":"Personalized nutrition in haemodialysis: a scoping review of studies published between 2015 and 2025","journal_title":"Clinical Kidney Journal","journal_issn":"2048-8505","published_at":"2026-05-07T00:00:00.000Z","url":"https://doi.org/10.1093/ckj/sfag117","source_score":42,"is_retracted":false,"is_open_access":true,"raw_metadata":{"ooir":{"day":"2026-04-19","doi":"10.1093/ckj/sfag117","days":"30","issn":"2048-8505","rank":"5","field":"Clinical Medicine","score":"42","category":"Urology & Nephrology","categories":["Urology & Nephrology"],"_categories":["Urology & Nephrology"]},"pubmed":{"doi":"10.1093/ckj/sfag117","title":"Personalized nutrition in haemodialysis: a scoping review of studies published between 2015 and 2025.","journal":"Clinical kidney journal","methods":"","results":"A total of 30 studies were included. The literature describes diverse personalized nutritional approaches, including oral and intradialytic supplementation, plant-forward dietary patterns, microbiota-oriented strategies, and targeted nutrient supplementation. Reported outcomes included nutritional biomarkers, inflammation, body composition, functional measures, and patient-reported experience. Key barriers to effective nutritional care were poor dietary adherence, psychosocial burden, limited health literacy, inconsistent professional guidance, and organizational constraints. Morphofunctional assessment tools provided added value beyond biochemical parameters, and the studies highlighted specific considerations for nutritional risk assessment in older adults undergoing HD.","abstract":"$30","keywords":["dietary adherence","haemodialysis","morphofunctional nutritional assessment","patient-centred care","personalized nutrition","protein-energy wasting"],"pubmed_id":"42094027","conclusions":"","publication_date":"2026-05-07T00:00:00"},"crossref":{"DOI":"10.1093/ckj/sfag117","URL":"https://doi.org/10.1093/ckj/sfag117","ISSN":["2048-8505","2048-8513"],"link":[{"URL":"https://academic.oup.com/ckj/advance-article-pdf/doi/10.1093/ckj/sfag117/68093728/sfag117.pdf","content-type":"application/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https://academic.oup.com/ckj/article-pdf/19/5/sfag117/68093728/sfag117.pdf","content-type":"application/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https://academic.oup.com/ckj/article-pdf/19/5/sfag117/68093728/sfag117.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"page":null,"type":"journal-article","issue":"5","score":1,"title":["Personalized nutrition in haemodialysis: a scoping review of studies published between 2015 and 2025"],"author":[{"given":"José Francisco","family":"Rojas-Pérez","sequence":"first","affiliation":[{"name":"Diaverum Málaga , Málaga ,"}]},{"given":"Sheila","family":"González-Salvatierra","sequence":"additional","affiliation":[{"name":"IBIMA Plataforma BIONAND, Instituto de Investigación Biomédica de Málaga , Málaga ,"},{"name":"Hospital Regional Universitario de Málaga Department of Endocrinology and Nutrition, , Málaga ,"},{"name":"Instituto de Salud Carlos III, CIBER of Frailty and Healthy Aging (CIBERFES) , Madrid ,"}]},{"given":"Alejandro","family":"Oncina-Cánovas","sequence":"additional","affiliation":[{"name":"Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL) , Alicante ,"},{"name":"Universidad Miguel Hernández (UMH) Unidad de Epidemiología de la Nutrición, Departamento de Salud Pública, Historia de la Ciencia y Ginecología, , Alicante ,"},{"name":"Instituto de Salud Carlos III, CIBER of Epidemiology and Public Health (CIBERESP) , Madrid ,"}]},{"given":"Marina","family":"Padial","sequence":"additional","affiliation":[{"name":"IBIMA Plataforma BIONAND, Instituto de Investigación Biomédica de Málaga , Málaga ,"},{"name":"Hospital Regional Universitario de Málaga Department of Endocrinology and Nutrition, , Málaga ,"},{"name":"University of Málaga Department of Medicine and Dermatology, , Málaga ,"}]},{"given":"Verónica","family":"López-Jiménez","sequence":"additional","affiliation":[{"name":"IBIMA Plataforma BIONAND, Instituto