Sains Malaysiana 45(12)(2016): 1823–1834

http://dx.doi.org/10.17576/jsm-2016-4512-06

 

Kemampanan Intervensi Suplementasi Minyak Ikan dan Pendidikan Kesihatan dalam Kalangan Warga Tua yang Mengalami Kecelaan Kognitif Ringan

(Sustainability Supplementation Intervention of Fish Oil and Health Education

among Elderly with Mild Cognitive Impairment)

 

SUZANA, S^1*., NIK NUR IZZATI, N.M.F¹., SITI HAJAR, M¹., HASNAH, H.²

& KAMARUDDIN, M.Z.A.²

 

¹Program Dietik, Pusat Pengajian Sains Jagaan Kesihatan, Fakulti Sains Kesihatan

Universiti Kebangsaan Malaysia, 50300 Jalan Raja Muda, Kuala Lumpur, Malaysia

 

²Program Sains Pemakanan, Pusat Pengajian Sains Jagaan Kesihatan, Fakulti Sains Kesihatan, Universiti Kebangsaan Malaysia, 50300 Jalan Raja Muda, Kuala Lumpur, Malaysia

 

Diserahkan: 21 April 2014/Diterima: 10 Mei 2016

 

ABSTRAK

Intervensi pemakanan berpotensi untuk melambatkan penurunan fungsi kognitif dalam kalangan warga tua yang mengalami kecelaan kognitif ringan (MCI). Walau bagaimanapun, kemampanan program sedemikian masih belum dapat dipastikan. Oleh itu, suatu kajian susulan dijalankan bagi menentukan kemampanan suplementasi minyak ikan dan pendidikan kesihatan bagi mengurangkan kemerosotan fungsi kognitif dalam kalangan warga tua yang mengalami MCI selepas setahun kajian intervensi dijalankan. Kajian ini melibatkan 18 orang subjek MCI iaitu 6 orang bagi setiap kumpulan intervensi suplementasi minyak ikan (A) dan pendidikan kesihatan (B) dan kumpulan kawalan (C). Analisis menunjukkan kesan intervensi yang signifikan bagi ujian Span Digit (p<0.05) dan aras serum folat (p<0.05) dengan kumpulan B menunjukkan min yang paling tinggi, diikuti dengan A dan C. Intervensi pendidikan kesihatan dan suplementasi minyak ikan mempunyai kesan kemampanan bagi meningkatkan aras serum folat dan memperbaiki status fungsi kognitif yang dinilai menggunakan Ujian Span Digit. Terdapat keperluan bagi promosi kesihatan dan suplementasi minyak ikan dalam mengekalkan fungsi kognitif individu warga tua yang mengalami MCI.

 

Kata kunci: Kecelaan kognitif ringan; pendidikan kesihatan; suplementasi minyak ikan; warga tua

 

ABSTRACT

Nutrition interventions has good potential in delaying cognitive decline among elderly with mild cognitive impairment (MCI). However, the sustainability of these programmes are still uncertain. Thus, a study has been conducted to determine the sustainability of fish oil supplementation and health education among elderly with MCI after one year of intervention. 18 subjects with MCI involved in this study with 6 persons were grouped into 3 different groups which is fish oil supplementation intervention (A), health education intervention (B) and control group (C), respectively. Analysis showed there were significant difference for intervention effect in Digit Span (p<0.05) and folat serum level (p<0.05) for group B with highest mean difference followed by group A and C. Health education and fish oil supplementation intervention have sustainability effect to increase folate serum level and to improve cognitive function using Digit Span Test. Thus, there is a need for health promotion and fish oil supplementation for cognitive function among elderly with MCI.

 

Keywords: Elderly; fish oil supplementation; health education; mild cognitive impairment

RUJUKAN

Agrell, B. & Dehlin, O. 2012. The Clock-Drawing Test. 1998. Age Ageing 41(Suppl 3(iii): 41-45.

Barberger-Gateau, P., Letenneur, L., Deschamps, V., Peres, K., Dartigues, J.F. & Renaud, S. 2002. Fish, meat, and risk of dementia: Cohort study. BMJ 325(7370): 932-933.

