Department of Neurology, Shuang-Ho Hospital, Taipei Medical University, Taipei, Taiwan.
Department of Neurology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.
Aging (Albany NY). 2024 May 2;16(9):7856-7869. doi: 10.18632/aging.205788.
Vitamin B12 and folic acid could reduce blood homocysteine levels, which was thought to slow down the progression of Alzheimer's disease (AD), but previous studies regarding the effect of vitamin B12 and folic acid in treatment of AD have not reached conclusive results. We searched PubMed and Embase until January 12, 2023. Only randomized control trials involving participants clearly diagnosed with AD and who received vitamin B12 and folic acid were enrolled. Five studies that met the criteria were selected for inclusion in the meta-analysis. Changes in cognitive function were measured based on either the Mini-Mental State Examination (MMSE) or the Alzheimer's Disease Assessment Scale-Cognitive Subscale (ADAS-Cog). Changes in daily life function and the level of blood homocysteine were also investigated. After a 6-month treatment, administration of vitamin B12 and folic acid improved the MMSE scores more than placebo did (SMD = 0.21, 95% CI = 0.01 to 0.32, = 0.04) but did not significantly affect ADAS-Cog scores (SMD = 0.06, 95% CI = -0.22 to 0.33, = 0.68) or measures of daily life function. Blood homocysteine levels were significantly decreased after vitamin B12 and folic acid treatment. Participants with AD who received 6 months of vitamin B12 and folic acid supplementation had better MMSE scores but had no difference in ADAS-Cog scores. Daily life function did not improve after treatment.
维生素 B12 和叶酸可以降低血液同型半胱氨酸水平，这被认为可以减缓阿尔茨海默病（AD）的进展，但之前关于维生素 B12 和叶酸治疗 AD 的研究并未得出明确的结果。我们检索了 PubMed 和 Embase，截止日期为 2023 年 1 月 12 日。仅纳入了明确诊断为 AD 并接受维生素 B12 和叶酸治疗的随机对照试验。选择了符合标准的五项研究进行荟萃分析。认知功能的变化是根据简易精神状态检查（MMSE）或阿尔茨海默病评估量表认知分量表（ADAS-Cog）来衡量的。还调查了日常生活功能和血液同型半胱氨酸水平的变化。经过 6 个月的治疗，与安慰剂相比，给予维生素 B12 和叶酸治疗可提高 MMSE 评分（SMD=0.21，95%CI=0.01 至 0.32， =0.04），但对 ADAS-Cog 评分无显著影响（SMD=0.06，95%CI=-0.22 至 0.33， =0.68）或日常生活功能的衡量标准。维生素 B12 和叶酸治疗后血液同型半胱氨酸水平显著降低。接受 6 个月维生素 B12 和叶酸补充治疗的 AD 患者 MMSE 评分更好，但 ADAS-Cog 评分无差异。治疗后日常生活功能没有改善。
