Plasmalogens and Alzheimer Disease

Plasmalogens are fats that form part of the outer skin of cells. The brain carries a great deal of them, and since the 1990s laboratories that examined brains after death have reported that people with Alzheimer disease had less of them than people without it. Later work found lower levels in the blood as well. That led researchers in Japan to test purified plasmalogens taken by mouth. This page sets out what the measurements showed, which explanations are still only proposals, what the supplement trials in people found, and what remains unknown. For the disease itself, see the main Alzheimer's Disease page.


Table of Contents

  1. What Plasmalogens Are
  2. Lower Plasmalogens in the Alzheimer Brain
  3. Lower Plasmalogens in the Blood
  4. The Proposed Mechanisms
  5. The Scallop Plasmalogen Trial in Mild Alzheimer Disease
  6. Other Supplement Trials in People
  7. Food Sources Reported in Studies
  8. What Is Not Known
  9. Key Research Papers
  10. Connections
  11. Featured Videos

What Plasmalogens Are

Every cell is wrapped in a thin double layer of fat-like molecules called phospholipids. Plasmalogens are one family of phospholipids with an unusual joint. In most phospholipids, both fatty tails are attached by an ordinary chemical link called an ester bond. In a plasmalogen, the first tail is attached by a different link, a vinyl-ether bond, and the second tail is usually a polyunsaturated fatty acid such as docosahexaenoic acid (DHA) or arachidonic acid. Because of that ether link, chemists group them with the "ether phospholipids".

Because the body makes its own plasmalogens, they are not a vitamin. The questions on this page are whether levels fall in Alzheimer disease, whether that fall matters, and whether taking them by mouth changes anything.

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Lower Plasmalogens in the Alzheimer Brain

The first evidence came from brain tissue examined after death. Several independent groups, using different methods and different brain banks, reported the same direction of change.

Specific to the regions Alzheimer disease damages (1995)

Ginsberg and colleagues reported a significant and selective shortage of ethanolamine plasmalogen, compared with its ordinary ester-linked relative, in brains from people who had Alzheimer disease. The shortage was greater in the mid-temporal cortex, a region the disease damages, than in the cerebellum, a region it largely spares. It was not seen in the main damaged region of Huntington disease (the caudate nucleus) or of Parkinson disease (the substantia nigra). The authors linked it to a tendency of Alzheimer brain membranes to become unstable.

Already present at the very mild stage (2001)

Han, Holtzman and McKeel measured plasmalogens in grey and white matter from people across the Clinical Dementia Rating scale, which runs from 0.5 (very mild dementia) to 3 (severe dementia). Their abstract reports:

In two strains of mice bred to develop Alzheimer-like amyloid deposits, the same team found a shortage of up to 10 mol% in the cerebral cortex at 18 months of age, and none in the cerebellum.

A large drop in choline plasmalogen (2011)

Igarashi and colleagues at the United States National Institute on Aging measured absolute lipid amounts in the prefrontal cortex of 10 people with Alzheimer disease and 9 without. Total brain lipid, phospholipid, cholesterol and triglyceride did not differ between the groups. Choline plasmalogen, however, was 73% lower in the Alzheimer group, while the other measured phospholipids did not differ. The authors read the pattern as a sign of extensive remodelling of brain membranes. The sample was small.

Linked to tangles and to peroxisome changes (2011)

Kou and colleagues studied brains from the Vienna-Transdanube Aging study, grouped by Braak stage, the standard scale of how far tau tangles have spread. In the most severely affected brains (stages V–VI), plasmalogens were lower and very long-chain fatty acids, which peroxisomes normally break down, had built up. Both changes pointed toward failing peroxisomes. The fall in plasmalogens was more closely tied to the amount of neurofibrillary tangles than to the amount of amyloid plaques.

One plasmalogen tracked memory before death (2022)

A 2022 analysis of the inferior temporal cortex of 100 elderly people from the Rush Memory and Aging Project (average age 88.5 years; 38 without cognitive impairment, 24 with mild cognitive impairment and 38 with Alzheimer dementia) measured individual plasmalogen species alongside tangles, amyloid and a lipid-raft protein. After statistical adjustment, the DHA-carrying ethanolamine plasmalogen called PL 18:0/22:6 (β = 0.506), tangles and the raft protein were independently associated with cognition near the time of death. The link between high DHA-plasmalogen levels and better cognition held regardless of plaque and tangle load. The paper's authors worked for a company that develops plasmalogen precursors.

