1Faculty Health,University of Canberra,Kirinari Street,Bruce,Canberra,ACT 2617,Australia.
2Collaborative Research in Bioactives and Biomarkers (CRIBB) Group,Kirinari Street,Bruce,Canberra,ACT 2617,Australia.
Br J Nutr. 2018 Feb;119(3):280-298. doi: 10.1017/S0007114517003452. Epub 2018 Jan 9.
Nutraceuticals have generated interest as a way to mitigate the cognitive decline in older adults. The aim of this systematic review was to determine the evidence for these claims from the scientific literature in randomised, double-blinded, controlled trials (duration: ≥1 year; participants: n≥100; age(mean): ≥65 years). Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we searched four electronic databases (PubMed, Scopus, CINAHL and Web of Science) and identified twenty-five studies published between the 15·June·2006 and 14·June·2016. Interventions included B-vitamins, n-3 fatty acids, antioxidant vitamins and herbs. Of the B-vitamin studies, four found benefits to cognition with supplementation. The first of these B-vitamin studies, in individuals with mild cognitive impairment (n 266; duration=2 years), included benefit to executive function (P=0·015) and improvements in the Mini-Mental State Examination (MMSE) among participants with baseline homocysteine above 11·3 µmol/l (P<0·001). In the same sample, the second study found cognitive benefits of B-vitamins dependent on the higher baseline plasma n-3 fatty acid status. The third B-vitamin study (n 900; duration=2 years) reported improved performance in immediate (P=0·046) and delayed recall (P=0·013), whereas the fourth study (n 856; duration=2 years) reported slower rate of cognitive decline in the MMSE (P=0·05). One study investigating DHA treatment (n 402; duration=1·5 years) revealed the slower rate of cognitive change in apoE e4 non-carriers (P=0·03). As only five included studies revealed notable benefits, presently based on the specific compounds explored here, there is not compelling evidence to support the use nutraceuticals to improve cognition in the elderly. Future long-term trials of nutraceuticals should investigate interactions with lifestyle, blood biomarkers and genetic risk factors.
作为减轻老年人认知能力下降的一种方法，营养保健品受到了关注。本系统评价的目的是从随机、双盲、对照试验的科学文献中确定这些说法的证据（持续时间：≥1 年；参与者：n≥100；年龄（平均值）：≥65 岁）。根据系统评价和荟萃分析的首选报告项目（PRISMA）指南，我们搜索了四个电子数据库（PubMed、Scopus、CINAHL 和 Web of Science），并确定了 2016 年 6 月 15 日至 2016 年 6 月 14 日期间发表的 25 项研究。干预措施包括 B 族维生素、n-3 脂肪酸、抗氧化维生素和草药。在 B 族维生素研究中，有四项研究发现补充剂对认知有好处。第一项 B 族维生素研究涉及轻度认知障碍患者（n 266；持续时间=2 年），包括补充剂对执行功能的益处（P=0·015）以及在基线同型半胱氨酸水平高于 11·3 μmol/l 的参与者中提高了简易精神状态检查（MMSE）（P<0·001）。在同一样本中，第二项研究发现 B 族维生素的认知益处取决于较高的基线血浆 n-3 脂肪酸状态。第三项 B 族维生素研究（n 900；持续时间=2 年）报告了即时（P=0·046）和延迟回忆（P=0·013）的表现改善，而第四项研究（n 856；持续时间=2 年）报告了 MMSE 认知衰退速度较慢（P=0·05）。一项关于 DHA 治疗的研究（n 402；持续时间=1·5 年）揭示了载脂蛋白 E e4 非携带者认知变化速度较慢（P=0·03）。由于只有五项纳入的研究显示出显著的益处，目前根据这里探索的特定化合物，没有令人信服的证据支持使用营养保健品来改善老年人的认知能力。未来应进行长期营养保健品试验，以研究其与生活方式、血液生物标志物和遗传风险因素的相互作用。
