Food and Behaviour Research

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The Effects of Multi-Nutrient Formulas containing a Combination of Omega-3 Polyunsaturated Fatty Acids and B vitamins on Cognition in the older adult: A Systematic Review and Meta-analysis

Fairbairn P, Dyall S, Tsofliou F (2022) The British Journal of Nutrition  Apr 27;1-42 doi: 10.1017/S0007114522001283 

Web URL: Read this article on PubMed


There is now evidence to suggest that there may be an interaction between B vitamins and omega-3 polyunsaturated fatty acids (PUFAs), with suggestions that increasing intake of both nutrients simultaneously may benefit cognition in older adults.

The aim of this systematic review was to investigate whether supplementation with a combination of omega-3 PUFAs and B vitamins can prevent cognitive decline in older adults. Randomised control trials conducted in older adults that measured cognitive function were retrieved. The included trials provided a combination of omega-3 PUFAs and B vitamins alone, or in combination with other nutrients. Trials that provided omega-3 PUFAs alone and also measured B vitamin status or provided B vitamin supplementation alone and measured omega-3 PUFA status were also included.

The databases searched were The Cochrane Library, EMBASE, CINAHL, Scopus, and MEDLINE. A total of 14 papers were included in the analysis (n=4913; age: 60-70 y; follow up 24 weeks to 4 years).

The meta-analysis results found a significant benefit of nutrient formulas, which included both omega-3 PUFAs and B vitamins alongside other nutrients, versus placebo on global cognition assessed using composite scores from a neuropsychological test battery (G=0.23, P=0.002), global cognition using single measures of cognition (G=0.28, P=0.004) and episodic memory (G=0.32, P=0.001).

The results indicate that providing a combination of omega-3 PUFA and B vitamins as part of a multi-nutrient formula benefits cognition in older adults versus a placebo, the potential for an interaction between these key nutrients should be considered in future experimental work.


This systematic review of 14 randomised controlled trials, including almost 5000 patients, found benefits for cognitive function in older adults from dietary supplementation with a combination of omega-3 fatty acids and B vitamins (with or without other nutrients).

Nutrients work in synergy, not in isolation, and previous clinical trials have already indicated that in patients with mild cognitive impairment or early-stage dementia, adequate supplies of both omega-3 EPA/DHA and certain B vitamins are needed to slow cognitive decline and prevent physical brain shinkage - and that neither in isolation has the same benefits. See for example:

Other clinical trials have also shown benefits for slowing cognitive decline in early-stage Alzheimer's from supplementation with omega-3 and a broad range of micronutrients in addition to B vitamins. See:

See also: