老年男性使用维生素E和C补充剂与认知功能及痴呆的关联

Association of vitamin E and C supplement use with cognitive function and dementia in elderly men.

作者信息

Masaki K H, Losonczy K G, Izmirlian G, Foley D J, Ross G W, Petrovitch H, Havlik R, White L R

机构信息

Division of Geriatric Medicine, University of Hawaii, John A. Burns School of Medicine, Honolulu, USA.

出版信息

Neurology. 2000 Mar 28;54(6):1265-72. doi: 10.1212/wnl.54.6.1265.

DOI:10.1212/wnl.54.6.1265

PMID:10746596

Abstract

OBJECTIVE

To determine whether use of vitamin E and C supplements protects against subsequent development of dementia and poor cognitive functioning.

METHODS

The Honolulu-Asia Aging Study is a longitudinal study of Japanese-American men living in Hawaii. Data for this study were obtained from a subsample of the cohort interviewed in 1982, and from the entire cohort from a mailed questionnaire in 1988 and the dementia prevalence survey in 1991 to 1993. The subjects included 3,385 men, age 71 to 93 years, whose use of vitamin E and C supplements had been ascertained previously. Cognitive performance was assessed with the Cognitive Abilities Screening Instrument, and subjects were stratified into four groups: low, low normal, mid normal, and high normal. For the dementia analyses, subjects were divided into five mutually exclusive groups: AD (n = 47), vascular dementia (n = 35), mixed/other types of dementia (n = 50), low cognitive test scorers without diagnosed dementia (n = 254), and cognitively intact (n = 2,999; reference).

RESULTS

In a multivariate model controlling for other factors, a significant protective effect was found for vascular dementia in men who had reported taking both vitamin E and C supplements in 1988 (odds ratio [OR], 0.12; 95% CI, 0.02 to 0.88). They were also protected against mixed/other dementia (OR, 0.31; 95% CI, 0.11 to 0.89). No protective effect was found for Alzheimer's dementia (OR, 1.81; 95% CI, 0.91 to 3.62). Among those without dementia, use of either vitamin E or C supplements alone in 1988 was associated significantly with better cognitive test performance at the 1991 to 1993 examination (OR, 1.25; 95% CI, 1.04 to 1.50), and use of both vitamin E and C together had borderline significance (OR, 1.18; 95% CI, 0.995 to 1.39).

CONCLUSIONS

These results suggest that vitamin E and C supplements may protect against vascular dementia and may improve cognitive function in late life.

摘要

目的

确定服用维生素E和C补充剂是否能预防随后发生的痴呆症和认知功能减退。

方法

檀香山-亚洲老龄化研究是一项针对居住在夏威夷的日裔美国男性的纵向研究。本研究的数据来自1982年接受访谈的队列的一个子样本，以及1988年通过邮寄问卷和1991年至1993年痴呆症患病率调查获得的整个队列的数据。研究对象包括3385名年龄在71至93岁之间的男性，他们之前服用维生素E和C补充剂的情况已得到确定。使用认知能力筛查工具评估认知表现，并将研究对象分为四组：低、低正常、中正常和高正常。在痴呆症分析中，研究对象被分为五个相互排斥的组：阿尔茨海默病（n = 47）、血管性痴呆（n = 35）、混合型/其他类型痴呆（n = 50）、认知测试得分低但未诊断为痴呆的人（n = 254）以及认知功能正常的人（n = 2999；参照组）。

结果

在控制了其他因素的多变量模型中，发现1988年报告同时服用维生素E和C补充剂的男性对血管性痴呆有显著的保护作用（优势比[OR]，0.12；95%置信区间，0.02至0.88）。他们也受到了对混合型/其他痴呆的保护（OR，0.31；95%置信区间，0.11至0.89）。未发现对阿尔茨海默病有保护作用（OR，1.81；95%置信区间，0.91至3.62）。在那些没有痴呆症的人当中，1988年单独服用维生素E或C补充剂与1991年至1993年检查时更好的认知测试表现显著相关（OR，1.25；95%置信区间，1.04至1.50），同时服用维生素E和C有临界显著性（OR，1.18；95%置信区间, 0.995至1.39）。