de Investigación Biomédica de Málaga , Málaga ,"},{"name":"University of Málaga Department of Medicine and Dermatology, , Málaga ,"},{"name":"Hospital Regional Universitario de Málaga Department of Nephrology, , Málaga ,"},{"name":"Instituto de Salud Carlos III, National Network for Kidney Research RICORS2040 RD21/0005/0012 , Madrid ,"}]},{"given":"Gabriel","family":"Olveira","sequence":"additional","affiliation":[{"name":"IBIMA Plataforma BIONAND, Instituto de Investigación Biomédica de Málaga , Málaga ,"},{"name":"Hospital Regional Universitario de Málaga Department of Endocrinology and Nutrition, , Málaga ,"},{"name":"University of Málaga Department of Medicine and Dermatology, , Málaga ,"},{"name":"Instituto de Salud Carlos III, CIBER of Diabetes and Associated Metabolic Diseases (CIBERDEM) , Madrid ,"}]}],"funder":[{"id":[{"id":"10.13039/501100004587","id-type":"DOI","asserted-by":"publisher"}],"DOI":"10.13039/501100004587","name":"Institute of Health Carlos III","award":["CD24/00003"],"award-info":[{"award-number":["CD24/00003"]}],"doi-asserted-by":"publisher"},{"id":[{"id":"10.13039/100009473","id-type":"DOI","asserted-by":"publisher"}],"DOI":"10.13039/100009473","name":"Universidad de 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Personalized oral/intradialytic supplementation, plant-forward diets, gut microbiota strategies, and targeted nutrients improved nutritional biomarkers and selected functional outcomes, but evidence was limited by small trials (<100 participants, 6–16 week follow-up) and high heterogeneity. Morphofunctional tools (muscle ultrasound, multifrequency BIA, MIS) outperformed serum albumin and BMI for detecting nutritional risk, especially in older adults. Only 36% of HD centres employed permanent renal dietitians, and <25% had standardized nutritional assessment protocols.","limitations":"- Most interventional studies were small and short-term, limiting generalizability and preventing firm recommendations.\n- Restriction to four databases and English-language publications may have missed relevant evidence.\n- Substantial methodological heterogeneity precluded meta-analysis; hard clinical endpoints (mortality, hospitalization) were rarely reported.","practice_takeaway":"Integrate renal dietitians and morphofunctional assessment (muscle ultrasound, BIA, MIS) into routine HD care rather than relying on albumin or BMI alone. Shift from rigid universal renal diets toward flexible, culturally adapted, patient-centred nutritional plans with structured psychosocial support to address the ~60% non-adherence rate."}},{"doi":"10.1016/j.jdermsci.2026.04.006","pmid":"42140827","title":"Unsaturated fatty acids mediate the bidirectional link between psoriasis and depression: Evidence from observational and mendelian randomization studies","journal_title":"Journal of Dermatological Science","journal_issn":"0923-1811","published_at":"2026-04-27T00:00:00.000Z","url":"https://doi.org/10.1016/j.jdermsci.2026.04.006","source_score":1,"is_retracted":false,"is_open_access":false,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-06-27T13:27:47.402Z","updated_at":"2026-06-27T13:27:47.402Z","tags":[{"paper_doi":"10.1016/j.jdermsci.2026.04.006","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1016/j.jdermsci.2026.04.006","tag_type":"category","value":"Dermatology","value_numeric":null},{"paper_doi":"10.1016/j.jdermsci.2026.04.006","tag_type":"condition","value":"Depression","value_numeric":null},{"paper_doi":"10.1016/j.jdermsci.2026.04.006","tag_type":"condition","value":"Psoriasis","value_numeric":null},{"paper_doi":"10.1016/j.jdermsci.2026.04.006","tag_type":"generic","value":"docosahexaenoic acid","value_numeric":null},{"paper_doi":"10.1016/j.jdermsci.2026.04.006","tag_type":"generic","value":"omega-3 polyunsaturated fatty acids","value_numeric":null},{"paper_doi":"10.1016/j.jdermsci.2026.04.006","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1016/j.jdermsci.2026.04.006","tag_type":"level_of_evidence","value":"3","value_numeric":null},{"paper_doi":"10.1016/j.jdermsci.2026.04.006","tag_type":"modality","value":"Omega-3 