These are snapshots of brains at death. They show that levels were lower; they cannot show whether the shortage came first or followed from the disease.

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Lower Plasmalogens in the Blood

Brain tissue can only be studied after death, so researchers asked whether a similar change shows up in the blood.

A 2026 narrative review in the Journal of Agricultural and Food Chemistry summarises the human data the same way: plasmalogen levels decline with age, and the decline is steeper in Alzheimer disease. A 2025 review from the United States National Institutes of Health notes that low plasmalogen levels are also reported in heart, kidney and liver disease, in cancer and in rare peroxisomal disorders, so a low level is not specific to Alzheimer disease.

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The Proposed Mechanisms

None of the explanations below has been proven in people. Each is a proposal drawn from cell, animal or post-mortem work, and the sentences say which.

Failing peroxisomes (proposed)

Because plasmalogen production starts in peroxisomes, a shortage could reflect peroxisomes that work poorly. The Vienna post-mortem study found two signs of that together in severely affected brains: fewer plasmalogens and a build-up of very long-chain fatty acids. It also saw, under the microscope, a loss of peroxisomes from nerve-cell branches that carried abnormal tau, and suggested that disturbed transport inside the nerve cell moves peroxisomes to the wrong places. The 2007 serum paper adds that production runs through a single peroxisomal pathway that declines with age.

Membrane structure and synapses (proposed)

Ginsberg and colleagues linked the shortage to unstable membranes in the Alzheimer brain, and Han and colleagues suggested that it may contribute to synapse loss and poor synaptic function. Both are inferences from tissue measurements.

Effects on amyloid production (in laboratory tests)

Rothhaar and colleagues tested plasmalogen species in laboratory preparations of cell membranes and in post-mortem Alzheimer brain tissue. Every species tested lowered the activity of gamma-secretase, one of the enzymes that cuts the amyloid precursor protein into amyloid-beta. The authors proposed a vicious cycle: amyloid-beta lowers plasmalogens, and lower plasmalogens let gamma-secretase make more amyloid-beta. This was not tested in living people.

Inflammation in brain support cells (in mice and cells)

Hossain and colleagues found that inflammatory signals lowered plasmalogen levels in mouse glial cells by switching down the enzyme that starts plasmalogen production, through the NF-kappa-B pathway. In mice, ageing, chronic restraint stress and injected bacterial toxin all lowered brain plasmalogens. Lowering plasmalogens in the mouse cortex in turn made microglia, the brain's immune cells, more active. The same enzyme change was seen in human cell lines, in a mouse model of Alzheimer disease and in post-mortem human Alzheimer brain tissue. Hossain is a co-author of the 2020 chapter on the scallop plasmalogen trials described below.

An antioxidant role (proposed and disputed)

The vinyl-ether bond reacts readily with oxidising molecules. One long-standing idea is that plasmalogens act as sacrificial antioxidants that take the damage in place of other membrane fats. Lessig and Fuchs, in a 2009 review, call this role controversial: the products of plasmalogen oxidation themselves build up in atherosclerosis, heart attack, ageing and Alzheimer disease. Reviews from 2019 and 2025 still list antioxidant and redox roles among plasmalogen functions.

Cause or consequence

The proposals point both ways. Some treat the shortage as an early driver; the inflammation work and the amyloid work both describe the disease process itself lowering plasmalogens. The evidence available does not settle which comes first.

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The Scallop Plasmalogen Trial in Mild Alzheimer Disease

The main trial in people with memory disease was published by Fujino and colleagues in EBioMedicine in 2017. It is the trial most often cited for plasmalogen supplements, so its design and results are set out in full.

Results

The authors concluded that scallop plasmalogens "may improve cognitive functions of mild AD". The trial was funded by the Japanese Plasmalogen Society.

The open-label extensions

The 2020 book chapter by Fujino, Hossain and Mawatari describes, alongside the randomised trial, three studies with no placebo group: 12 weeks in moderate Alzheimer disease (57 people), 12 weeks in severe Alzheimer disease (18 people) and 24 weeks in Parkinson disease (10 people). The authors report significant improvement in cognitive function and other symptoms with rising blood plasmalogen levels, and no adverse events. Because everyone knew they were receiving the supplement and there was no comparison group, these studies cannot separate an effect of plasmalogens from the placebo effect, practice on repeated tests, or chance.

