are with the Discipline of Nutrition and Dietetics, Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, and The Charles Perkins Centre, The University of Sydney, Camperdown, New South Wales, Australia.
Nutr Rev. 2023 Oct 10;81(11):1462-1489. doi: 10.1093/nutrit/nuad013.
CONTEXT: Nutritional interventions may benefit cognition in people with mild cognitive impairment (MCI). However, evidence is yet to be synthesized in a way that can inform recommendations for clinical and public health settings. OBJECTIVE: To systematically review evidence on the effect of dietary patterns, foods, and nutritional supplements on cognitive decline in individuals with MCI. DATA SOURCES: Guided by the Preferred Reporting items for Systematic Review and Meta-Analysis Protocols 2015 statement, the Medline, EMBASE, and CINAHL databases, the JBI Database of Systematic Reviews and Implementation Reports, Cochrane Database of Systematic Reviews, and Database of Abstracts of Reviews of Effects were searched (publication years 2005 to 2020). Included studies were English-language systematic reviews and meta-analyses of randomized controlled trials and cohort studies reporting on the effectiveness of nutritional interventions on cognition of individuals with MCI. DATA EXTRACTION: Two reviewers independently selected studies and extracted data on cognitive outcomes and adverse events. Review quality was assessed using AMSTAR 2 (A Measurement Tool to Assess Systematic Reviews-2). Primary study overlap was managed following Cochrane Handbook guidelines. DATA ANALYSIS: Of the 6677 records retrieved, 20 reviews were included, which, in turn, reported on 43 randomized controlled trials and 1 cohort study that, together, addressed 18 nutritional interventions. Most reviews were limited by quality and the small number of primary studies with small sample sizes. Reviews were mostly positive for B vitamins, omega-3 fatty acids, and probiotics (including 12, 11 and 4 primary studies, respectively). Souvenaid and the Mediterranean diet reduced cognitive decline or Alzheimer's disease progression in single trials with <500 participants. Findings from studies with a small number of participants suggest vitamin D, a low-carbohydrate diet, medium-chain triglycerides, blueberries, grape juice, cocoa flavanols, and Brazil nuts may improve individual cognitive subdomains, but more studies are needed. CONCLUSIONS: Few nutritional interventions were found to convincingly improve cognition of individuals with MCI. More high-quality research in MCI populations is required to determine if nutritional treatments improve cognition and/or reduce progression to dementia. SYSTEMATIC REVIEW REGISTRATION: Open Science Framework protocol identifier DOI:10.17605/OSF.IO/BEP2S.
背景:营养干预可能有益于轻度认知障碍(MCI)患者的认知功能。然而,目前还没有以一种能够为临床和公共卫生环境提供建议的方式综合证据。
目的:系统回顾饮食模式、食物和营养补充剂对 MCI 个体认知衰退影响的证据。
数据来源:根据 2015 年系统评价和荟萃分析报告的首选报告项目、Medline、EMBASE 和 CINAHL 数据库、JBI 系统评价和实施报告数据库、Cochrane 系统评价数据库和效果摘要数据库,对 2005 年至 2020 年发表的文献进行检索。纳入的研究为英语系统评价和荟萃分析,包括随机对照试验和队列研究,报告了营养干预对 MCI 个体认知的有效性。
数据提取:两名评审员独立选择研究并提取认知结果和不良事件数据。使用 AMSTAR 2(评估系统评价的测量工具-2)评估研究质量。按照 Cochrane 手册指南管理主要研究重叠。
数据分析:在 6677 条记录中,有 20 篇综述被纳入,其中包括 43 项随机对照试验和 1 项队列研究,共涉及 18 项营养干预措施。大多数综述受到质量和初级研究数量少、样本量小的限制。B 族维生素、ω-3 脂肪酸和益生菌的综述结果大多为阳性(分别有 12、11 和 4 项初级研究)。Souvenaid 和地中海饮食在仅有<500 名参与者的单一试验中减少了认知衰退或阿尔茨海默病的进展。来自参与者人数较少的研究的结果表明,维生素 D、低碳水化合物饮食、中链甘油三酯、蓝莓、葡萄汁、可可黄烷醇和巴西坚果可能改善个体认知子领域,但需要更多的研究。
结论:目前发现很少有营养干预措施能令人信服地改善 MCI 患者的认知功能。需要在 MCI 人群中进行更多高质量的研究,以确定营养治疗是否能改善认知功能和/或降低痴呆进展的风险。
系统评价注册:Open Science Framework 协议标识符 DOI:10.17605/OSF.IO/BEP2S。
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