Barnes, D.E., Yaffe, K., Belfor, N., Jagust, W.J., Decarli, C., Reed, B.R. & Kramer, J.H. 2009. Computer-based cognitive training for mild cognitive impairment: Results from a pilot randomized, controlled trial. Alzheimer Dis. Assoc. Disord. 23(3): 205-210.

Carrero, J.J., Lopez-Huertas, E., Salmeron, L.M., Baro, L. & Ros, E. 2005. Daily supplementation with (N-3) pufas, oleic acid, folic acid, and vitamins B-6 and E increases pain-free walking distance and improves risk factors in men with peripheral vascular disease. J. Nutr. 135(6): 1393-1399.

Chiu, C.C., Su, K.P., Cheng, T.C., Liu, H.C., Chang, C.J., Dewey, M.E., Stewart, R. & Huang, S.Y. 2008. The effects of omega-3 fatty acids monotherapy in Alzheimer’s disease and mild cognitive impairment: A preliminary randomized double-blind placebo-controlled study. Prog. Neuropsychopharmacol. Biol. Psychiatry 32(6): 1538-1544.

Connor, W.E. & Connor, S.L. 2007. The importance of fish and docosahexaenoic acid in Alzheimer disease. Am. J. Clin. Nutr. 85(4): 929-930.

Dangour, A.D., Allen, E., Elbourne, D., Fasey, N., Fletcher, A.E., Hardy, P., Holder, G.E., Knight, R., Letley, L., Richards, M. & Uauy, R. 2010. Effect of 2-Y N-3 long-chain polyunsaturated fatty acid supplementation on cognitive function in older people: A randomized, double-blind, controlled trial. Am. J. Clin. Nutr. 91(6): 1725-1732.

Dickinson, H.O., Nicolson, D.J., Campbell, F., Beyer, F.R. & Mason, J. 2006. Potassium supplementation for the management of primary hypertension in adults. Cochrane Database Syst. Rev. 3: CD004641.

Dufouil, C., Alperovitch, A. & Tzourio, C. 2003. Influence of education on the relationship between white matter lesions and cognition. Neurology 60(5): 831-836.

Folch, J., Lees, M. & Sloane Stanley, G.H. 1957. A simple method for the isolation and purification of total lipides from animal tissues. J. Biol. Chem. 226(1): 497-509.

Folstein, M. 1998. Mini-mental and son. Int. J. Geriatr. Psychiatry 13(5): 290-294.

Folstein, M.F., Folstein, S.E. & Mchugh, P.R. 1975. Mini-mental state. A practical method for grading the cognitive state of patients for the clinician. J. Psychiatr. Res. 12(3): 189-198.

Freund-Levi, Y., Eriksdotter-Jonhagen, M., Cederholm, T., Basun, H., Faxen-Irving, G., Garlind, A., Vedin, I., Vessby, B., Wahlund, L.O. & Palmblad, J. 2006. Omega-3 fatty acid treatment in 174 patients with mild to moderate Alzheimer disease: Omegad study: A randomized double-blind trial. Arch. Neurol. 63(10): 1402-1408.

Johari, S.I.M. 2012. Kajian keberkesanan pakej pendidikan dan gaya hidup dalam kalangan warga tua dengan kecelaan kognitif ringan. Tesis Sarjana. Universiti Kebangsaan Malaysia (tidak diterbitkan).

Joosten-Weyn Banningh, L.W., Roelofs, S.C., Vernooij-Dassen, M.J., Prins, J.B., Olde Rikkert, M.G. & Kessels, R.P. 2013. Long-term effects of group therapy for patients with mild cognitive impairment and their significant others: A 6- to 8-month follow-up study. Dementia (London) 12(1): 81-91.

Kalmijn, S., Launer, L.J., Ott, A., Witteman, J.C., Hofman, A. & Breteler, M.M. 1997. Dietary fat intake and the risk of incident dementia in the Rotterdam study. Ann. Neurol. 42(5): 776-782.

Kotani, S., Sakaguchi, E., Warashina, S., Matsukawa, N., Ishikura, Y., Kiso, Y., Sakakibara, M., Yoshimoto, T., Guo, J. & Yamashima, T. 2006. Dietary supplementation of arachidonic and docosahexaenoic acids improves cognitive dysfunction. Neurosci. Res. 56(2): 159-164.

