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维生素 B12、B6 或叶酸与社区老年人认知功能的关系:系统评价和荟萃分析。

Vitamin B12, B6, or Folate and Cognitive Function in Community-Dwelling Older Adults: A Systematic Review and Meta-Analysis.

机构信息

Department of Biostatistics, School of Public Health, Fudan University, Shanghai, China.

NHC Key Laboratory of Health Technology Assessment (Fudan University), Shanghai, China.

出版信息

J Alzheimers Dis. 2020;77(2):781-794. doi: 10.3233/JAD-200534.

Abstract

BACKGROUND

Previous studies have indicated that B vitamin deficiencies are an essential cause of neurological pathology. There is a need to provide evidence of the benefit of B vitamins for the prevention of cognitive decline in community-dwelling older adults.

OBJECTIVE

To examine the association between intake and plasma levels of vitamins B12, B6, and folate and cognitive function in older populations through a systematic review and meta-analysis.

METHODS

Medline (PubMed), EMBASE, and Cochrane databases were used to search the literature though August 8, 2019. We included observational population-based studies evaluating the association between concentrations or intake levels of vitamins B6, B12, or folate and cognition in older adults aged ≥45 years. The quality of all studies was assessed by the modified Newcastle-Ottawa Scale. Odds ratios (ORs) and hazard ratios (HRs) were analyzed by the random-effects model. Sensitivity analyses were conducted by excluding the studies with significant heterogeneity.

RESULTS

Twenty-one observational studies with sample sizes ranging from 155-7030 were included in the meta-analysis. Higher levels of vitamin B12 (OR = 0.77, 95% CI = 0.61-0.97) and folate concentration (OR = 0.68, 95% CI = 0.51-0.90) were associated with better cognition in cross-sectional studies, but not in sensitivity analyses or prospective studies. High vitamin B6 concentrations showed no significant benefit on cognition and dementia risk. Prospective studies did not provide substantial evidence for the relationship.

CONCLUSION

The results from our meta-analysis suggest that vitamins B12, B6, and folate may not be modifiable risk factors for slowing cognitive decline among community-dwelling older individuals.

摘要

背景

先前的研究表明,B 族维生素缺乏是神经病理学的一个重要原因。有必要提供证据表明 B 族维生素有益于预防社区居住的老年人认知能力下降。

目的

通过系统评价和荟萃分析,检查维生素 B12、B6 和叶酸的摄入量和血浆水平与老年人群认知功能之间的关系。

方法

使用 Medline(PubMed)、EMBASE 和 Cochrane 数据库,于 2019 年 8 月 8 日之前搜索文献。我们纳入了评估维生素 B6、B12 或叶酸浓度或摄入量与 45 岁及以上老年人认知功能之间关系的观察性基于人群的研究。使用改良的纽卡斯尔-渥太华量表评估所有研究的质量。使用随机效应模型分析比值比(OR)和风险比(HR)。通过排除具有显著异质性的研究进行敏感性分析。

结果

荟萃分析纳入了 21 项研究,样本量从 155 到 7030 不等。横断面研究显示,较高的维生素 B12 水平(OR=0.77,95%CI=0.61-0.97)和叶酸浓度(OR=0.68,95%CI=0.51-0.90)与认知功能较好相关,但在敏感性分析或前瞻性研究中则不然。较高的维生素 B6 浓度对认知和痴呆风险没有显著益处。前瞻性研究没有提供大量证据支持这种关系。

结论

我们的荟萃分析结果表明,B 族维生素 B12、B6 和叶酸可能不是减缓社区居住的老年个体认知能力下降的可改变风险因素。

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