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Other Supplement Trials in People

The remaining randomised trials found in PubMed were run in people without a dementia diagnosis. They say nothing directly about treating Alzheimer disease, but they are the rest of the human evidence.

One further small study, an uncontrolled trial of a synthetic DHA plasmalogen precursor in 22 cognitively impaired people published in 2022, carried an expression of concern in January 2026 and was retracted by its journal in August 2026. It is not used as evidence on this page.

A PubMed search in November 2026 found no meta-analysis or systematic review that pools plasmalogen supplement trials for dementia or cognition. Reviews such as Paul, Lancaster and Meikle (2019) describe other ways researchers have tried to raise plasmalogen levels, including inositol and naturally occurring precursors called alkylglycerols, mostly in animal and early clinical work.

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Food Sources Reported in Studies

Plasmalogens are made by animals, so the foods that contain them are animal foods. Laboratory surveys of food give these findings:

No study found here measured whether eating shellfish or meat changes brain plasmalogen levels or the risk of Alzheimer disease in people. For the wider evidence on seafood fats and the brain, see the Omega-3 Fatty Acids for Brain and Cognition page, and for organ meats see Organ Meats for Brain and DHA.

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What Is Not Known

Questions about any supplement for memory problems are for a clinician who knows the person's medicines and history.

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Key Research Papers

  1. Ginsberg L, Rafique S, Xuereb JH, Rapoport SI, Gershfeld NL. Disease and anatomic specificity of ethanolamine plasmalogen deficiency in Alzheimer's disease brain. Brain Res. 1995;698(1-2):223-6. PubMed PMID: 8581486
  2. Han X, Holtzman DM, McKeel DW Jr. Plasmalogen deficiency in early Alzheimer's disease subjects and in animal models: molecular characterization using electrospray ionization mass spectrometry. J Neurochem. 2001;77(4):1168-80. PubMed PMID: 11359882
  3. Goodenowe DB, Cook LL, Liu J, Lu Y, Jayasinghe DA, Ahiahonu PW, et al. Peripheral ethanolamine plasmalogen deficiency: a logical causative factor in Alzheimer's disease and dementia. J Lipid Res. 2007;48(11):2485-98. PubMed PMID: 17664527
  4. Wood PL, Mankidy R, Ritchie S, Heath D, Wood JA, Flax J, et al. Circulating plasmalogen levels and Alzheimer Disease Assessment Scale-Cognitive scores in Alzheimer patients. J Psychiatry Neurosci. 2010;35(1):59-62. PubMed PMID: 20040248
  5. Igarashi M, Ma K, Gao F, Kim HW, Rapoport SI, Rao JS. Disturbed choline plasmalogen and phospholipid fatty acid concentrations in Alzheimer's disease prefrontal cortex. J Alzheimers Dis. 2011;24(3):507-17. PubMed PMID: 21297269
  6. Kou J, Kovacs GG, Höftberger R, Kulik W, Brodde A, Forss-Petter S, et al. Peroxisomal alterations in Alzheimer's disease. Acta Neuropathol. 2011;122(3):271-83. PubMed PMID: 21594711
  7. Goodenowe DB, Senanayake V. Brain ethanolamine phospholipids, neuropathology and cognition: A comparative post-mortem analysis of structurally specific plasmalogen and phosphatidyl species. Front Cell Dev Biol. 2022;10:866156. PubMed PMID: 36092723
  8. Braverman NE, Moser AB. Functions of plasmalogen lipids in health and disease. Biochim Biophys Acta. 2012;1822(9):1442-52. PubMed PMID: 22627108
  9. Labadaridis I, Moraitou M, Theodoraki M, Triantafyllidis G, Sarafidou J, Michelakakis H. Plasmalogen levels in full-term neonates. Acta Paediatr. 2009;98(4):640-2. PubMed PMID: 19290965
  10. Lessig J, Fuchs B. Plasmalogens in biological systems: their role in oxidative processes in biological membranes, their contribution to pathological processes and aging and plasmalogen analysis. Curr Med Chem. 2009;16(16):2021-41. PubMed PMID: 19519379