Fatty Acid Supplementation","value_numeric":null},{"paper_doi":"10.1016/j.jdermsci.2026.04.006","tag_type":"sample_size","value":"n=211","value_numeric":211},{"paper_doi":"10.1016/j.jdermsci.2026.04.006","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1016/j.jdermsci.2026.04.006","tag_type":"study_design","value":"Cross-Sectional Study with Mendelian Randomization","value_numeric":null},{"paper_doi":"10.1016/j.jdermsci.2026.04.006","tag_type":"warning","value":"The sample size tag reflects only the clinical cross-sectional cohort (n=211); the MR analyses used much larger GWAS datasets (up to 170,756 depression cases). Level of evidence is approximate given the hybrid study design combining observational and genetic approaches.","value_numeric":null},{"paper_doi":"10.1016/j.jdermsci.2026.04.006","tag_type":"warning","value":"The study is published in 2026 and represents recent findings; independent replication has not yet been established at the time of this summary.","value_numeric":null}],"summaries":{"what_studied":"This study evaluated the bidirectional causal relationship between psoriasis and depression, and the mediating role of circulating unsaturated fatty acids (UFAs), using a cross-sectional cohort of 211 psoriasis patients with serum metabolomics, combined with bidirectional Mendelian randomization (MR) from large GWAS datasets (9,267 psoriasis cases; 170,756 depression cases).","key_result":"Clinically significant depressive symptoms (PHQ-9 ≥ 10) were found in 32.7% of psoriasis patients. MR confirmed a robust bidirectional causal link between psoriasis and depression, independent of BMI and smoking. The DHA-to-total fatty acid ratio was identified as a key mediator from psoriasis to depression; depression also altered PUFA/MUFA ratios to increase psoriasis risk.","limitations":"- Cross-sectional design of the clinical cohort limits temporal inference.\n- MR relies on GWAS summary statistics, which may not fully capture all confounders or population diversity.\n- Mediation proportions and absolute effect sizes for the UFA pathways are not reported in the abstract.","practice_takeaway":"Consider screening psoriasis patients routinely for depression, especially those with higher BMI, smoking history, special site involvement, or high PASI scores. Omega-3 supplementation, weight management, and smoking cessation are modifiable targets that may improve both skin and mental health outcomes simultaneously."}},{"doi":"10.1016/j.tjpad.2026.100569","pmid":"42000571","title":"The association between omega-3 supplementation and cognitive decline in older adults","journal_title":"The Journal of Prevention of Alzheimer's Disease","journal_issn":"2274-5807","published_at":"2026-04-19T00:00:00.000Z","url":"https://doi.org/10.1016/j.tjpad.2026.100569","source_score":167,"is_retracted":false,"is_open_access":true,"raw_metadata":{"ooir":{"day":"2026-04-19","doi":"10.1016/j.tjpad.2026.100569","days":"30","issn":"2274-5807","rank":"6","field":"Clinical Medicine","score":"167","category":"Clinical Neurology","categories":["Clinical Neurology"],"_categories":["Clinical Neurology"]},"pubmed":{"doi":"10.1016/j.tjpad.2026.100569","title":"The association between omega-3 supplementation and cognitive decline in older adults.","journal":"The journal of prevention of Alzheimer's disease","methods":"","results":"Omega-3 supplementation was associated with significantly accelerated cognitive decline, as evidenced by a faster decrease in MMSE scores (β = -0.266, p < 0.001) and a faster increase in both ADAS-Cog13 (β = 0.823, p < 0.001) and CDR-SB scores (β = 0.205, p < 0.001). 