Engelborghs Sebastiaan, Vloeberghs Ellen, Maertens Karen, Mariën Peter, Somers Nore, Symons Anoek, Clement Frederik, Ketels Veerle, Saerens Jos, Goeman Johan, Pickut Barbara A, Vandevivere Johan, De Deyn Peter P
Department of Neurology & Memory Clinic, Middelheim General Hospital, Antwerp, Belgium.
Int J Geriatr Psychiatry. 2004 Apr;19(4):365-70. doi: 10.1002/gps.1092.
Associations between low levels of folate and vitamin B12 and cognitive impairment in patients with dementia have been reported. Some studies revealed correlations between low levels of vitamin B12 and behavioural and psychological signs and symptoms of dementia (BPSD) in Alzheimer's disease (AD) patients. Given the lack of studies in frontotemporal dementia (FTD) and on folate and given the methodological shortcomings of former publications, we set up a prospective study.
At inclusion, AD (n=152) and FTD (n=28) patients underwent a neuropsychological examination. Behaviour was assessed using a battery of behavioural assessment scales. Determination of serum vitamin B12 and red cell folate levels were performed within a time frame of two weeks of inclusion.
In both patient groups, significantly negative correlations between levels of serum vitamin B12 and red cell folate and the degree of cognitive deterioration were found. No correlations with BPSD were found in the AD patient group. In FTD patients, levels of vitamin B12 were negatively correlated with both hallucinations (p=0.022) and diurnal rhythm disturbances (p=0.036).
The observed negative correlations between levels of vitamin B12 and folate and cognitive impairment in both AD and FTD patients, raise the possibility of a non-specific etiological role. Although levels of vitamin B12 and folate did not correlate with BPSD in AD patients, negative correlations between serum vitamin B12 levels and BPSD in FTD patients were revealed. Decreased serum vitamin B12 levels may predispose FTD patients to develop hallucinations and diurnal rhythm disturbances.
已有报道称痴呆患者体内低水平叶酸和维生素B12与认知障碍之间存在关联。一些研究揭示了维生素B12水平低与阿尔茨海默病（AD）患者痴呆的行为和心理症状及体征（BPSD）之间的相关性。鉴于额颞叶痴呆（FTD）方面以及叶酸相关研究的缺乏，且既往出版物存在方法学缺陷，我们开展了一项前瞻性研究。
纳入研究时，AD患者（n = 152）和FTD患者（n = 28）接受了神经心理学检查。使用一系列行为评估量表对行为进行评估。在纳入后的两周内测定血清维生素B12和红细胞叶酸水平。
在两组患者中，均发现血清维生素B12和红细胞叶酸水平与认知衰退程度之间存在显著负相关。在AD患者组中未发现与BPSD相关的情况。在FTD患者中，维生素B12水平与幻觉（p = 0.022）和昼夜节律紊乱（p = 0.036）均呈负相关。
AD和FTD患者中观察到的维生素B12和叶酸水平与认知障碍之间的负相关，增加了其非特异性病因学作用的可能性。虽然AD患者中维生素B12和叶酸水平与BPSD无相关性，但FTD患者血清维生素B12水平与BPSD之间存在负相关。血清维生素B12水平降低可能使FTD患者易出现幻觉和昼夜节律紊乱。
