Background: Indications have been seen of a protective effect of fish consumption and the intake of n–3 fatty acids on cognitive decline. However, studies are scarce and results inconsistent.

Objective: The objective of the study was to examine the associations between fish consumption, the intake of the n–3 fatty acids eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) from fish and other foods, and subsequent 5-y cognitive decline.

Design: Data on fish consumption of 210 participants in the Zutphen Elderly Study, who were aged 70–89 y in 1990, and data on cognitive functioning collected in 1990 and 1995 were used in the study. The intake of EPA and DHA (EPA+DHA) was calculated for each participant. Multivariate linear regression analysis with multiple adjustments was used to assess associations.

Results: Fish consumers had significantly (P = 0.01) less 5-y subsequent cognitive decline than did nonconsumers. A linear trend was observed for the relation between the intake of EPA+DHA and cognitive decline (P = 0.01). An average difference of 380 mg/d in EPA+DHA intake was associated with a 1.1-point difference in cognitive decline (P = 0.01).

Conclusions: A moderate intake of EPA+DHA may postpone cognitive decline in elderly men. Results from other studies are needed before definite conclusions about this association can be drawn.