Department of Psychiatry and Psychotherapy, Medical Faculty, University of Magdeburg, Magdeburg, Germany.
Institute for Clinical Chemistry and Pathobiochemistry, Otto-von-Guericke University of Magdeburg, Magdeburg, Germany.
J Alzheimers Dis. 2021;81(4):1781-1792. doi: 10.3233/JAD-201481.
Although it is known that the nutritional status among elderly persons and, in particular, patients with dementia, is compromised, malnutrition that results in insufficient uptake of several vitamins is often not diagnosed.
An elevated homocysteine level is a known strong risk factor for vascular dementia (VaD) and Alzheimer's disease (AD). Several B vitamins are involved in the metabolism of homocysteine. Therefore, we investigated the serum levels of vitamin B1, vitamin B6, folate, and vitamin B12 in 97 patients with mild cognitive impairment (MCI) or different forms of dementia and 54 elderly control persons without dementia.
Compared to aged non-demented people, vitamins B1, B6, B12, and folate were decreased in serum of patients with AD, and patients with Lewy body dementia had reduced vitamin B12 level. Vitamin B6 was diminished in VaD. Patients with frontotemporal dementia showed no alterations in vitamin levels. Age was identified as an important factor contributing to the concentrations of vitamin B1 and B6 in serum, but not vitamin B12 and folate. Increased levels of total homocysteine were detected especially in MCI and AD. Homocysteine correlated negatively with levels of vitamins B6, B12, and folate and positively with Q Albumin.
Our data suggest that despite increased homocysteine already present in MCI, vitamin levels are decreased only in dementia. We propose to determine the vitamin levels in patients with cognitive decline, but also elderly people in general, and recommend supplementing these nutrients if needed.
尽管人们已经知道老年人，尤其是痴呆症患者的营养状况受损，但由于多种维生素摄入不足导致的营养不良往往未被诊断出来。
同型半胱氨酸水平升高是血管性痴呆（VaD）和阿尔茨海默病（AD）的已知强危险因素。几种 B 族维生素参与同型半胱氨酸的代谢。因此，我们调查了 97 例轻度认知障碍（MCI）或不同类型痴呆症患者和 54 例无痴呆症的老年对照者的血清维生素 B1、B6、叶酸和维生素 B12 水平。
与年龄相匹配的非痴呆老年人相比，AD 患者血清中的维生素 B1、B6、B12 和叶酸水平降低，路易体痴呆患者维生素 B12 水平降低。VaD 患者维生素 B6 减少。额颞叶痴呆患者的维生素水平没有改变。年龄是影响血清中维生素 B1 和 B6 浓度的重要因素，但不是维生素 B12 和叶酸的重要因素。总同型半胱氨酸水平升高尤其在 MCI 和 AD 中检测到。同型半胱氨酸与维生素 B6、B12 和叶酸水平呈负相关，与 Q 白蛋白呈正相关。
我们的数据表明，尽管 MCI 中已经存在同型半胱氨酸升高，但只有在痴呆症中才会降低维生素水平。我们建议在出现认知能力下降的患者中确定维生素水平，也建议在一般老年人中确定维生素水平，如果需要，建议补充这些营养素。
