Department of Nutrition and Food Science, School of Public Health, Tianjin Medical University, Tianjin, China.
Department of Nutrition, Tianjin First Central Hospital, Tianjin, China.
J Alzheimers Dis. 2021;81(1):155-167. doi: 10.3233/JAD-200997.
The neuroprotective benefits of combined folic acid and docosahexaenoic acid (DHA) on cognitive function in mild cognitive impairment (MCI) patients are suggested but unconfirmed.
To explore the effects of 6-month folic acid + DHA on cognitive function in patients with MCI.
Our randomized controlled trial (trial number ChiCTR-IOR-16008351) was conducted in Tianjin, China. We divided 160 MCI patients aged > 60 years into four regimen groups randomly: folic acid (0.8 mg/day) + DHA (800 mg/day), folic acid (0.8 mg/day), DHA (800 mg/day), and placebo, for 6 months. Cognitive function and blood amyloid-β peptide (Aβ) biomarker levels were measured at baseline and 6 months. Cognitive function was also measured at 12 months.
A total of 138 patients completed this trial. Folic acid improved the full-scale intelligence quotient (FSIQ), arithmetic, and picture complement scores; DHA improved the FSIQ, information, arithmetic, and digit span scores; folic acid + DHA improved the arithmetic (difference 1.67, 95% CI 1.02 to 2.31) and digital span (1.33, 0.24 to 2.43) scores compared to placebo. At 12 months, all scores declined in the intervention groups. Folic acid and folic acid + DHA increased blood folate (folic acid + DHA: 7.70, 3.81 to 11.59) and S-adenosylmethionine (23.93, 1.86 to 46.00) levels and reduced homocysteine levels (-6.51, -10.57 to -2.45) compared to placebo. DHA lower the Aβ40 levels (-40.57, -79.79 to -1.35) compared to placebo (p < 0.05), and folic acid + DHA reduced the Aβ42 (-95.59, -150.76 to -40.43) and Aβ40 levels (-45.75, -84.67 to -6.84) more than DHA (p < 0.05).
Folic acid and DHA improve cognitive function and reduce blood Aβ production in MCI patients. Combination therapy may be more beneficial in reducing blood Aβ-related biomarkers.
联合使用叶酸和二十二碳六烯酸（DHA）对轻度认知障碍（MCI）患者的认知功能具有神经保护作用，但尚未得到证实。
探讨 6 个月叶酸+DHA 对 MCI 患者认知功能的影响。
我们在中国天津进行了这项随机对照试验（试验编号 ChiCTR-IOR-16008351）。我们将 160 名年龄大于 60 岁的 MCI 患者随机分为四组方案：叶酸（0.8mg/天）+DHA（800mg/天）、叶酸（0.8mg/天）、DHA（800mg/天）和安慰剂组，治疗 6 个月。在基线和 6 个月时测量认知功能和血液淀粉样蛋白-β 肽（Aβ）生物标志物水平。12 个月时还测量了认知功能。
共有 138 名患者完成了这项试验。叶酸可提高全智商（FSIQ）、算术和图片补充分数；DHA 可提高 FSIQ、信息、算术和数字跨度分数；与安慰剂相比，叶酸+DHA 可改善算术（差值 1.67，95%置信区间 1.02 至 2.31）和数字跨度（1.33，0.24 至 2.43）分数。在 12 个月时，干预组的所有分数都下降了。与安慰剂相比，叶酸和叶酸+DHA 增加了血液叶酸（叶酸+DHA：7.70，3.81 至 11.59）和 S-腺苷甲硫氨酸（23.93，1.86 至 46.00）水平，并降低了同型半胱氨酸水平（-6.51，-10.57 至-2.45）。与安慰剂相比，DHA 降低了 Aβ40 水平（-40.57，-79.79 至-1.35）（p<0.05），而叶酸+DHA 降低了 Aβ42（-95.59，-150.76 至-40.43）和 Aβ40 水平（-45.75，-84.67 至-6.84）比 DHA 更多（p<0.05）。
叶酸和 DHA 可改善 MCI 患者的认知功能并降低血液 Aβ 生成。联合治疗可能更有益于降低与血液 Aβ 相关的生物标志物。
