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健康德国老年女性的认知表现与维生素状态的关系——6个月多种维生素补充的效果

Cognitive performance in relation to vitamin status in healthy elderly German women-the effect of 6-month multivitamin supplementation.

作者信息

Wolters Maike, Hickstein Mirja, Flintermann Anke, Tewes Uwe, Hahn Andreas

机构信息

Nutrition Physiology and Human Nutrition Unit, Institute of Food Science, Centre of Applied Chemistry, University of Hanover, Wunstorfer Street 14, D-30453, Hannover, Germany.

出版信息

Prev Med. 2005 Jul;41(1):253-9. doi: 10.1016/j.ypmed.2004.11.007. Epub 2005 Jan 6.

Abstract

BACKGROUND

Prior investigations have reported a link between poor status of antioxidants, folate, and cobalamin resulting in elevated total plasma homocysteine (tHcy) and methylmalonic acid (MMA) concentrations with an increased risk for reduced cognitive performance. The aim of the study was to evaluate the effect of a 6-month multivitamin supplementation on the cognitive performance of female seniors and to assess cognitive functioning in relation to vitamin status, tHcy, and MMA values at baseline.

METHODS

The study was performed as a randomized placebo-controlled double-blind trial. 220 healthy, free-living women (aged 60-91 years) were included. Blood drawings and cognitive tests were performed at the Institute of Food Science of the University of Hanover, Germany. Vitamin and cognitive status have been evaluated prior to and 6 months after supplementation. Plasma ascorbic acid, serum concentrations of alpha-tocopherol, beta-carotene, and coenzyme Q10, serum and erythrocyte folate as well as serum cobalamin, serum MMA, and plasma tHcy concentrations were measured. Activity coefficient of erythrocyte alpha aspartic aminotransferase was used as functional index for vitamin B(6) status. The cognitive performance was assessed by the Symbol Search test, a subtest of the Wechsler Adult Intelligence Scale (WAIS-III) and the pattern-recognition test. Intelligence as assessed by the 'Kurztest für Allgemeine Intelligenz' (KAI) was a further variable.

RESULTS

No significant differences in pattern-recognition and intelligence score were observed between vitamin and placebo group prior to and after multivitamin supplementation. In the Symbol Search test, the vitamin group exhibited better test results than the placebo group at both measure points. One-way ANOVA showed a marginally significant linear trend between the baseline tHcy concentration and the pattern-recognition score (P = 0.051) in the total sample. Multiple backward regression revealed only a significant influence of the school graduation on baseline cognitive function test results. A general linear model showed that the changes in cognitive function scores could not be explained by the type of treatment or blood parameters.

CONCLUSIONS

Our data indicate that 6 months supplementation of physiological dosages of antioxidants and B vitamins have no effect on cognitive performance in presumedly healthy and well-nourished female seniors. An intervention period of only 6 months may be too short for improving cognitive performance in well-educated elderly women without dementia.

摘要

背景

先前的研究报告称,抗氧化剂、叶酸和钴胺素状态不佳会导致血浆总同型半胱氨酸(tHcy)和甲基丙二酸(MMA)浓度升高,进而增加认知能力下降的风险。本研究的目的是评估为期6个月的多种维生素补充剂对老年女性认知能力的影响,并在基线时评估与维生素状态、tHcy和MMA值相关的认知功能。

方法

该研究作为一项随机安慰剂对照双盲试验进行。纳入了220名健康的、独立生活的女性(年龄在60 - 91岁之间)。血液检测和认知测试在德国汉诺威大学食品科学研究所进行。在补充前和补充6个月后评估维生素和认知状态。测量血浆抗坏血酸、血清α-生育酚、β-胡萝卜素和辅酶Q10的浓度,血清和红细胞叶酸以及血清钴胺素、血清MMA和血浆tHcy的浓度。红细胞α-天冬氨酸转氨酶的活性系数用作维生素B6状态的功能指标。认知能力通过符号搜索测试(韦氏成人智力量表(WAIS-III)的一个子测试)和模式识别测试进行评估。通过“简易一般智力测试”(KAI)评估的智力是另一个变量。

结果

在补充多种维生素之前和之后,维生素组和安慰剂组在模式识别和智力得分方面均未观察到显著差异。在符号搜索测试中,维生素组在两个测量点的测试结果均优于安慰剂组。单因素方差分析显示,在总样本中,基线tHcy浓度与模式识别得分之间存在微弱的显著线性趋势(P = 0.051)。多元向后回归显示,只有学校毕业情况对基线认知功能测试结果有显著影响。一个通用线性模型表明,认知功能得分的变化无法用治疗类型或血液参数来解释。

结论

我们的数据表明,为期6个月补充生理剂量的抗氧化剂和B族维生素对推测健康且营养良好的老年女性的认知能力没有影响。对于没有痴呆症的受过良好教育的老年女性,仅6个月的干预期可能太短,不足以改善其认知能力。

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