Mizrahi Eliyahu H, Lubart Emilia, Leibovitz Arthur
Department of Geriatric Medicine and Rehabilitation, Shmuel Harofe Hospital, Beer Yaakov, affiliated with Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Isr Med Assoc J. 2017 May;19(5):305-308.
The progression from cognitive impairment to dementia is a multifactorial process that involves genetic and environmental factors. Vitamin B12 deficiency can be an important factor in the progress from cognitive decline to dementia.
To examine the relationship between borderline low level of vitamin B12 (≤ 350 pg/ml) and cognitive decline among a group of elderly hip fracture patients.
This retrospective chart review study was conducted in a geriatric rehabilitation ward of a university-affiliated referral hospital. It comprised 91 elderly hip fracture patients. Cognition was assessed by the Mini-Mental State Examination (MMSE) tool. Fasting serum vitamin B12 levels were measured within 24 hours after admission to the rehabilitation ward.
Twenty-two of the patients had vitamin B12 levels ≤ 350 pg/ml. In a multiple linear regression analysis, after adjusting for confounding variables, serum vitamin B12 levels ≤ 350 pg/ml were linked to a higher risk of developing cognitive decline (ß coefficient = -0.28, P = 0.008).
In our study, serum vitamin B12 levels ≤ 350 pg/ml, were independently associated with lower MMSE scores in elderly hip fracture patients. Serum vitamin B12 may assist in identifying patients in the early stages of cognitive decline. This study joins others that have reported on the association of low normal range vitamin B12 blood levels and conditions like dementia, falls, fractures and frailty. We suggest a reexamination of what is currently considered as the normal range of vitamin B12 in the elderly.
从认知障碍发展到痴呆是一个多因素过程，涉及遗传和环境因素。维生素B12缺乏可能是从认知衰退发展到痴呆的一个重要因素。
研究一组老年髋部骨折患者中维生素B12临界低水平（≤350 pg/ml）与认知衰退之间的关系。
这项回顾性图表审查研究在一家大学附属医院的老年康复病房进行。研究对象为91名老年髋部骨折患者。采用简易精神状态检查表（MMSE）工具评估认知情况。在患者入住康复病房后24小时内测量空腹血清维生素B12水平。
22名患者的维生素B12水平≤350 pg/ml。在多元线性回归分析中，在调整混杂变量后，血清维生素B12水平≤350 pg/ml与发生认知衰退的较高风险相关（β系数 = -0.28，P = 0.008）。
在我们的研究中，血清维生素B12水平≤350 pg/ml与老年髋部骨折患者较低的MMSE评分独立相关。血清维生素B12可能有助于识别处于认知衰退早期阶段的患者。这项研究与其他报告低正常范围维生素B12血液水平与痴呆、跌倒、骨折和衰弱等情况之间关联的研究一致。我们建议重新审视目前认为的老年人维生素B12正常范围。