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Impairment","value_numeric":null},{"paper_doi":"10.1016/j.tjpad.2026.100569","tag_type":"generic","value":"fish oil","value_numeric":null},{"paper_doi":"10.1016/j.tjpad.2026.100569","tag_type":"generic","value":"omega-3 polyunsaturated fatty acids","value_numeric":null},{"paper_doi":"10.1016/j.tjpad.2026.100569","tag_type":"impact_flag","value":"safety_signal","value_numeric":null},{"paper_doi":"10.1016/j.tjpad.2026.100569","tag_type":"level_of_evidence","value":"3","value_numeric":null},{"paper_doi":"10.1016/j.tjpad.2026.100569","tag_type":"modality","value":"Omega-3 Fatty Acid Supplementation","value_numeric":null},{"paper_doi":"10.1016/j.tjpad.2026.100569","tag_type":"sample_size","value":"n=819","value_numeric":819},{"paper_doi":"10.1016/j.tjpad.2026.100569","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1016/j.tjpad.2026.100569","tag_type":"study_design","value":"Longitudinal Observational Cohort Study","value_numeric":null},{"paper_doi":"10.1016/j.tjpad.2026.100569","tag_type":"warning","value":"Omega-3 exposure was primarily fish oil; findings may not apply to purified EPA/DHA formulations with lower oxidative risk.","value_numeric":null},{"paper_doi":"10.1016/j.tjpad.2026.100569","tag_type":"warning","value":"The harmful association contradicts most prior RCT evidence; authors acknowledge healthy-user bias and unmeasured confounding may not be fully excluded.","value_numeric":null},{"paper_doi":"10.1016/j.tjpad.2026.100569","tag_type":"warning","value":"The level of evidence is rated 3 (matched cohort), not 1, despite statistically significant findings with mediation analysis.","value_numeric":null},{"paper_doi":"10.1016/j.tjpad.2026.100569","tag_type":"warning","value":"The study population is predominantly White and highly educated, which limits generalizability to other demographic groups.","value_numeric":null},{"paper_doi":"10.1016/j.tjpad.2026.100569","tag_type":"warning","value":"This is an observational study using ADNI data with propensity-score matching — causal inference is not possible; a true randomized design was not used.","value_numeric":null}],"summaries":{"what_studied":"This longitudinal observational study used ADNI data to examine whether omega-3 supplementation (fish oil, flaxseed oil, krill oil) was associated with cognitive decline in 273 users vs. 546 propensity-score-matched non-users (ages 55–90, median follow-up 5 years), and whether core AD pathologies (Aβ-PET, tau-PET, MRI gray matter, FDG-PET) mediated that relationship.","key_result":"Omega-3 supplementation was linked to **faster cognitive deterioration** across all three scales: MMSE (β = −0.266/year, p < 0.001), ADAS-Cog13 (β = +0.823/year, p < 0.001), and CDR-SB (β = +0.205/year, p < 0.001). This was **not mediated** by Aβ, tau, or gray matter atrophy. FDG hypometabolism (synaptic dysfunction) was a significant mediator, explaining 30.8%, 40.8%, and 19.0% of the effect on MMSE, ADAS-Cog13, and CDR-SB, respectively.","limitations":"- **Unmeasured confounding**: despite propensity-score matching, residual confounders (e.g., cardiovascular disease, family history of dementia) could bias results.\n- **Exposure misclassification**: precise dosage and adherence data were unavailable for the full follow-up; formulation type (fish oil vs. other forms) could not be stratified.\n- **Generalizability**: cohort is predominantly White and highly educated; tau-PET data were limited, reducing power for tau-related analyses.","practice_takeaway":"Clinicians should not assume omega-3 supplements are uniformly safe for cognitive protection in older adults — this study raises a safety signal, particularly for long-term use of fish oil formulations. Until dose-, formulation-, and patient-specific evidence is clearer, routine omega-3 supplementation for dementia prevention warrants cautious reassessment."}}],"initialOffset":5,"fetchConfig":{"kind":"tags","tags":[{"tag_type":"modality","value":"Omega-3 Fatty Acid Supplementation"}]},"breadcrumbItems":[{"name":"Home","href":"/"},{"name":"Research Hub","href":"/hub"},{"name":"Modalities","href":"/hub/tag/modality"},{"name":"Omega-3 Fatty Acid Supplementation"}],"hrefConfig":{"basePath":"/hub/papers","webViewQueryParams":{"hub_ctx":"tag","hub_tag_type":"modality","hub_tag_value":"Omega-3 Fatty Acid Supplementation"}}}]]

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