  11. Rothhaar TL, Grösgen S, Haupenthal VJ, Burg VK, Hundsdörfer B, Mett J, et al. Plasmalogens inhibit APP processing by directly affecting γ-secretase activity in Alzheimer's disease. ScientificWorldJournal. 2012;2012:141240. PubMed PMID: 22547976
  12. Hossain MS, Abe Y, Ali F, Youssef M, Honsho M, Fujiki Y, et al. Reduction of Ether-Type Glycerophospholipids, Plasmalogens, by NF-κB Signal Leading to Microglial Activation. J Neurosci. 2017;37(15):4074-4092. PubMed PMID: 28292831
  13. Paul S, Lancaster GI, Meikle PJ. Plasmalogens: A potential therapeutic target for neurodegenerative and cardiometabolic disease. Prog Lipid Res. 2019;74:186-195. PubMed PMID: 30974122
  14. Curran CS, Remaley AT, Torabi-Parizi P. Plasmalogens as biomarkers and therapeutic targets. J Lipid Res. 2025;66(12):100925. PubMed PMID: 41130295
  15. Fujino T, Yamada T, Asada T, Tsuboi Y, Wakana C, Mawatari S, et al. Efficacy and Blood Plasmalogen Changes by Oral Administration of Plasmalogen in Patients with Mild Alzheimer's Disease and Mild Cognitive Impairment: A Multicenter, Randomized, Double-blind, Placebo-controlled Trial. EBioMedicine. 2017;17:199-205. PubMed PMID: 28259590
  16. Fujino T, Hossain MS, Mawatari S. Therapeutic Efficacy of Plasmalogens for Alzheimer's Disease, Mild Cognitive Impairment, and Parkinson's Disease in Conjunction with a New Hypothesis for the Etiology of Alzheimer's Disease. Adv Exp Med Biol. 2020;1299:195-212. PubMed PMID: 33417216
  17. Watanabe H, Okawara M, Matahira Y, Mano T, Wada T, Suzuki N, et al. The Impact of Ascidian (Halocynthia roretzi)-derived Plasmalogen on Cognitive Function in Healthy Humans: A Randomized, Double-blind, Placebo-controlled Trial. J Oleo Sci. 2020;69(12):1597-1607. PubMed PMID: 33177278
  18. Fujino M, Fukuda J, Isogai H, Ogaki T, Mawatari S, Takaki A, et al. Orally Administered Plasmalogens Alleviate Negative Mood States and Enhance Mental Concentration: A Randomized, Double-Blind, Placebo-Controlled Trial. Front Cell Dev Biol. 2022;10:894734. PubMed PMID: 35721497
  19. Yamada S, Shirai M, Katsumata M, Kurono M, Matahira Y, Ono K, et al. Beneficial Effects of a Formulated Supplement of Ascidiacea (Halocynthia-roretzi)-derived Plasmalogen and Tuna-derived Elastin on Memory Function in Elderly Japanese Subjects; A Randomized, Double-blind, Placebo-controlled Study. J Oleo Sci. 2024;73(10):1319-1328. PubMed PMID: 39313395
  20. Fukuchi M, Tanaka M, Nagata M, Takara T, Sasuga Y. Orally administered scallop-derived plasmalogens improve cognitive function in healthy middle-aged and older adults: a randomized, double-blind, placebo-controlled trial. Front Nutr. 2026;13:1906996. PubMed PMID: 42656342
  21. Yamashita S, Kanno S, Honjo A, Otoki Y, Nakagawa K, Kinoshita M, et al. Analysis of Plasmalogen Species in Foodstuffs. Lipids. 2016;51(2):199-210. PubMed PMID: 26732602
  22. Wu Y, Chen Z, Chiba H, Hui SP. Plasmalogen fingerprint alteration and content reduction in beef during boiling, roasting, and frying. Food Chem. 2020;322:126764. PubMed PMID: 32325364
  23. Wu Y, Chen Z, Jia J, Chiba H, Hui SP. Quantitative and Comparative Investigation of Plasmalogen Species in Daily Foodstuffs. Foods. 2021;10(1):124. PubMed PMID: 33435634
  24. Zhang Y, Chen J, Jiang J, Yang N, Guo S, Gao F, et al. Plasmalogens in Alzheimer's Disease: A Narrative Review of Dietary Sources, Metabolism, and Neuroprotective Mechanisms. J Agric Food Chem. 2026;74(25):19375-19392. PubMed PMID: 42310520

PubMed Topic Searches

  1. PubMed: plasmalogens in the Alzheimer brain
  2. PubMed: blood plasmalogens and dementia
  3. PubMed: plasmalogen supplement trials and cognition
  4. PubMed: peroxisomes, plasmalogens and Alzheimer disease
  5. PubMed: plasmalogens in foods

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Connections

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