Lee, L.K., Shahar, S., Chin, A.V. & Yusoff, N.A. 2013. Docosahexaenoic acid-concentrated fish oil supplementation in subjects with mild cognitive impairment (Mci): A 12-month randomised, double-blind, placebo-controlled trial. Psychopharmacology (Berl) 225(3): 605-612.

Lee, L.K., Shahar, S., Chin, A.V., Mohd Yusoff, N.A., Rajab, N. & Aziz, S.A. 2012. Prevalence of gender disparities and predictors affecting the occurrence of mild cognitive impairment (Mci). Arch. Gerontol. Geriatr. 54(1): 185-191.

Lepage, G. & Roy, C.C. 1984. Improved recovery of fatty acid through direct transesterification without prior extraction or purification. J. Lipid Res. 25(12): 1391-1396.

Marshall, S.M. & Flyvbjerg, A. 2006. Prevention and early detection of vascular complications of diabetes. BMJ 333(7566): 475-480.

Nettleton, J.A. & Katz, R. 2005. N-3 Long-chain polyunsaturated fatty acids in Type 2 diabetes: A review. J. Am. Diet Assoc. 105(3): 428-440.

Petersen, R.C., Doody, R., Kurz, A., Mohs, R.C., Morris, J.C., Rabins, P.V., Ritchie, K., Rossor, M., Thal, L. & Winblad, B. 2001. Current concepts in mild cognitive impairment. Arch. Neurol. 58(12): 1985-1992.

Quadri, P., Fragiacomo, C., Pezzati, R., Zanda, E., Forloni, G., Tettamanti, M. & Lucca, U. 2004. Homocysteine, folate, and vitamin B-12 in mild cognitive impairment, Alzheimer disease, and vascular dementia. Am. J. Clin. Nutr. 80(1): 114-122.

Rey, A. 1964. L’examen Clinique En Psychologie (Clinical Psychological Examination). Paris: Presses Universitaires de France.

Roubenoff, R. 1999. The pathophysiology of wasting in the elderly. J. Nutr. 129(1S Suppl): 256S-259S.

Rubenstein, L.Z. & Nahas, R. 1998. Primary and secondary prevention strategies in the older adult. Geriatr. Nurs. 19(1): 11-17; quiz 18, 28.

Scarmeas, N., Levy, G., Tang, M.X., Manly, J. & Stern, Y. 2001. Influence of leisure activity on the incidence of Alzheimer’s disease. Neurology 57(12): 2236-2242.

Shahar, S., Earland, J. & Abdulrahman, S. 2000. Validation of a dietary history questionnaire against a 7-D weighed record for estimating nutrient intake among rural elderly Malays. Malays. J. Nutr. 6(1): 33-44.

Shiekh, J. & Yesavage, J. 1986. Geriatric depression scale: Recent findings and development of a short version. Clinical Gerontology: A Guide to Assessment and Intervention, BrinkT (ed.). New York: Howarth Press.

Shulman, K.I., Shedletsky, R. & Silver, I.L. 1986. The challenge of time: Clock-drawing and cognitive function in the elderly. International Journal of Geriatric Psychiatry 1(2): 135-140.

Siuda, J., Gorzkowska, A., Patalong-Ogiewa, M., Krzystanek, E., Czech, E., Wiechula, B., Garczorz, W., Danch, A., Jasinska- Myga, B. & Opala, G. 2009. From mild cognitive impairment to Alzheimer’s disease - Influence of homocysteine, vitamin B12 and folate on cognition over time: Results from one-year follow-up. Neurol. Neurochir. Pol. 43(4): 321-329.

Sunderland, T., Hill, J.L., Mellow, A.M., Lawlor, B.A., Gundersheimer, J., Newhouse, P.A. & Grafman, J.H. 1989. Clock drawing in Alzheimer’s disease. A novel measure of dementia severity. J. Am. Geriatr. Soc. 37(8): 725-729.

Zarina, Z.A., Zahiruddin, O. & Che Wan, A.H. 2007. Validation of Malay Mini Mental State Examination. Malaysian Journal of Psychiatry Ejournal 16(1): 16-19.

 

 

*Pengarang untuk surat-menyurat; email: suzana.shahar@gmail.com